Investigation of an Instrumented Mouthguard for Measuring Head Impact Exposure

描述(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，美国每年有超过100万例与运动相关的脑震荡。然而，损伤的机制以及由此而来的诊断并不是很清楚。脑震荡的诊断是出了名的困难，因为症状和医生对它们的解释是高度可变和主观的。一个更大的挑战是，很少有青年体育赛事培训医务人员来识别和评估受伤的运动员。适当的损伤处理对于避免短期风险，如再次受伤，甚至脑出血，以及从认知缺陷到痴呆症的长期风险至关重要。因此，需要对脑震荡进行实时、公正和定量的测量，以防止进一步的伤害。这一拟议项目的中心是使用一种新型的仪表式护口器，大学足球运动员将在练习和比赛中佩戴这种护口器来测量三个轴的线和旋转加速度。最近的研究强调了旋转加速在脑震荡中的潜在重要性，以及在长期神经退行性疾病中累积影响的重要性。我们假设这个护口器可以准确地检测头部的线性和旋转加速度的大小，以及记录在比赛过程中发生的头部撞击事件。这项R21建议的目标是在实验室和田间适当地证实这一假设。这将使开展更大规模的研究能够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)在实验室中使用仪表化的假人头来验证护口器的运动学；(2)使用练习和游戏视频来验证活体中的碰撞检测。为了验证护口器的有效性，我们将把护口器的头部加速度测量结果与仪表化的假人头部在进行标准头部撞击测试时捕获的数据进行比较。此外，还将使用在实践中捕获的高速视频在3D中重建真实的撞击，以评估实验室头部撞击系统的有效性。最后，使用游戏视频修改后处理算法来确认来自护口器的头部撞击事件，以优化检测真实头部撞击事件的准确性。这两个目标的实现将为今后多部位临床研究多项运动中创伤性脑损伤的机制奠定基础。

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.