Abstract
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/s2 avg.) than those without (1412 rad/s2 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.
Highlights
Mild traumatic brain injury is a growing health threat that is notoriously underreported, difficult to screen, and poorly understood
We focused on the calculation of fractional anisotropy (FA) and increased mean diffusivity (MD) because concurrent observation of decreased FA and increased MD is a clinical marker of long-term injury
The alteration of consciousness (AOC) Mild traumatic brain injury (mTBI) had a peak of 12,900 rad/s2 while the SR mTBI had a peak of 4294 rad/s2
Summary
Mild traumatic brain injury (mTBI) is a growing health threat that is notoriously underreported, difficult to screen, and poorly understood. Extended author information available on the last page of the article (Cassidy et al 2004). Evidence of long-term neurological impairment in athletes suffering repeat mTBI (Guskiewicz et al 2003; Omalu et al 2005, 2006; Maroon et al 2015; Montenigro et al 2017) suggests a pressing need to improve current screening methods by uncovering the mechanism of injury.
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
