Investigation of an Instrumented Mouthguard for Measuring Head Impact Exposure

描述（由申请人提供）：脑震荡在军队和体育运动中是一个普遍存在的问题，据估计，美国每年发生超过100万例与体育相关的脑震荡。然而，损伤的机制，因此诊断，不是很清楚。脑震荡的诊断是出了名的困难，因为症状和医生的解释是高度可变和主观的。一个更大的挑战是，青年体育赛事很少训练医务人员来识别和评估受伤的运动员。对损伤进行适当的管理对于避免诸如再损伤甚至脑出血等短期风险以及从认知缺陷到痴呆等长期风险至关重要。因此，需要对脑震荡进行实时、客观、定量的测量，以防止进一步的损伤。这个提议的项目的中心是使用一种新型的仪器护齿器，大学足球运动员将在练习和比赛中佩戴它来测量线性和旋转加速度的三个轴。最近的研究强调了旋转加速度在脑震荡中的潜在重要性，以及长期神经退行性疾病累积影响的重要性。我们假设这种护齿可以准确地检测头部的线性和旋转加速度的大小，并记录在比赛中发生的头部撞击事件。本R21提案的目标是在实验室和现场适当地证实这一假设。这将使更大规模的研究得以开展，从而更好地阐明脑震荡损伤的机制和神经退行性疾病的风险。我们将通过以下具体目标来做到这一点：(1)在实验室中使用仪器化的假头验证护齿的运动学；(2)使用练习和游戏视频验证体内的冲击检测。为了验证护齿器，将从护齿器获得的头部加速度测量值与在进行标准头部撞击试验时仪器假头捕获的数据进行比较。此外，将使用实际拍摄的高速视频对真实碰撞进行三维重建，以评估实验室头部碰撞系统的有效性。最后，利用游戏视频对牙套头部撞击事件进行确认，修改后处理算法，以优化检测真实头部撞击事件的准确性。实现这两个目标，将是今后开展多种运动中创伤性脑损伤机制的多地点临床研究的基础。

DESCRIPTION (provided by applicant): Concussion is a widespread problem in the military and in sports, with over 1 million estimated sports related concussions occurring in the U.S. each year. However, the mechanism of injury, and therefore diagnosis, is not well understood. Diagnosis of concussion is notoriously difficult because the symptoms, and their interpretation by physicians, are highly variable and subjective. An even greater challenge is that rarely do youth sporting events have trained medical personnel to identify and evaluate injured athletes. Proper management of injury is essential to avoid short-term risks such as re- injury, or even brain hemorrhage, as well as long-term risks ranging from cognitive deficits to dementia. Therefore, an unbiased and quantitative measure of concussion in real-time is needed to prevent further injury. This proposed project centers on the use of a novel instrumented mouthguard that will be worn by collegiate football players in practice and in games to measure three axes of both linear and rotational acceleration. Recent research emphasizes the potential importance of rotational acceleration in concussions as well as the importance of cumulative impacts in long-term neurodegenerative diseases. We hypothesize that this mouthguard can accurately detect magnitudes of linear and rotational acceleration of the head as well as record head impact events that occur during play. The goal of this R21 proposal is to appropriately confirm this hypothesis both in laboratory and on the field. This will enable larger studies to be performed that may better elucidate the mechanism of concussive injury and the risk of neurodegenerative disease. We will do so through the following specific aims: (1) Validate mouthguard kinematics in the laboratory using an instrumented dummy head and (2) Verify impact detection in vivo using practice and game video. In order to validate the mouthguard, head acceleration measurements from mouthguard will be compared to data captured by the instrumented dummy head while undergoing a standard head impact test. In addition, high-speed speed video captured in practice will be used to reconstruct real impacts in 3D to assess validity of laboratory head impact system. Finally, head impact events from mouthguards will be confirmed using game video to modify post-process algorithms in order to optimize the accuracy in detecting real head impact events. Achieving these 2 aims will be the basis for future multi-site clinical studies on the mechanism of traumatic brain injury in multiple sports.