Development of an Anisotropic Finite Element Head Model for Traumatic Brain Injury Prediction

Abstract: Traumatic brain injury (TBI) is a worldwide health care problem with very high associatedmorbidity and mortality rates. In particular, the diagnosis of TBI is challenging: symptomsoverlap with other pathologies and the injury is typically not visible with conventionalneuroimaging techniques.Finite element (FE) head models can provide valuable insight into uncovering themechanism underlying brain damage. These models enable the calculation of tissue loadsand deformation patterns, which are thought to be associated with the injury. Measuresbased on tissue strain or invariants of the strain tensor are used as injury predictors and riskinjury curves can be inferred to establish the tolerance of the human head to external loads.However, while in-vitro research shows that the vulnerability to injury is due to highlyorganized structure in white matter tracts, the majority of the current FE models model thebrain as isotropic and homogenous. The deformation of white matter tracts is not calculated.The aim of this doctoral thesis was to incorporate the effects of inhomogeneity andanisotropy of brain tissue into injury analysis. Based on in-vitro experimental evidence, thestrain in the direction of the axons (axonal strain) was proposed as a new, more anatomicallyrelevant, injury predictor. The initial hypothesis to investigate was that an FE anisotropichead model is a better tool to represent TBI because it is more biofidelic in describing thelocal mechanism of axonal impairment.The studies reported in this thesis describe a method for implementing the orientation of thewhite matter tracts in an anisotropic constitutive law for FE modeling. Results from thestudies suggested that the anisotropy of the brain significantly affected the injury predictionsof an FE head model. For an injury dataset from the American National Football League, thepeak of axonal strain - MAS - was found to be a better predictor of injury than isotropic localor global predictors. Finally, based on 27 cases of intracranial pressure, relative skull-brainmotion and brain deformation, the introduction of the brain anisotropy in the FE modelpartially enhanced the biofidelity of the simulations. However, given that the enhancementin biofidelity was not major, it was concluded that further research is necessary forunderstanding the relationship between tissue-level loading and axonal injury.