Approximating subject-specific brain injury models via scaling based on head-brain morphological relationships

A fast-modeling framework for personalized human body models based on a single image

Finite element human body models (HBMs) are the primary method for predicting human biological responses in vehicle collisions, especially personalized HBMs that allow accounting for diverse populations. Yet, creating personalized HBMs from a single image is a challenging task. This study addresses this challenge by providing a framework for HBM personalization, starting from a single image used to estimate the subject's skin point cloud, the skeletal point cloud, and the relative positions of the skeletons. Personalized HBMs were created by morphing the baseline HBM accounting skin and skeleton point clouds using a point cloud registration-based mesh morphing method. Using this framework, eight personalized HBMs with various biological characteristics (e.g., sex, height, and weight) were created, with comparable element quality to the baseline HBM. The mean geometric errors of the personalized FEMs generated by the framework are less than 7 mm, which was found to be acceptable based on biomechanical response evaluations conducted in this study.

Role of player-specific white matter parcellation and scaling in impact-induced strain responses

Head finite element models (hFEMs) are valuable in understanding injury mechanisms in head impacts. Personalizing hFEMs is important for capturing individualized brain responses, with brain volume scaling proving effective. However, the role of refined white matter (WM) parcellation in hFEMs for evaluating brain strain responses, particularly important in the context of subconcussive head impacts (SHIs) often assessed through changes in WM integrity, remains relatively underexplored. This study evaluated the effect of refined subject-specific WM parcellation in 34 WM segments on responses variability due to brain volume variations, using peak maximum principal strain (95MPS) and strain rate (95MPSr) as injury predictive metrics. Data from diffusion-weighted imaging of 21 Canadian varsity football players were utilized to personalize 21 hFEMs. Simulating four different head impacts, representing 50th and 99th percentile resultant accelerations in frontal and angled-top-right directions, refined player-specific WM parcellation better captured variability of strain responses compared to baseline parcellation. Up to 75.71% of 95MPS and 77.14% of 95MPSr responses were deemed different across refined WM segments for players, compared to a maximum of 16.19% of responses with baseline parcellation. These results suggest that player-specific refined WM parcellation improves the ability to capture player-specific responses. Both impact direction and intensity influenced variations in strain response, with angled-top head impacts combined with high intensity showing greater player-specificity compared to lower intensity and frontal head impacts. These findings highlight the potential benefit of model scaling along with player-specific refined WM parcellation in hFEMs for comprehensively evaluating strain responses. Detailed WM parcellation in hFEMs is important for comprehensive injury assessment, enhancing the alignment of hFEMs with imaging studies evaluating changes in WM integrity across segments. The simple and straightforward method presented herein to achieve player-specific strain response is promising for future SHI studies.

Head Impact Kinematics and Brain Tissue Strains in High School Lacrosse

Male lacrosse and female lacrosse have differences in history, rules, and equipment. There is current debate regarding the need for enhanced protective headwear in female lacrosse like that worn by male lacrosse players. To inform this discussion, 17 high school lacrosse players (6 female and 11 male) wore the Stanford Instrumented Mouthguard during 26 competitive games over the 2021 season. Time-windowing and video review were used to remove false-positive recordings and verify head acceleration events (HAEs). The HAE rate in high school female lacrosse (0.21 per athlete exposure and 0.24 per player hour) was approximately 35% lower than the HAE rate in high school male lacrosse (0.33 per athlete exposure and 0.36 per player hour). Previously collected kinematics data from the 2019 high school male and female lacrosse season were combined with the newly collected 2021 kinematics data, which were used to drive a finite element head model and simulate 42 HAEs. Peak linear acceleration (PLA), peak angular velocity (PAV), and 95th percentile maximum principal strain (MPS95) of brain tissue were compared between HAEs in high school female and male lacrosse. Median values for peak kinematics and MPS95 of HAEs in high school female lacrosse (PLA, 22.3 g; PAV, 10.4 rad/s; MPS95, 0.05) were lower than for high school male lacrosse (PLA, 24.2 g; PAV, 15.4 rad/s; MPS95, 0.07), but the differences were not statistically significant. Quantifying a lower HAE rate in high school female lacrosse compared to high school male lacrosse, but similar HAE magnitudes, provides insight into the debate regarding helmets in female lacrosse. However, due to the small sample size, additional video-verified data from instrumented mouthguards are required.

American Football On-Field Head Impact Kinematics: Influence of Acceleration Signal Characteristics on Peak Maximal Principal Strain

Recorded head kinematics from head-impact measurement devices (HIMd) are pivotal for evaluating brain stress and strain through head finite element models (hFEM). The variability in kinematic recording windows across HIMd presents challenges as they yield inconsistent hFEM responses. Despite establishing an ideal recording window for maximum principal strain (MPS) in brain tissue, uncertainties persist about the impact characteristics influencing vulnerability when this window is shortened. This study aimed to scrutinize factors within impact kinematics affecting the reliability of different recording windows on whole-brain peak MPS using a validated hFEM. Utilizing 53 on-field head impacts recorded via an instrumented mouthguard during a Canadian varsity football game, 10 recording windows were investigated with varying pre- and post-impact-trigger durations. Tukey pair-wise comparisons revealed no statistically significant differences in MPS responses for the different recording windows. However, specific impacts showed marked variability up to 40%. It was found, through correlation analyses, that impacts with lower peak linear acceleration exhibited greater response variability across different pre-trigger durations. Signal shape, analyzed through spectral analysis, influenced the time required for MPS development, resulting in specific impacts requiring a prolonged post-trigger duration. This study adds to the existing consensus on standardizing HIMd acquisition time windows and sheds light on impact characteristics leading to peak MPS variation across different head impact kinematic recording windows. Considering impact characteristics in research assessments is crucial, as certain impacts, affected by recording duration, may lead to significant errors in peak MPS responses during cumulative longitudinal exposure assessments.

Effect of Direction and Frequency of Skull Motion on Mechanical Vulnerability of the Human Brain

Strain energy and kinetic energy in the human brain were estimated by magnetic resonance elastography (MRE) during harmonic excitation of the head, and compared to characterize the effect of loading direction and frequency on brain deformation. In brain MRE, shear waves are induced by external vibration of the skull and imaged by a modified MR imaging sequence; the resulting harmonic displacement fields are typically "inverted" to estimate mechanical properties, like stiffness or damping. However, measurements of tissue motion from MRE also illuminate key features of the response of the brain to skull loading. In this study, harmonic excitation was applied in two different directions and at five different frequencies from 20 to 90 Hz. Lateral loading induced primarily left-right head motion and rotation in the axial plane; occipital loading induced anterior-posterior head motion and rotation in the sagittal plane. The ratio of strain energy to kinetic energy (SE/KE) depended strongly on both direction and frequency. The ratio of SE/KE was approximately four times larger for lateral excitation than for occipital excitation and was largest at the lowest excitation frequencies studied. These results are consistent with clinical observations that suggest lateral impacts are more likely to cause injury than occipital or frontal impacts, and also with observations that the brain has low-frequency (∼10 Hz) natural modes of oscillation. The SE/KE ratio from brain MRE is potentially a simple and powerful dimensionless metric of brain vulnerability to deformation and injury.

A Morphologically Individualized Deep Learning Brain Injury Model

The brain injury modeling community has recommended improving model subject specificity and simulation efficiency. Here, we extend an instantaneous (< 1 sec) convolutional neural network (CNN) brain model based on the anisotropic Worcester Head Injury Model (WHIM) V1.0 to account for strain differences due to individual morphological variations. Linear scaling factors relative to the generic WHIM along the three anatomical axes are used as additional CNN inputs. To generate training samples, the WHIM is randomly scaled to pair with augmented head impacts randomly generated from real-world data for simulation. An estimation of voxelized peak maximum principal strain of the whole-brain is said to be successful when the linear regression slope and Pearson's correlation coefficient relative to directly simulated do not deviate from 1.0 (when identical) by more than 0.1. Despite a modest training dataset (N = 1363 vs. ∼5.7 k previously), the individualized CNN achieves a success rate of 86.2% in cross-validation for scaled model responses, and 92.1% for independent generic model testing for impacts considered as complete capture of kinematic events. Using 11 scaled subject-specific models (with scaling factors determined from pre-established regression models based on head dimensions and sex and age information, and notably, without neuroimages), the morphologically individualized CNN remains accurate for impacts that also yield successful estimations for the generic WHIM. The individualized CNN instantly estimates subject-specific and spatially detailed peak strains of the entire brain and thus, supersedes others that report a scalar peak strain value incapable of informing the location of occurrence. This tool could be especially useful for youths and females due to their anticipated greater morphological differences relative to the generic model, even without the need for individual neuroimages. It has potential for a wide range of applications for injury mitigation purposes and the design of head protective gears. The voxelized strains also allow for convenient data sharing and promote collaboration among research groups.