Biomechanical Basis of Pediatric mTBI Due to Sports Related Concussion

 描述(由申请人提供)：我们建议为儿科人群建立轻度创伤性脑损伤(MTBI)生物力学基础的定量模型。这是在我们最初的五年生物工程研究伙伴关系(BRP)的基础上扩展的，在该伙伴关系中，我们为大学人群开发了MTBI的生物力学模型，该模型已经产生了一个数据库，其中记录了大学运动中超过500,000次头部撞击。这项工作在损伤机制和头部撞击暴露方面的知识取得了实质性进展，并产生了翻译成果，包括：1)提供了改进的诊断策略和预防系统的成人脑损伤标准，2)优化了头盔设计标准和公开可用的头盔评估，改进了头盔技术，以及3)减少了大学橄榄球比赛中头部撞击暴露的足球练习指南。拟议的儿科MTBI模型将使转化性研究和新的临床和治疗方法的开发成为可能，以减少青年运动员MTBI的发生率和负面影响。我们团队成员的实验和临床项目将使我们能够测试针对儿科MTBI潜在病理机制和临床后遗症的假设。1050名年龄在6岁到14岁之间的青少年足球运动员将戴上仪表式头盔，在5年内收集头部加速数据和临床数据。运动环境为收集大量头部撞击的数据提供了丰富的机会，这使得将生物力学头部撞击数据与随后的大脑神经生物和功能变化相结合的研究成为可能。到目前为止，MTBI的生物力学研究主要集中在美国大约10万名参加大学和职业足球的运动员；然而，人们对每年350万名青年(6岁至14岁)足球运动员知之甚少。我们假设，撞击导致的头部加速可以预测脑损伤的类型和严重程度，并与儿童MTBI的具体临床措施相关。我们的目标是：1)量化青少年足球中的头部撞击暴露；2)确定维持儿童MTBI的头部加速度损伤耐受性；3)将头部加速与儿童MTBI相关的临床变量联系起来。我们为119名7至18岁的青少年足球运动员进行了一项先导研究，以证明拟议工作的可行性。拟议的假设驱动研究的成功完成将导致开发新的防护设备战略、用于现场使用和其他保健环境的诊断工具、用于回归发挥决策的新战略，以及在儿科人群中传播关于MTBI评估和预防的信息的教育工具。此外，我们的研究结果将对普通人群具有翻译相关性，包括机动车撞车事故和儿科消费品。

 DESCRIPTION (provided by applicant): We propose to develop a quantitative model of the biomechanical basis of mild traumatic brain injury (MTBI) for a pediatric population. This expands upon our initial five year Bioengineering Research Partnership (BRP) in which we developed a biomechanical model of MTBI for a collegiate population, which has resulted in a database of more than 500,000 recorded head impacts in collegiate sports. This work has produced substantial advancements in the knowledge of injury mechanisms and head impact exposure, and resulted in translational outcomes, including: 1) adult brain injury criteria that provide improved diagnosis strategies and prevention systems, 2) optimized helmet design criteria and publically available helmet evaluations that have improved helmet technologies, and 3) football practice guidelines that have reduced head impact exposure in collegiate football. The proposed pediatric MTBI model will enable translational research and the development of new clinical and therapeutic approaches to reduce the incidence and negative effects of MTBI in youth athletes. Experimental and clinical projects among our team members will allow us to test hypotheses specific to the underlying pathomechanics and clinical sequelae of pediatric MTBI. A cohort of 1050 youth football players between the ages of 6 and 14 years will wear instrumented helmets to collect head acceleration data and clinical data over a 5 year period. Athletic environments offer a rich opportunity for collecting data on large numbers of head impacts, which enables research that combines biomechanical head impact data with the subsequent neurobiologic and functional changes in the brain. To date, biomechanical MTBI research has focused primarily on the approximately 100,000 athletes participating in college and professional football in the United States; however, little is known about the 3,500,000 youth (6 years to 14 years) athletes playing football each year. We hypothesize that head acceleration due to impact is predictive of the type and severity of brain injury, and correlates t specific clinical measures of pediatric MTBI. We aim to: 1) Quantify head impact exposure in youth football, 2) Determine head acceleration injury tolerance for sustaining pediatric MTBI, and 3) Correlate head acceleration with clinical variables related to pediatric MTBI. We have performed a pilot study on 119 youth football players aged 7 to 18 years to demonstrate the feasibility of the proposed work. Successful completion of the proposed hypothesis-driven research will result in the development of novel protective equipment strategies, diagnostic tools for field use and other healthcare settings, novel strategies for return to play decisions, and educational tools for disseminating information about the evaluation and prevention of MTBI in the pediatric population. Additionally, our research results will have translational relevance to the general population, including motor vehicle crashes and pediatric consumer products.