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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，患有正常压力脑积水（NPH）的患者数量有所增加，NPH是一种脑脊液（CSF）内腔的病理性扩大，但不伴有压力升高。目前，其病理生理机制尚不完全清楚，但已知颅内顺应性降低在发病机制中起重要作用。因此，本研究项目旨在研究颅内顺应性，特别是其动力学，仅在其与NPH的关系方面进行了充分的分析，并为这种疾病开发新的治疗和诊断选择。为了更好地了解导致颅内顺应性降低的潜在机制，本项目最初侧重于迄今为止尚未研究的参数建模，以进行敏感性分析。由于现有的模型再现动态顺应性不足，简化了脑脊液的重吸收和脉搏波的形成，整个系统的动态失真。在此背景下，将创建一个新的模型，映射颅脊髓系统的形态和功能合理的动态顺应性。在有限元模型中，基于结缔组织的不同动脉壁层的结构力学行为，将对大颅动脉上的动脉脉搏波与CSF的耦合进行建模，并在模拟中分析结缔组织的年龄相关变化的影响。参数研究应阐明各种因素对顺应性的影响，对软组织的组织损伤动态载荷，从而对NPH的形成。根据这些参数研究的结果，将相应地调整现有的具有颅脊髓系统集中参数（包括自动调节和动态脊柱顺应性）的实时模型。在该模型中，将特别考虑由年龄相关的脊髓缩短引起的脊髓重吸收部位的年龄相关或病理改变的流出阻力和其他影响。基于对影响参数的更好理解和相应扩展的建模，将开发旨在改进治疗的人工顺应性和生物阻抗测量导管。实时模型用于配置人工顺应性，新开发的有限元模型用于设计生物阻抗导管。使用生物阻抗测量心室大小和大小变化，可以得出整体顺应性的结论，随后可以在必要时用于控制现有的引流系统。在进行研究的同时，将开发一个模块化体模模型，以验证生物电和生物力学模拟中显示的相关性，并测试人工顺应性和生物阻抗导管。