American Football Helmet Effectiveness Against a Strain-Based Concussion Mechanism.
Concussion
Convolutional neural network
Helmet
STAR
Traumatic brain injury
Worcester Head Injury Model
Journal
Annals of biomedical engineering
ISSN: 1573-9686
Titre abrégé: Ann Biomed Eng
Pays: United States
ID NLM: 0361512
Informations de publication
Date de publication:
Nov 2022
Nov 2022
Historique:
received:
09
02
2022
accepted:
30
06
2022
pubmed:
12
7
2022
medline:
16
11
2022
entrez:
11
7
2022
Statut:
ppublish
Résumé
Brain strain is increasingly being used in helmet design and safety performance evaluation as it is generally considered as the primary mechanism of concussion. In this study, we investigate whether different helmet designs can meaningfully alter brain strains using two commonly used metrics, peak maximum principal strain (MPS) of the whole brain and cumulative strain damage measure (CSDM). A convolutional neural network (CNN) that instantly produces detailed brain strains is first tested for accuracy for helmeted head impacts. Based on N = 144 impacts in 12 impact conditions from three random and representative helmet models, we conclude that the CNN is sufficiently accurate for helmet testing applications, for elementwise MPS (success rate of 98.6%), whole-brain peak MPS and CSDM (coefficient of determination of 0.977 and 0.980, with root mean squared error of 0.015 and 0.029, respectively). We then apply the technique to 23 football helmet models (N = 1104 impacts) to reproduce elementwise MPS. Assuming a concussion would occur when peak MPS or CSDM exceeds a threshold, we sweep their thresholds across the value ranges to evaluate the number of predicted hypothetical concussions that different helmets sustain across the impact conditions. Relative to the 12 impact conditions tested, we find that the "best" and "worst" helmets differ by an average of 22.5% in terms of predicted concussions, ranging from 0 to 42% (the latter achieved at the threshold value of 0.28 for peak MPS and 0.4 for CSDM, respectively). Such a large variation among helmets in strain-based concussion predictions demonstrate that helmet designs can still be optimized in a clinically meaningful way. The robustness and accuracy of the CNN tool also suggest its potential for routine use for helmet design and safety performance evaluation in the future. The CNN is freely available online at https://github.com/Jilab-biomechanics/CNN-brain-strains .
Identifiants
pubmed: 35816264
doi: 10.1007/s10439-022-03005-z
pii: 10.1007/s10439-022-03005-z
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1498-1509Informations de copyright
© 2022. The Author(s) under exclusive licence to Biomedical Engineering Society.
Références
Allison, M. A., Y. S. Kang, J. H. Bolte IV., M. R. Maltese, K. B. Arbogast, J. H. Bolte, M. R. Maltese, and K. B. Arbogast. Validation of a helmet-based system to measure head impact biomechanics in ice hockey. Med. Sci. Sports Exerc. 46:115–123, 2014
pubmed: 23846161
Anderson, E. D., J. S. Giudice, T. Wu, M. B. Panzer, and D. F. Meaney. Predicting concussion outcome by integrating finite element modeling and network analysis. Front. Bioeng. Biotechnol. 8:309, 2020
pubmed: 32351948
pmcid: 7174699
Bailey, A. M., T. L. McMurry, J. M. Cormier, J. R. Funk, J. R. Crandall, C. D. Mack, B. S. Myers, and K. B. Arbogast. Comparison of laboratory and on-field performance of American Football Helmets. Ann. Biomed. Eng. 48:2531–2541, 2020
pubmed: 33025320
Bailey, A. M., E. J. Sanchez, G. Park, L. F. Gabler, J. R. Funk, J. R. Crandall, M. Wonnacott, C. Withnall, B. S. Myers, and K. B. Arbogast. Development and evaluation of a test method for assessing the performance of American Football Helmets. Ann. Biomed. Eng. 48:2566–2579, 2020
pubmed: 33025321
Barlow, K. M., S. Crawford, A. Stevenson, S. S. Sandhu, F. Belanger, and D. Dewey. Epidemiology of postconcussion syndrome in pediatric mild traumatic brain injury. Pediatrics. 126:e374–e381, 2010
pubmed: 20660554
Bartsch, A. J., D. Hedin, J. Alberts, E. C. Benzel, J. Cruickshank, R. S. Gray, K. Cameron, M. N. Houston, T. Rooks, G. McGinty, E. Kozlowski, S. Rowson, J. C. Maroon, V. J. Miele, J. C. Ashton, G. P. Siegmund, A. Shah, M. McCrea, and B. Stemper. High energy side and rear American Football Head impacts cause obvious performance decrement on video. Ann. Biomed. Eng. 48:2667–2677, 2020
pubmed: 33111969
pmcid: 7674260
Beckwith, J. G., R. M. Greenwald, and J. J. Chu. Measuring head kinematics in football: correlation between the head impact telemetry system and Hybrid III headform. Ann. Biomed. Eng. 40:237–248, 2012
pubmed: 21994068
Bian, K., and H. Mao. Mechanisms and variances of rotation-induced brain injury: a parametric investigation between head kinematics and brain strain. Biomech. Model. Mechanobiol. 2020. https://doi.org/10.1007/s10237-020-01341-4
doi: 10.1007/s10237-020-01341-4
pubmed: 32449073
Bland, M. L., C. McNally, D. S. Zuby, B. C. Mueller, and S. Rowson. Development of the STAR evaluation system for assessing bicycle helmet protective performance. Ann. Biomed. Eng. 48:47–57, 2020
pubmed: 31372859
Cassidy, J. D., L. J. Carroll, P. M. Peloso, J. Borg, H. von Holst, L. Holm, J. Kraus, and V. Coronado. Incidence, risk factors and prevention of mild traumatic brain injury: results of the WHO Collaborating Centre Task Force on Mild Traumatic Brain Injury. J. Rehabil. Med. 43(43):28–60, 2004
Clark, J. M., A. Post, T. B. Hoshizakib, and M. D. Gilchrista. Distribution of brain strain in the cerebrum for laboratory impacts to ice hockey goaltender masks. J. Biomech. Eng.140:121007, 2018
Cobb, B. R., A. M. Zadnik, and S. Rowson. Comparative analysis of helmeted impact response of Hybrid III and National Operating Committee on Standards for Athletic Equipment headforms. Proc. Inst. Mech. Eng. Part P. 230:50–60, 2016
CPSC. Safety Standard for Bicycle Helmets Final Rule (16 CFR Part 1203). United States Consumer Product Safety Commission. 1998
Cripton, P. A., D. M. Dressler, C. A. Stuart, C. R. Dennison, and D. Richards. Bicycle helmets are highly effective at preventing head injury during head impact: Head-form accelerations and injury criteria for helmeted and unhelmeted impacts. Accid. Anal. Prev. 70:1–7, 2014
pubmed: 24686160
DiGiacomo, G., S. Tsai, and M. Bottlang. Impact performance comparison of advanced snow sport helmets with dedicated rotation-damping systems. Ann. Biomed. Eng. 2021. https://doi.org/10.1007/s10439-021-02723-0
doi: 10.1007/s10439-021-02723-0
pubmed: 33528683
pmcid: 8510952
Dompier, T. P., Z. Y. Kerr, S. W. Marshall, B. Hainline, E. M. Snook, R. Hayden, and J. E. Simon. Incidence of concussion during practice and games in youth, high school, and collegiate American football players. JAMA Pediatr. 169:659–665, 2015
pubmed: 25938704
European Committee for Standardization, C. E. 1078: Helmets for pedal cyclists and for users of skateboards and roller skates. 1997
Fahlstedt, M., F. Abayazid, M. B. Panzer, A. Trotta, W. Zhao, M. Ghajari, M. D. Gilchrist, S. Ji, S. Kleiven, X. Li, A. N. Annaidh, and P. Halldin. Ranking and rating bicycle helmet safety performance in oblique impacts using eight different brain injury models. Ann. Biomed. Eng. 49:1097–1109, 2021
pubmed: 33475893
pmcid: 7952345
Funk, J. R., S. M. Duma, S. J. Manoogian, and S. Rowson. Biomechanical risk estimates for mild traumatic brain injury. Annu. Proc. 51:343, 2007
Gabler, L. F., J. R. Crandall, and M. B. Panzer. Development of a second-order system for rapid estimation of maximum brain strain. Ann. Biomed. Eng. 2018. https://doi.org/10.1007/s10439-018-02179-9
doi: 10.1007/s10439-018-02179-9
pubmed: 30515603
Ghazi, K., S. Wu, W. Zhao, and S. Ji. Instantaneous whole-brain strain estimation in dynamic head impact. J. Neurotrauma. 38:1023–1035, 2021
pubmed: 33126836
pmcid: 8054523
Graham, R., F. P. Rivara, M. A. Ford, C. M. Spicer, and R. Graham. Sports-related concussions in youth. 2014, 239 pp
Greenwald, R. M., J. T. Gwin, J. J. Chu, and J. J. Crisco. Head impact severity measures for evaluating mild traumatic brain injury risk exposure. Neurosurgery. 62:789–798, 2008
pubmed: 18496184
Hernandez, F., L. C. Wu, M. C. Yip, K. Laksari, A. R. Hoffman, J. R. Lopez, G. A. Grant, S. Kleiven, and D. B. Camarillo. Six degree-of-freedom measurements of human mild traumatic brain injury. Ann. Biomed. Eng. 43:1918–1934, 2015
pubmed: 25533767
Høye, A. Bicycle helmets—To wear or not to wear? A meta-analyses of the effects of bicycle helmets on injuries. Accid. Anal. Prev. 117:85–97, 2018
pubmed: 29677686
Ji, S., H. Ghadyani, R. Bolander, J. Beckwith, J. C. Ford, T. McAllister, L. A. Flashman, K. D. Paulsen, K. Ernstrom, S. Jain, R. Raman, L. Zhang, and R. M. Greenwald. Parametric comparisons of intracranial mechanical responses from three validated finite element models of the human head. Ann. Biomed. Eng. 42:11–24, 2014
pubmed: 24077860
pmcid: 4397967
Ji, S., M. Ghajari, H. Mao, R. H. Kraft, M. Hajiaghamemar, M. B. Panzer, R. Willinger, M. D. Gilchrist, S. Kleiven, and J. D. Stitzel. Use of brain biomechanical models for monitoring impact exposure in contact sports. Ann. Biomed. Eng. 13(5):1121–1136, 2022
Ji, S., and S. S. Margulies. In vivo pons motion within the skull. J. Biomech. 40:, 2007
Ji, S., W. Zhao, J. C. Ford, J. G. Beckwith, R. P. Bolander, R. M. Greenwald, L. A. Flashman, K. D. Paulsen, and T. W. McAllister. Group-wise evaluation and comparison of white matter fiber strain and maximum principal strain in sports-related concussion. J. Neurotrauma. 32:441–454, 2015
pubmed: 24735430
pmcid: 4376290
Ji, S., W. Zhao, Z. Li, and T. W. McAllister. Head impact accelerations for brain strain-related responses in contact sports: a model-based investigation. Biomech. Model. Mechanobiol. 13:1121–1136, 2014
pubmed: 24610384
pmcid: 5621926
Ji, S., Q. Zhu, L. Dougherty, and S. S. S. Margulies. In vivo measurements of human brain displacement. Stapp Car Crash J. 48:527–539, 2004
King, A. I., K. H. Yang, L. Zhang, W. Hardy, and D. C. Viano. Is head injury caused by linear or angular acceleration? 2003
Kleiven, S. Predictors for traumatic brain injuries evaluated through accident reconstructions. Stapp Car Crash J. 51:81–114, 2007
pubmed: 18278592
Levy, M. L., B. M. Ozgur, C. Berry, H. E. Aryan, and M. L. J. Apuzzo. Birth and evolution of the football helmet. Neurosurgery. 55:656–662, 2004
pubmed: 15335433
Li, X., Z. Zhou, and S. Kleiven. An anatomically accurate and personalizable head injury model: significance of brain and white matter tract morphological variability on strain. Biomech. Model. Mechanobiol. 2020. https://doi.org/10.1101/2020.05.20.105635
doi: 10.1101/2020.05.20.105635
pubmed: 33037509
pmcid: 7979680
Liu, Y., A. G. Domel, S. A. Yousefsani, J. Kondic, G. Grant, M. Zeineh, and D. B. Camarillo. Validation and comparison of instrumented mouthguards for measuring head kinematics and assessing brain deformation in football impacts. Ann. Biomed. Eng. 48:2580–2598, 2020
pubmed: 32989591
pmcid: 9555247
Mao, H., L. Zhang, B. Jiang, V. Genthikatti, X. Jin, F. Zhu, R. Makwana, A. Gill, G. Jandir, A. Singh, and K. Yang. Development of a finite element human head model partially validated with thirty five experimental cases. J. Biomech. Eng. 135:111002–111015, 2013
pubmed: 24065136
McCrea, M., T. Hammeke, G. Olsen, P. Leo, and K. Guskiewicz. Unreported concussion in high school football players: implications for prevention. Clin J Sport Med. 14:13–17, 2004
pubmed: 14712161
McIntosh, A. S., and A. Lai. Motorcycle helmets: head and neck dynamics in helmeted and unhelmeted oblique impacts. Traffic Inj. Prev. 14:835–844, 2013
pubmed: 24073772
McKee, A., T. Stein, C. Nowinski, R. Stern, D. Daneshvar, and V. E. Alvarez. The spectrum of disease in chronic traumatic encephalopathy. Brain. 136:43–64, 2013
pubmed: 23208308
Meaney, D. F., B. Morrison, and C. R. Bass. The mechanics of traumatic brain injury: a review of what we know and what we need to know for reducing its societal burden. J. Biomech. Eng. 136:1–8, 2014
Mez, J., D. Daneshvar, V. Kiernan, P. T. Abdolmohammadi, B. Alvarez, et al. Clinicopathological evaluation of chronic traumatic encephalopathy in players of American football. JAMA. 318:360–370, 2017
pubmed: 28742910
pmcid: 5807097
Miller, L. E., J. E. Urban, E. M. Davenport, A. K. Powers, C. T. Whitlow, J. A. Maldjian, and J. D. Stitzel. Brain strain: computational model-based metrics for head impact exposure and injury correlation. Ann. Biomed. Eng. 49:1083–1096, 2021
pubmed: 33258089
Miller, L. E., J. E. Urban, and J. D. Stitzel. Development and validation of an atlas-based finite element brain model model. Biomech. Model. 15:1201–1214, 2016
Miller, L., C. Kuo, L. C. Wu, J. Urban, D. Camarillo, and J. D. Stitzel. Validation of a custom instrumented retainer form factor for measuring linear and angular head impact kinematics. J. Biomech. Eng. 140:1–6, 2018
National Operating Committee on Standards for Athletic Equipment. Standard performance specification for newly manufactured baseball/softball batter’s helmets NOCSAE doc ( ND ) 022- 10m12. 6–11, 2019
National Operating Committee on Standards for Athletic Equipment. Standard Performance Specification for Newly Manufactured Baseball/Softball Batter’s Helmets. NOCSAE DOC (ND) 022-20, 2020
National Operating Committee on Standards for Athletic Equipment. Standard Performance Specification for Newly Manufactured Football Helmets. NOCSAE DOC (ND)002-17m21, 2021
Pellman, E. J., D. C. Viano, A. M. Tucker, I. R. Casson, J. F. Waeckerle, J. C. Maroon, M. R. Lovell, M. W. Collins, D. F. Kelly, A. B. Valadka, R. C. Cantu, J. E. Bailes, and M. L. Levy. Concussion in professional football: reconstruction of game impacts and injuries. Neurosurgery. 53:799–814, 2003
pubmed: 14519212
Rowson, S., E. T. Campolettano, S. M. Duma, B. Stemper, A. Shah, J. Harezlak, L. Riggen, J. P. Mihalik, A. Brooks, K. L. Cameron, S. J. Svoboda, M. N. Houston, T. McAllister, S. Broglio, and M. McCrea. Concussion risk between individual football players: survival analysis of recurrent events and non-events. Ann. Biomed. Eng. 48:2626–2638, 2020
pubmed: 33113020
Rowson, S., and S. M. Duma. Development of the STAR evaluation system for football helmets: integrating player head impact exposure and risk of concussion. Ann. Biomed. Eng. 39:2130–2140, 2011
pubmed: 21553135
Rowson, S., and S. M. Duma. Brain injury prediction: assessing the combined probability of concussion using linear and rotational head acceleration. Ann. Biomed. Eng. 41:873–882, 2013
pubmed: 23299827
pmcid: 3624001
Rowson, S., S. M. Duma, R. M. Greenwald, J. G. Beckwith, J. J. Chu, K. M. Guskiewicz, J. P. Mihalik, J. J. Crisco, B. J. Wilcox, T. W. McAllister, A. C. Maerlender, S. P. Broglio, B. Schnebel, S. Anderson, and P. G. Brolinson. Can helmet design reduce the risk of concussion in football? J. Neurosurg. 120:919–922, 2014
pubmed: 24484225
Rowson, S., S. M. Duma, B. D. Stemper, A. Shah, J. P. Mihalik, J. Harezlak, L. D. Riggen, C. C. Giza, J. P. DiFiori, A. Brooks, K. Guskiewicz, D. Campbell, G. McGinty, S. J. Svoboda, K. L. Cameron, S. P. Broglio, T. W. McAllister, and M. McCrea. Correlation of concussion symptom profile with head impact biomechanics: a case for individual-specific injury tolerance. J. Neurotrauma. 35:681–690, 2018
pubmed: 29132269
Rowson, B., S. Rowson, and S. M. Duma. Hockey STAR: a methodology for assessing the biomechanical performance of hockey helmets. Ann. Biomed. Eng. 43:2429–2443, 2015
pubmed: 25822907
pmcid: 4569651
Sanchez, E. J., L. F. Gabler, A. B. Good, J. R. Funk, J. R. Crandall, and M. B. Panzer. A reanalysis of football impact reconstructions for head kinematics and finite element modeling. Clin. Biomech. 64:82–89, 2018
Stemper, B. D., et al. Comparison of head impact exposure between concussed football athletes and matched controls: evidence for a possible second mechanism of sport-related concussion. Ann. Biomed. Eng. 2018. https://doi.org/10.1007/s10439-018-02136-6
doi: 10.1007/s10439-018-02136-6
pubmed: 30362082
pmcid: 6785644
Takhounts, E. G., S. A. Ridella, R. E. Tannous, J. Q. Campbell, D. Malone, K. Danelson, J. Stitzel, S. Rowson, and S. Duma. Investigation of traumatic brain injuries using the next generation of simulated injury monitor (SIMon) finite element head model. Stapp Car Crash J. 52:1–31, 2008
pubmed: 19085156
Tyson, A. M., and S. Rowson. Varsity Football Helmet STAR Protocol. 2018
Versace, J. A review of the severity index. 1971. https://doi.org/10.4271/710881
Viano, D. C., I. R. Casson, E. J. Pellman, L. Zhang, A. I. King, and K. H. Yang. Concussion in professional football: brain responses by finite element analysis: part 9. Neurosurgery. 57:891–915, 2005
pubmed: 16284560
Wu, S., W. Zhao, K. Ghazi, and S. Ji. Convolutional neural network for efficient estimation of regional brain strains. Sci. Rep. 9:17326, 2019
pubmed: 31758002
pmcid: 6874599
Wu, S., W. Zhao, and S. Ji. Real-time dynamic simulation for highly accurate spatiotemporal brain deformation from impact. Comput. Methods Appl. Mech. Eng.394:114913, 2022
pubmed: 35572209
Wu, S., W. Zhao, B. Rowson, S. Rowson, and S. Ji. A network-based response feature matrix as a brain injury metric. Biomech Model Mechanobiol. 19:927–942, 2020
pubmed: 31760600
Wu, S., W. Zhao, J. Ruan, S. Barbat, and S. Ji. Instantaneous brain strain estimation for automotive head impacts via deep learning. Stapp Car Crash J. 65:1–8, 2021
Zhao, W., and S. Ji. Brain strain uncertainty due to shape variation in and simplification of head angular velocity profiles. Biomech. Model. Mechanobiol. 16:449–461, 2017
pubmed: 27644441
Zhao, W., and S. Ji. White matter anisotropy for impact simulation and response sampling in traumatic brain injury. J. Neurotrauma. 36:250–263, 2019
pubmed: 29681212
Zhao, W., and S. Ji. Displacement- and strain-based discrimination of head injury models across a wide range of blunt conditions. Ann. Biomed. Eng. 20:1661–1677, 2020