Current understanding of the biomechanics of cervical spine injuries in head-first impact is based on decades of epidemiology, mathematical models, and in vitro experimental studies. Recent mathematical modeling suggests that muscle activation and muscle forces influence injury risk and mechanics in head-first impact. It is also known that muscle forces are central to the overall physiologic stability of the cervical spine. Despite this knowledge, the vast majority of in vitro head-first impact models do not incorporate musculature. We hypothesize that the simulation of the stabilizing mechanisms of musculature during head-first osteoligamentous cervical spine experiments will influence the resulting kinematics and injury mechanisms. Therefore, the objective of this study was to document differences in the kinematics, kinetics, and injuries of ex vivo osteoligamentous human cervical spine and surrogate head complexes that were instrumented with simulated musculature relative to specimens that were not instrumented with musculature. We simulated a head-first impact (3 m/s impact speed) using cervical spines and surrogate head specimens (n = 12). Six spines were instrumented with a follower load to simulate in vivo compressive muscle forces, while six were not. The principal finding was that the axial coupling of the cervical column between the head and the base of the cervical spine (T1) was increased in specimens with follower load. Increased axial coupling was indicated by a significantly reduced time between head impact and peak neck reaction force (p = 0.004) (and time to injury (p = 0.009)) in complexes with follower load relative to complexes without follower load. Kinematic reconstruction of vertebral motions indicated that all specimens experienced hyperextension and the spectrum of injuries in all specimens were consistent with a primary hyperextension injury mechanism. These preliminary results suggest that simulating follower load that may be similar to in vivo muscle forces results in significantly different impact kinetics than in similar biomechanical tests where musculature is not simulated.
A closed-loop system for the automated detection and control of epileptic seizures was created and tested in three Genetic Absence Epilepsy Rats from Strasbourg (GAERS) rats. In this preliminary study, a set of four EEG features were used to detect seizures and three different electrical stimulation strategies (standard (130 Hz), very high (500 Hz) and ultra high (1000 Hz)) were delivered to terminate seizures. Seizure durations were significantly shorter with all three stimulation strategies when compared to non-stimulated (control) seizures. We used mean seizure duration of epileptiform discharges persisting beyond the end of electrical stimulation as a measure of stimulus efficacy. When compared to the duration of seizures stimulated in the standard approach (7.0 s ± 10.1), both very high and ultra high frequency stimulation strategies were more effective at shortening seizure durations (1.3 ± 2.2 s and 3.5 ± 6.4 s respectively). Further studies are warranted to further understand the mechanisms by which this therapeutic effect may be conveyed, and which of the novel aspects of the very high and ultra high frequency stimulation strategies may have contributed to the improvement in seizure abatement performance when compared to standard electrical stimulation approaches.
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