Inertial sensors are commonly used to measure human head motion.(R1–3) Some sensors have been tested with dummy or cadaver experiments with mixed results, and methods to evaluate sensors in vivo are lacking. Here we present an in vivo(R3–10) method using high speed video to test teeth-mounted (mouthguard), soft tissue-mounted (skin patch), and headgear-mounted (skull cap) sensors during 6–13g(R1–20) sagittal soccer head impacts. Sensor coupling to the skull (R1–3) was quantified by displacement from an ear-canal reference. Mouthguard displacements were within video measurement error (<1mm), while the skin patch and skull cap displaced up to 4mm and 13mm from the ear-canal reference, respectively. We used the mouthguard, which had the least displacement from skull (R1–5), as the reference to assess 6-degree-of-freedom skin patch and skull cap measurements. Linear and rotational acceleration magnitudes were over-predicted by both the skin patch (with 120% NRMS error for amag, 290% for αmag(R1–6)) and the skull cap (320% NRMS error for amag, 500% for αmag(R1–6)). Such over-predictions were largely due to out-of-plane motion. To model sensor error, we found that in-plane skin patch acceleration peaks in the anterior-posterior direction could be modeled by an underdamped viscoelastic system. In summary, the mouthguard showed tighter skull coupling than the other sensor mounting approaches(R1–7). Furthermore, the in vivo methods presented are valuable for investigating skull acceleration sensor technologies.

This preliminary study investigated whether direct measurement of head rotation improves prediction of mild traumatic brain injury (mTBI). Although many studies have implicated rotation as a primary cause of mTBI, regulatory safety standards use 3 degree of freedom (3DOF) translation-only kinematic criteria to predict injury. Direct 6DOF measurements of human head rotation (3DOF) and translation (3DOF) have not been previously available to examine whether additional DOFs improve injury prediction. We measured head impacts in American football, boxing, and mixed martial arts using 6DOF instrumented mouthguards, and predicted clinician-diagnosed injury using 12 existing kinematic criteria and 6 existing brain finite element (FE) criteria. Among 513 measured impacts were the first two 6DOF measurements of clinically-diagnosed mTBI. For this dataset, 6DOF criteria were most predictive of injury, more than 3DOF translation-only and 3DOF rotation-only criteria. Peak principal strain in the corpus callosum, a 6DOF FE criteria, was the strongest predictor, followed by two criteria that included rotation measurements, peak rotational acceleration magnitude and Head Impact Power (HIP). These results suggest head rotation measurements may improve injury prediction. However, more 6DOF data is needed to confirm this evaluation of existing injury criteria, and to develop new criteria that considers directional sensitivity to injury.

Corpus callosum trauma has long been implicated in mild traumatic brain injury (mTBI), yet the mechanism by which forces penetrate this structure is unknown. We investigated the hypothesis that coronal and horizontal rotations produce motion of the falx cerebri that damages the corpus callosum. We analyzed previously published head kinematics of 115 sports impacts (2 diagnosed mTBI) measured with instrumented mouthguards and used finite element (FE) simulations to correlate falx displacement with corpus callosum deformation. Peak coronal accelerations were larger in impacts with mTBI (8592 rad/ s 2 avg.) than those without (1412 rad/s 2 avg.). From FE simulations, coronal acceleration was strongly correlated with deep lateral motion of the falx center (r = 0.85), while horizontal acceleration was correlated with deep lateral motion of the falx periphery (r > 0.78). Larger lateral displacement at the falx center and periphery was correlated with higher tract-oriented strains in the corpus callosum body (r = 0.91) and genu/splenium (r > 0.72), respectively. The relationship between the corpus callosum and falx was unique: removing the falx from the FE model halved peak strains in the corpus callosum from 35% to 17%. Consistent with model results, we found indications of corpus callosum trauma in diffusion tensor imaging of the mTBI athletes. For a measured alteration of consciousness, depressed fractional anisotropy and increased mean diffusivity indicated possible damage to the mid-posterior corpus callosum. Our results suggest that the corpus callosum may be sensitive to coronal and horizontal rotations because they drive lateral motion of a relatively stiff membrane, the falx, in the direction of commissural fibers below.

We investigated whether humans could sustain high head rotational velocities without brain injury. Rotational velocity has long been implicated for predicting concussion risk, and has recently been used to develop the rotational velocity-based Brain Injury Criterion (BrIC). To assess the efficacy of rotational velocity and BrIC for predicting concussion risk, we instrumented 9 male subjects with sensor-laden mouthguards and measured six-degree-of-freedom head accelerations for 27 rapid voluntary head rotations. The fastest rotations produced peak rotational velocities of 12.6, 17.4, and 25.0 rad/s in the coronal, sagittal, and horizontal planes, respectively. All of these exceeded the corresponding medians from padded sports impacts (8.9, 10.7, and 8.4 rad/s, respectively) and, in the case of sagittal and horizontal rotation, were within 1 standard deviation of published concussion averages. In the horizontal plane, four voluntary rotations exceeded the concussive impact median BrIC. The area under the precision-recall curve was lower in BrIC (0.49) than just using horizontal rotational acceleration (0.8), which distinguished concussive and subconcussive motions better. Voluntary motions produced less than 4% max principal strain (MPS) in finite element simulation, 5 times below predictions from dummy impacts used to develop BrIC. Despite having the highest critical velocity in BrIC, coronal rotation produced more tract-oriented strain in the corpus callosum than other planes. Baseline and post-experiment neurological testing revealed no significant deficits. We find that the head can tolerate high-velocity, low-acceleration rotational inputs too slow to produce substantial brain deformation. These findings suggest that the time regime over which angular velocities occur must be carefully considered for concussion prediction.

This work describes methodology for evaluating laboratory models of head impact biomechanics. Using this methodology, we investigated: how closely does twin-wire drop testing model head rotation in American football impacts? Head rotation is believed to cause mild traumatic brain injury (mTBI) but helmet safety standards only model head translations believed to cause severe TBI. It is unknown whether laboratory head impact models in safety standards, like twin-wire drop testing, reproduce six degree-of-freedom (6DOF) head impact biomechanics that may cause mTBI. We compared 6DOF measurements of 421 American football head impacts to twin-wire drop tests at impact sites and velocities weighted to represent typical field exposure. The highest rotational velocities produced by drop testing were the 74th percentile of non-injury field impacts. For a given translational acceleration level, drop testing underestimated field rotational acceleration by 46% and rotational velocity by 72%. Primary rotational acceleration frequencies were much larger in drop tests (~100Hz) than field impacts (~10Hz). Drop testing was physically unable to produce acceleration directions common in field impacts. Initial conditions of a single field impact were highly resolved in stereo high-speed video and reconstructed in a drop test. Reconstruction results reflected aggregate trends of lower amplitude rotational velocity and higher frequency rotational acceleration in drop testing, apparently due to twin-wire constraints and the absence of a neck. These results suggest twin-wire drop testing is limited in modeling head rotation during impact, and motivate continued evaluation of head impact models to ensure helmets are tested under conditions that may cause mTBI.