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Rowland JA, Martindale SL. Considerations for the assessment of blast exposure in service members and veterans. Front Neurol 2024; 15:1383710. [PMID: 38685944 PMCID: PMC11056521 DOI: 10.3389/fneur.2024.1383710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 03/29/2024] [Indexed: 05/02/2024] Open
Abstract
Introduction Blast exposure is an increasingly present occupational hazard for military service members, particularly in modern warfare scenarios. The study of blast exposure in humans is limited by the lack of a consensus definition for blast exposure and considerable variability in measurement. Research has clearly demonstrated a robust and reliable effect of blast exposure on brain structure and function in the absence of other injury mechanisms. However, the exact mechanisms underlying these outcomes remain unclear. Despite clear contributions from preclinical studies, this knowledge has been slow to translate to clinical applications. The present manuscript empirically demonstrates the consequences of variability in measurement and definition across studies through a re-analysis of previously published data from the Chronic Effects of Neurotrauma Study 34. Methods Definitions of blast exposure used in prior work were examined including Blast TBI, Primary Blast TBI, Pressure Severity, Distance, and Frequency of Exposure. Outcomes included both symptom report and cognitive testing. Results Results demonstrate significant differences in outcomes based on the definition of blast exposure used. In some cases the same definition was strongly related to one type of outcome, but unrelated to another. Discussion The implications of these results for the study of blast exposure are discussed and potential actions to address the major limitations in the field are recommended. These include the development of a consensus definition of blast exposure, further refinement of the assessment of blast exposure, continued work to identify relevant mechanisms leading to long-term negative outcomes in humans, and improved education efforts.
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Affiliation(s)
- Jared A. Rowland
- Salisbury VA Healthcare System, Salisbury, NC, United States
- Veterans Integrated Service Network (VISN)-6 Mid-Atlantic Mental Illness, Research Education and Clinical Center (MIRECC), Durham, NC, United States
- Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Sarah L. Martindale
- Salisbury VA Healthcare System, Salisbury, NC, United States
- Veterans Integrated Service Network (VISN)-6 Mid-Atlantic Mental Illness, Research Education and Clinical Center (MIRECC), Durham, NC, United States
- Wake Forest School of Medicine, Winston-Salem, NC, United States
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Kailash KA, Guertler CA, Johnson CL, Okamoto RJ, Bayly PV. Measurement of relative motion of the brain and skull in the mini-pig in-vivo. J Biomech 2023; 156:111676. [PMID: 37329640 PMCID: PMC11086683 DOI: 10.1016/j.jbiomech.2023.111676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 06/05/2023] [Accepted: 06/07/2023] [Indexed: 06/19/2023]
Abstract
The mechanical role of the skull-brain interface is critical to the pathology of concussion and traumatic brain injury (TBI) and may evolve with age. Here we characterize the skull-brain interface in juvenile, female Yucatan mini-pigs from 3 to 6 months old using techniques from magnetic resonance elastography (MRE). The displacements of the skull and brain were measured by a motion-sensitive MR imaging sequence during low-amplitude harmonic motion of the head. Each animal was scanned four times at 1-month intervals. Harmonic motion at 100 Hz was excited by three different configurations of a jaw actuator in order to vary the direction of loading. Rigid-body linear motions of the brain and skull were similar, although brain rotations were consistently smaller than corresponding skull rotations. Relative displacements between the brain and skull were estimated for voxels on the surface of the brain. Amplitudes of relative displacements between skull and brain were 1-3 μm, approximately 25-50% of corresponding skull displacements. Maps of relative displacement showed variations by anatomical region, and the normal component of relative displacement was consistently 25-50% of the tangential component. These results illuminate the mechanics of the skull-brain interface in a gyrencephalic animal model relevant to human brain injury and development.
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Affiliation(s)
- Keshav A Kailash
- Washington University in St. Louis, Biomedical Engineering, United States
| | - Charlotte A Guertler
- Washington University in St. Louis, Mechanical Engineering and Material Science, United States
| | | | - Ruth J Okamoto
- Washington University in St. Louis, Mechanical Engineering and Material Science, United States
| | - Philip V Bayly
- Washington University in St. Louis, Biomedical Engineering, United States; Washington University in St. Louis, Mechanical Engineering and Material Science, United States.
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Argo Iv TF, Wagner CD, Walilko TJ, Bentley TB. Transfer Function for Relative Blast Overpressure Through Porcine and Human Skulls In Situ. Mil Med 2023; 188:e607-e614. [PMID: 34677614 DOI: 10.1093/milmed/usab412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 05/08/2021] [Accepted: 09/27/2021] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION The overarching objective of the Office of Naval Research sponsored Blast Load Assessment Sense and Test (BLAST) program was to quantify neurofunctional risk from repeated blast exposure. However, human studies have limitations in data collection that can only be addressed by animal models. To utilize a large animal model in this work, researchers developed an approach for scaling blast exposure data from animal to human-equivalent loading. For this study, energy interacting with the brain tissue was selected as a translation metric because of the hypothesized association between observed neurological changes and energy transmitted through the skull. This article describes the methodology used to derive an energy-based transfer function capable of serving as a global correspondence rule for primary blast injury exposure, allowing researchers to derive human-appropriate thresholds from animal data. METHODS AND MATERIALS To generate data for the development of the transfer functions, three disarticulated cadaveric Yucatan minipigs and three postmortem human surrogate heads were exposed to blast overpressure using a large bore, compressed-gas shock tube. Pressure gauges in the free field, on the skull surface, and pressure probes within the brain cavity filled with Sylgard silicone gel recorded the pressure propagation through the skull of each specimen. The frequency components of the freefield and brain cavity measurements from the pig and human surrogates were interrogated in the frequency domain. Doing so quantifies the differences in the amount of energy, in each frequency band, transmitted through both the porcine and the human skull, and the transfer function was calculated to quantify those differences. RESULTS Nonlinear energy transmission was observed for both the porcine and human skulls, indicating that linear scaling would not be appropriate for developing porcine to human transfer functions. This study demonstrated similar responses between species with little to no attenuation at frequencies below 30 Hz. The phase of the pressure transmission to the brain is also similar for both species up to approximately 10 kHz. There were two notable differences between the porcine and human surrogates. First, in the 40-100 Hz range, human subjects have approximately 8 dB more pressure transmitted through the skull relative to porcine subjects. Second, in the 1-10 kHz range, human subjects have up to 10 dB more pressure transmitted into the brain (10 dB more attenuation) relative to the porcine subjects. CONCLUSIONS The fundamental goal of this study was to develop pig-to-human transfer functions to allow researchers to interpret data collected from large animal studies and aid in deriving risk functions for repeated blast exposures. Similarities in porcine and human brain physiology make the minipig experimental model an excellent candidate for blast research. However, differences in the skull geometry have historically made the interpretation of animal data difficult for the purposes of characterizing potential neurological risk in humans. Human equivalent loading conditions are critical so that the thresholds are not over- or underpredicted due to differences in porcine skull geometry. This research provides a solution to this challenge, providing a robust methodology for interpreting animal data for blast research.
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Bortoluzzi EM, Goering MJ, Ochoa SJ, Holliday AJ, Mumm JM, Nelson CE, Wu H, Mote BE, Psota ET, Schmidt TB, Jaberi-Douraki M, Hulbert LE. Evaluation of Precision Livestock Technology and Human Scoring of Nursery Pigs in a Controlled Immune Challenge Experiment. Animals (Basel) 2023; 13:ani13020246. [PMID: 36670787 PMCID: PMC9854951 DOI: 10.3390/ani13020246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 12/08/2022] [Accepted: 01/04/2023] [Indexed: 01/12/2023] Open
Abstract
The objectives were to determine the sensitivity, specificity, and cutoff values of a visual-based precision livestock technology (NUtrack), and determine the sensitivity and specificity of sickness score data collected with the live observation by trained human observers. At weaning, pigs (n = 192; gilts and barrows) were randomly assigned to one of twelve pens (16/pen) and treatments were randomly assigned to pens. Sham-pen pigs all received subcutaneous saline (3 mL). For LPS-pen pigs, all pigs received subcutaneous lipopolysaccharide (LPS; 300 μg/kg BW; E. coli O111:B4; in 3 mL of saline). For the last treatment, eight pigs were randomly assigned to receive LPS, and the other eight were sham (same methods as above; half-and-half pens). Human data from the day of the challenge presented high true positive and low false positive rates (88.5% sensitivity; 85.4% specificity; 0.871 Area Under Curve, AUC), however, these values declined when half-and-half pigs were scored (75% sensitivity; 65.5% specificity; 0.703 AUC). Precision technology measures had excellent AUC, sensitivity, and specificity for the first 72 h after treatment and AUC values were >0.970, regardless of pen treatment. These results indicate that precision technology has a greater potential for identifying pigs during a natural infectious disease event than trained professionals using timepoint sampling.
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Affiliation(s)
- Eduarda M. Bortoluzzi
- Department of Animal Sciences and Industry, Kansas State University, Manhattan, KS 66506, USA
| | - Mikayla J. Goering
- Department of Animal Sciences and Industry, Kansas State University, Manhattan, KS 66506, USA
| | - Sara J. Ochoa
- Department of Animal Sciences and Industry, Kansas State University, Manhattan, KS 66506, USA
| | - Aaron J. Holliday
- Department of Animal Science, University of Nebraska-Lincoln, Lincoln, NE 68505, USA
| | - Jared M. Mumm
- Department of Animal Sciences and Industry, Kansas State University, Manhattan, KS 66506, USA
| | - Catherine E. Nelson
- Department of Animal Sciences and Industry, Kansas State University, Manhattan, KS 66506, USA
| | - Hui Wu
- Department of Statistics, Kansas State University, Manhattan, KS 66506, USA
| | - Benny E. Mote
- Department of Animal Science, University of Nebraska-Lincoln, Lincoln, NE 68505, USA
| | - Eric T. Psota
- Department of Electrical and Computer Engineering, University of Nebraska-Lincoln, Lincoln, NE 68588, USA
| | - Ty B. Schmidt
- Department of Animal Science, University of Nebraska-Lincoln, Lincoln, NE 68505, USA
| | - Majid Jaberi-Douraki
- Department of Statistics, Kansas State University, Manhattan, KS 66506, USA
- Department of Mathematics, Kansas State University, Manhattan, KS 66506, USA
- 1-DATA, Kansas State University Olathe, Olathe, KS 66061, USA
| | - Lindsey E. Hulbert
- Department of Animal Sciences and Industry, Kansas State University, Manhattan, KS 66506, USA
- Correspondence: ; Tel.: +1-785-477-2904
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