Analysis of dynamic system compliance for the therapy of Normal Pressure Hydrocephalus

常压脑积水治疗的动态系统顺应性分析

基本信息

批准号：
274362184
负责人：
Professor Dr.-Ing. Steffen Leonhardt
金额：
--
依托单位：
Lehrstuhl für Medizinische Informationstechnik (MedIT)
依托单位国家：
德国
项目类别：
Research Grants
财政年份：
2015
资助国家：
德国
起止时间：
2014-12-31 至 2019-12-31
项目状态：
已结题

来源：
https://gepris.dfg.de/gepris/projekt/274362184?language=en
关键词：
Analysis dynamic system compliance therapy

项目摘要

The number of patients suffering from Normal Pressure Hydrocephalus (NPH), a pathological enlargement of the inner cerebrospinal fluid (CSF) spaces without accompanying pressure rise, has increased in recent years. Currently the pathophysiology is not completely understood, but it is known that reduced intracranial compliance plays an important role in the pathogenesis. Therefore, this research project aims to investigate the intracranial compliance especially concerning its dynamics, which has only been insufficiently analyzed in its relation to NPH, and to develop new therapeutic and diagnostic options for this disease. In order to understand the underlying mechanism leading to a reduced intracranial compliance better, this project initially focuses on the modeling of parameters so far not investigated to perform a sensitivity analysis. Since existing models reproduce the dynamic compliance insufficiently and simplify the reabsorption of cerebrospinal fluid and the formation of the pulse wave, the dynamics of the entire system are distorted. Against this background, a new model will be created, which maps the craniospinal system with a morphologically and functionally justified dynamic compliance. In a finite element model the coupling of the arterial pulse wave over large cranial arteries to the CSF will be modeled, based on the structural mechanical behavior of the different arterial wall layers of connective tissue, and the influence of age-related changes of connective tissue will be analyzed in simulation. Parameter studies should shed light on the influence of various factors on the compliance, on tissue-damaging dynamic loads on the parenchyma and thus on the formation of NPH. On the basis of these findings from the parameter studies an existing real-time capable model with concentrated parameters of the craniospinal system including autoregulation and dynamic spinal compliance will be adapted accordingly. In this model in particular age-related or pathologically altered outflow resistance at the spinal reabsorption sites caused by an age-related shortening of the spinal cord and other effects will be taken into account. Based on an improved understanding of the influencing parameters and a correspondingly extended modeling an artificial compliance and a bioimpedance measuring catheter aiming at an improved therapy will be developed. The real-time model serves to configure the artificial compliance, the newly developed finite element model to design the bioimpedance catheter. Using bioimpedance to measure the ventricular size and the change in size conclusions can be drawn on the overall compliance, which subsequently can be used to control the existing drainage system when necessary. Parallel to the investigation, a modular phantom model will be developed in order to validate the correlations shown in bioelectrical and biomechanical simulation as well as to test both the artificial compliance and the bioimpedance catheter.

近年来，脑脊髓液（CSF）空间的病理增大而没有伴随压力升高的患者数量已增加。目前，病理生理学尚未完全了解，但是众所周知，较低的颅内依从性在发病机理中起着重要作用。因此，该研究项目旨在调查有关其动力学的颅内依从性，该依从性仅在与NPH的关系中没有充分分析，并为该疾病开发了新的治疗和诊断选择。为了更好地了解导致较低颅内依从性的基本机制，该项目最初着重于迄今未研究参数的建模以进行灵敏度分析。由于现有模型不足以重现动态依从性，并简化了脑脊液的重吸收和脉搏波的形成，因此整个系统的动力学被扭曲。在此背景下，将创建一个新的模型，该模型在形态和功能上合理的动态合规性绘制颅骨系统。在有限元模型中，将基于结缔组织不同动脉壁层的结构机械行为对大型颅动脉上的动脉脉冲波与CSF进行建模，并将在模拟中分析结缔组织年龄相关变化的影响。参数研究应阐明各种因素对合规性的影响，对实质对组织的动态负荷以及NPH的形成。根据参数研究的这些发现，现有的实时能力模型具有颅骨系统的集中参数，包括自动调节和动态脊柱依从性。在该模型中，在该模型中，将考虑与年龄相关的脊髓缩短和其他效果引起的脊柱重吸收位点的流出耐药性。基于对影响参数的改进理解，并相应扩展的建模人工合规性和旨在改善治疗的导管的生物阻抗。实时模型可配置人工合规性，即新开发的有限元模型，以设计生物阻抗导管。使用生物阻抗来测量心室大小和大小结论的变化，可以根据整体依从性得出，随后可以在必要时用于控制现有的排水系统。与研究并行，将开发一个模块化幻影模型，以验证生物电和生物力学模拟中显示的相关性，并测试人工依从性和生物阻抗导管。