Tolerances for cerebral concussion from head impact and whiplash in primates

Ommaya, Ayub K.; Hirsch, Arthur E.

doi:10.1016/0021-9290(71)90011-x

Cited by 252 publications

(140 citation statements)

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“…Our piglet data refute the hypothesis that scaling rotational loads by brain mass as proposed by Ommaya and colleagues (Ommaya et al, 1967;Ommaya and Hirsch, 1971) results in similar brain injuries in 4-week-old and 5-day-old animals. In the unscaled rotations, we expected more severe subarachnoid and axonal injury in 4-week-old than in 5-day-old animals because of the larger, softer brain (Prange and Margulies, 2002) in the 4-week-old animals; instead we saw …”

Section: Improved Scaling Lawsupporting

confidence: 90%

“…Previously published primate data in the rhesus (brain mass 70-100 g) and the squirrel (brain mass 20-27 g) monkey revealed that concussion was associated with larger velocities and accelerations, and not with smaller loads (Ommaya et al, 1966(Ommaya et al, , 1967Ommaya and Hirsch, 1971). Nonimpact rotational loads in the adult mini-pig demonstrated that increasing peak angular velocity correlated positively with coma severity and the number of damaged axons (Smith et al, 2000).…”

Section: Discussionmentioning

confidence: 97%

“…, and the mild acceleration represented the mass-scaled value required to achieve the same injury in the 4-week-old animals, according to the mass scaling principle proposed by Ommaya and Hirsch (Ommaya and Hirsch, 1971). The massscaling principle (Eq.…”

Section: )mentioning

confidence: 99%

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Physiological and Pathological Responses to Head Rotations in Toddler Piglets

Ibrahim

Ralston

Smith

et al. 2010

Journal of Neurotrauma

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Closed head injury is the leading cause of death in children less than 4 years of age, and is thought to be caused in part by rotational inertial motion of the brain. Injury patterns associated with inertial rotations are not well understood in the pediatric population. To characterize the physiological and pathological responses of the immature brain to inertial forces and their relationship to neurological development, toddler-age (4-week-old) piglets were subjected to a single non-impact head rotation at either low (31.6 AE 4.7 rad/sec 2 , n ¼ 4) or moderate (61.0 AE 7.5 rad/sec 2 , n ¼ 6) angular acceleration in the axial direction. Graded outcomes were observed for both physiological and histopathological responses such that increasing angular acceleration and velocity produced more severe responses. Unlike low-acceleration rotations, moderate-acceleration rotations produced marked EEG amplitude suppression immediately post-injury, which remained suppressed for the 6-h survival period. In addition, significantly more severe subarachnoid hemorrhage, ischemia, and axonal injury by b-amyloid precursor protein (b-APP) were observed in moderate-acceleration animals than low-acceleration animals. When compared to infant-age (5-day-old) animals subjected to similar (54.1 AE 9.6 rad/sec 2 ) acceleration rotations, 4-week-old moderate-acceleration animals sustained similar severities of subarachnoid hemorrhage and axonal injury at 6 h post-injury, despite the larger, softer brain in the older piglets. We conclude that the traditional mechanical engineering approach of scaling by brain mass and stiffness cannot explain the vulnerability of the infant brain to acceleration-deceleration movements, compared with the toddler.

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Section: Improved Scaling Lawsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 97%

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Physiological and Pathological Responses to Head Rotations in Toddler Piglets

Ibrahim

Ralston

Smith

et al. 2010

Journal of Neurotrauma

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“…It has been shown that as frequency and severity of impacts increase, the amount of brain injury increases. [43][44][45] It is also well documented that mTBI events in children, as well as adults, have led to changes in DTI scalars, FA in particular. 22,25,26,[46][47][48] Our study shows changes in DTI scalars that are significantly associated with RWE metrics in the absence of a clinical diagnosis of concussion or clinically apparent mTBI.…”

Section: Discussionmentioning

confidence: 99%

Abnormal White Matter Integrity Related to Head Impact Exposure in a Season of High School Varsity Football

Davenport

Whitlow

Urban

et al. 2014

Journal of Neurotrauma

198

155

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The aim of this study was to determine whether the cumulative effects of head impacts from a season of high school football produce magnetic resonance imaging (MRI) measureable changes in the brain in the absence of clinically diagnosed concussion. Players from a local high school football team were instrumented with the Head Impact Telemetry System (HITSÔ) during all practices and games. All players received pre-and postseason MRI, including diffusion tensor imaging (DTI). Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) was also conducted. Total impacts and risk-weighted cumulative exposure (RWE), including linear (RWE Linear ), rotational (RWE Rotational ), and combined components (RWE CP ), were computed from the sensor data. Fractional, linear, planar, and spherical anisotropies (FA, C L , C P , and C S , respectively), as well as mean diffusivity (MD), were used to determine total number of abnormal white matter voxels defined as 2 standard deviations above or below the group mean. Delta (post-preseason) ImPACT scores for each individual were computed and compared to the DTI measures using Spearman's rank correlation coefficient. None of the players analyzed experienced clinical concussion (N = 24). Regression analysis revealed a statistically significant linear relationship between RWE CP and FA. Secondary analyses demonstrated additional statistically significant linear associations between RWE (RWE CP and RWE Linear ) and all DTI measures. There was also a strong correlation between DTI measures and change in Verbal Memory subscore of the ImPACT. We demonstrate that a single season of football can produce brain MRI changes in the absence of clinical concussion. Similar brain MRI changes have been previously associated with mild traumatic brain injury.

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“…Based on the experimental results obtained by Holbourn 28,29 with a spheroid brain model and on their own experiments [31][32][33] , Ommaya & Gennarelli 15 proposed that the inertial strains produced by angular acceleration affect the brain in a centripetal progression, i.e., the damaging force would decrease as it is transmitted from the surface to the center of the brain. Based on that hypothesis, the authors concluded that center brain lesions are rare because centripetal force of sufficient intensity to reach that region is infrequent and, when present, would be associated with lesions in the periphery of the brain.…”

Section: Discussionmentioning

confidence: 99%

The conformation of the brain plays an important role in the distribution of diffuse axonal injury in fatal road traffic accident

Pittella

Gusmão

2004

Arq. Neuro-Psiquiatr.

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-Objective: A study was made of the brain lesions in 120 random victims of fatal road traffic accidents to determine the frequency and topographic distribution of diffuse axonal damage (DAI) in relation to the midline brain structures. Method: The identification of axons was carried out with a mouse antibody anti-neurofilament proteins 70-, 160-, and 210-kD. Results: DAI was identified in 96 (80%) brains and classified as Grade 1 in 21.9%, as Grade 2 in 51%, and as Grade 3 in 27.1% of the patients. In spite of the diffuse distribution that is characteristic of DAI, damage occurred preferentially in the interhemispheric formations (corpus callosum and fornix) and rostral portion of the brainstem, usually to one side of the midline. Conclusion: From a mechanical point of view, the interhemispheric formations and the rostral portion of the brainstem act as fixating structures for the cerebral hemispheres during rotational acceleration of the head. It is known that the motion of the cerebral hemispheres is delayed at the points of fixation, where greater stress would be produced, particularly on the side subjected to greater displacement. The frequent involvement by DAI of deep, center-medial brain structures, usually to one side of the midline, supports the mechanism proposed above.KEY WORDS: diffuse axonal injury, head injury, road traffic accident, biomechanics.A conformação do encéfalo é um fator importante na distribuição da lesão axonal difusa no acidente de trân-sito fatal RESUMO -Objetivo: Foram estudadas as lesões encefálicas de 120 vítimas fatais de acidentes de trânsito, selecionadas aleatoriamente, com a finalidade de determinar a freqüência e distribuição topográfica da lesão axonal difusa (LAD) em relação com as estruturas encefálicas da linha média. Método: A identificação dos axônios foi efetuada com antisoro anti-proteínas do neurofilamento 70-, 160-e 210-kD obtido em camundongo. Resultados: A LAD foi observada em 96 (80%) dos encéfalos examinados, tendo sido classificada em Grau 1 em 21,9%, Grau 2 em 51% e Grau 3 em 27,1% dos pacientes. A despeito da distribuição difusa que é característica da LAD, a lesão afetou preferencialmente as formações inter-hemisféricas (corpo caloso e fórnix) e a porção rostral do tronco encefálico, usualmente em um dos lados da linha média. Conclusão: As formações inter-hemisféricas e a porção rostral do tronco encefálico funcionam, do ponto de vista mecânico, como estruturas de fixação dos hemisférios cerebrais durante a aceleração rotacional da cabeça. Sabe-se que a movimentação dos hemisférios cerebrais é retardada nas áreas de fixação, gerando aí maior estresse, particularmente no lado submetido ao maior deslocamento. O frequente envolvimento pela LAD das estruturas encefálicas centro-mediais profundas, usualmente em um dos lados da linha média, favorece o mecanismo acima proposto. PALAVRAS-CHAVE: lesão axonal difusa, trauma crânio-encefálico, acidente de trânsito, biomecânica.Diffuse axonal injury (DAI) is a consistent feature of traumatic brain injury foll...

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Tolerances for cerebral concussion from head impact and whiplash in primates

Cited by 252 publications

References 5 publications

Physiological and Pathological Responses to Head Rotations in Toddler Piglets

Physiological and Pathological Responses to Head Rotations in Toddler Piglets

Abnormal White Matter Integrity Related to Head Impact Exposure in a Season of High School Varsity Football

The conformation of the brain plays an important role in the distribution of diffuse axonal injury in fatal road traffic accident

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