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Stapp Car Crash Journal, Vol. 57 (November 2013), pp.

243-266
2013-10

Development of Brain Injury Criteria (BrIC)


Erik G. Takhounts, Matthew J. Craig, Kevin Moorhouse, Joe McFadden
National Highway Traffic Safety Administration

Vikas Hasija
Bowhead Systems Management, Inc.

__________________________________

ABSTRACT Rotational motion of the head as a mechanism for brain injury was proposed back in the 1940s. Since then a
multitude of research studies by various institutions were conducted to confirm/reject this hypothesis. Most of the studies were
conducted on animals and concluded that rotational kinematics experienced by the animals head may cause axonal deformations
large enough to induce their functional deficit. Other studies utilized physical and mathematical models of human and animal
heads to derive brain injury criteria based on deformation/pressure histories computed from their models. This study differs from
the previous research in the following ways: first, it uses two different detailed mathematical models of human head (SIMon and
GHBMC), each validated against various human brain response datasets; then establishes physical (strain and stress based) injury
criteria for various types of brain injury based on scaled animal injury data; and finally, uses Anthropomorphic Test Devices
(ATDs) (Hybrid III 50th Male, Hybrid III 5th Female, THOR 50th Male, ES-2re, SID-IIs, WorldSID 50th Male, and WorldSID
5th Female) test data (NCAP, pendulum, and frontal offset tests) to establish a kinematically based brain injury criterion (BrIC)
for all ATDs. Similar procedures were applied to college football data where thousands of head impacts were recorded using a
six degrees of freedom (6 DOF) instrumented helmet system. Since animal injury data used in derivation of BrIC were
predominantly for diffuse axonal injury (DAI) type, which is currently an AIS 4+ injury, cumulative strain damage measure
(CSDM) and maximum principal strain (MPS) were used to derive risk curves for AIS 4+ anatomic brain injuries. The AIS 1+,
2+, 3+, and 5+ risk curves for CSDM and MPS were then computed using the ratios between corresponding risk curves for head
injury criterion (HIC) at a 50% risk. The risk curves for BrIC were then obtained from CSDM and MPS risk curves using the
linear relationship between CSDM - BrIC and MPS BrIC respectively. AIS 3+, 4+ and 5+ field risk of anatomic brain injuries
was also estimated using the National Automotive Sampling System - Crashworthiness Data System (NASS-CDS) database for
crash conditions similar to the frontal NCAP and side impact conditions that the ATDs were tested in. This was done to assess
the risk curve ratios derived from HIC risk curves. The results of the study indicated that: (1) the two available human head
models SIMon and GHBMC were found to be highly correlated when CSDMs and max principal strains were compared; (2)
BrIC correlates best to both - CSDM and MPS, and rotational velocity (not rotational acceleration) is the mechanism for brain
injuries; and (3) the critical values for angular velocity are directionally dependent, and are independent of the ATD used for
measuring them. The newly developed brain injury criterion is a complement to the existing HIC, which is based on translational
accelerations. Together, the two criteria may be able to capture most brain injuries and skull fractures occurring in automotive or
any other impact environment. One of the main limitations for any brain injury criterion, including BrIC, is the lack of human
injury data to validate the criteria against, although some approximation for AIS 2+ injury is given based on the angular
velocities calculated at 50% probability of concussion in college football players instrumented with 5 DOF helmet system.
Despite the limitations, a new kinematic rotational brain injury criterion BrIC may offer a way to capture brain injuries in
situations when using translational accelerations based HIC alone may not be sufficient.

KEYWORDS brain injury criteria, finite element modeling of brain, SIMon, GHBMC, risk curves
__________________________________

INTRODUCTION important public health problem in the United States.


TBI is frequently referred to as the silent epidemic
According to the Centers for Disease Control and
because the complications from TBI, such as changes
Prevention (CDC) traumatic brain injury (TBI) is an
affecting thinking, sensation, language, or emotions,
Address correspondence to Erik G Takhounts, Ph.D., may not be readily apparent. The most recent CDC
USDOT, 1200 New Jersey Avenue, SE Washington, D.C. 20590. report (Frieden et. al, 2010) estimates 1.7 million
Electronic mail: erik.takhounts@dot.gov
people sustain a TBI annually, of them 52,000 die.
243
244 Takhounts et al. / Stapp Car Crash Journal 57 (November 2013) 243-266

The report finds that among all age groups, motor Safety (IIHS), and others. However, despite of all
vehicle-traffic (MVT) was the second leading cause these requirements TBI is still one of the most
of TBI (17.3%) and resulted in the largest percentage frequent injury types in motor vehicle crashes (Eigen
of TBI-related deaths (31.8%). and Martin, 2005). The reasons for this may be
multiple: (1) the mandatory and voluntary
Based on National Automotive Sampling System requirements may not capture some real world crash
Crashworthiness Data System (NASS-CDS) analyses scenarios leading to TBI, (2) the Anthropomorphic
of tow-away crashes (Eigen and Martin, 2005), Test Devices (ATDs) used in these tests are not
fatalities attributable to head injuries are second only interacting with vehicle environment in the way
to fatalities attributable to thoracic region with humans do, and (3) the interpretation of the ATDs
societal costs exceeding $60 billion. measurements is not sufficient to capture all possible
types of TBI.
Utilizing NASS-CDS from 1997 to 2011, a weighted
annual estimate for AIS 3+ anatomic brain injuries It is reason 3 that is investigated in this paper with the
averaged roughly 6500 cases with that value focus on the rotationally induced anatomic brain
remaining as high as 9000 cases per year as recently injuries. First, we make use of the scaled animal data
as 2010. This was a population limited to belted (Abel et al., 1978; Stalnaker et al., 1977; Meaney et
occupants 15 and older in crashes where the most al., 1993) along with the National Highway Traffic
severe event was a frontal and side impact without Safety Administration (NHTSA) developed finite
rollover. Figure 1 shows the annual average risk of element (FE) model of human brain, i.e. the
AIS 3+, 4+, and 5+ anatomic brain injuries from simulated injury monitor (SIMon) and its
1999 to 2011. Note, the percent risk is a running biomechanical injury criteria for diffuse axonal injury
three year average (e.g., 1999 is the average risk from (DAI) type brain injuries cumulative strain damage
1997 to 1999 and so on) and, per above, includes all measure (CSDM) (Takhounts et al., 2003 and 2008)
frontal, near-side, and far-side crashes involving age and maximum principal strain (MPS); as well as the
15 and older, belted occupants. Model years were head model developed by the Global Human Body
restricted to newer vehicles in each case year by Modeling Consortium, LLC (GHBMC) with the
limiting model years to the case year minus 10. It same injury criteria (Mao et al., 2013). Then,
can be seen from Figure 1 that the weighted risk of assuming DAI type anatomic brain injuries in
AIS 3+, 4+, and 5+ anatomic brain injuries, if animals (over 15 minutes loss of consciousness,
anything, has been increasing over the last decade. severe hematoma, etc., along with the AIS 4+ injuries
wherever available) to be equivalent to an AIS 4+
injury in humans (AAAM, 2008), the risk curves for
CSDM and MPS were derived and then scaled to AIS
1+, 2+, 3+, and 5+ using ratios between the risk
curves similar to those developed for HIC at 50% risk
(NHTSA, 1995). These scaled CSDM and MPS risk
curves represent various severities of concussive and
hemorrhagic brain injuries. For example, AIS 3+ risk
curve is a risk of severe concussion with the loss of
consciousness 1-6 hours (AAAM, 2008), while AIS
4+ risk curve is for the loss of consciousness lasting
over 6 hours. Finally, kinematic brain injury criterion
(BrIC) was developed and applied to each test
dummy (Hybrid III 50th male, Hybrid III 5th female,
THOR 50th male, ES-2re, SID-IIs, WorldSID 50th
Figure 1. Anatomic brain injury risk in frontal and male, and WorldSID 5th female) as well as human
side impact tow-away crashes in NASS-CDS. volunteers based on college football data (Rowson et
al., 2009, 2012).
Many attempts have been made in the past to reduce
the occurrence and severity of TBI in automotive The following hypotheses were tested in this study:
crashes. Among them are design and development of
improved safety systems governed by various Federal 1. BrIC correlates best to both - CSDM and MPS,
Motor Vehicle Safety Standards (FMVSS), and rotational velocity (not rotational acceleration) is
requirements of the New Car Assessment Program the mechanism for anatomic brain injuries.
(NCAP), tests of Insurance Institute for Highway
Takhounts et al. / Stapp Car Crash Journal 57 (November 2013) 243-266 245

2. The critical values for angular velocity are 2012) within 5%. The subject selection and imaging
directionally dependent, and are independent of the protocol was approved by the Wake Forest
ATD used for measuring them. University School of Medicine Institutional Review
Board (IRB, #5705) [Gayzik 2009]. The
participants age, height and weight during
METHODS enrollment were 26 years, 174.9 cm, and 78.6 0.77
kg. Subject anthropometries pertinent to the head
Comparison of the SIMon and GHBMC FE Head model were head breadth (16.4 cm), length (19.8 cm)
Models and circumference (57.8 cm). The model consists of
different anatomical structures of the brain including
The SIMon and GHBMC human head models were the cerebrum gray and white matter, corpus callosum,
tested using available experimental animal injury basal ganglia, thalamus, brainstem, cerebellum, and
data, including rhesus monkeys (Abel et al., 1978; lateral and third ventricles (Figure 3), as well as
Stalnaker et al., 1977), baboons (Stalnaker et al., cerebrospinal fluid (CSF), dural membranes, bridging
1977), and miniature pigs (Meaney et al., 1993). A veins, skull, facial bones, head flesh and head skin.
total of 67 animal brain injury experiments were The head model weighs 4.4 kg consisting of 270,787
simulated in the development of the biomechanical elements with over 211,000 of which are solid
injury metrics CSDM and MPS. The experimental elements.
kinematic loading conditions were scaled in
amplitude and time to satisfy the equal stress/velocity
scaling relationship, i.e., translational velocity scaled
as 1, angular velocity as 1/, and time scaled as ,
where is the scaling ratio (Takhounts et al., 2003).
Once correctly scaled, these loading conditions were
applied to the SIMon and GHBMC models. The
SIMon FE model consists of 42,500 nodes and
45,875 elements, of which 5153 are shell elements
(3790 rigid), 14 are beam elements, and 40,708 are
solid elements (Takhounts et al., 2008). Major parts
of the brain were represented: cerebrum, cerebellum,
brainstem, ventricles, combined CSF and pia
arachnoid complex (PAC) layer, falx, tentorium, and
parasagittal blood vessels (Figure 2). Figure 3. GHBMC v 3.5 head model, shown with full
body model, parts labeled.
Blood vessels
Falx
Both - SIMon and GHBMC head models were
Cerebrum Ventricles
validated using the following tests: pressure was
validated against a series of cadaveric intracranial
pressure data reported by Nahum et al. (1977) and
Trosseille et al. (1992). Brain motion with respect to
the skull was validated against experimentally
Tentorium
measured data from cadavers due to sagittal, coronal,
PAC and CSF and horizontal blunt head impacts performed by
layer
Hardy et al. (2001, 2007). Validation of the SIMon
model is given in Takhounts et al. (2008), and that of
Brainstem Cerebellum
the GHBMC model in Mao et al. (2013). In
addition, dynamic responses of the facial bone at
various regions of GHBMC model were validated
Figure 2. SIMon Finite Element Head Model. against force-deformation curves from nasal impact
(Nyquist et al., 1986), zygoma and maxilla impact
The head of the GHBMC 50th percentile male human (Allsop et al., 1988). The validations for the skull
body model was extracted from the full body and bones were performed for frontal angled impact,
used as part of this study. All image data used was crown impact, and occipital impact reported by
acquired from a pre-screened individual who Yoganandan et al. (1995) and frontal horizontal
matched numerous anthropometric targets for the 50th impact reported by Hodgson et al. (1970).
percentile male (Gordon et al. 1989, Gayzik et al
246 Takhounts et al. / Stapp Car Crash Journal 57 (November 2013) 243-266

To compare the response of the two models all the impact dummies. The wait time between consecutive
animal data referenced above and described in tests on any particular head was 1 hour to allow for
Takhounts et al. (2003, 2008) were run with both recovery of the soft materials. Overall 190 tests were
SIMon and GHBMC FE head models and the injury conducted on all ATDs and then simulated with both
risk curves were developed using both models. The FE models SIMon and GHBMC to test the first
results of both models were compared using R2 hypothesis.
coefficient of determination.
Correlations between physical and kinematic
Pendulum Tests to Correlate Physical and parameters were assessed using R2 coefficient of
Kinematic Parameters determination, root mean square error (RMSE), and
Coefficient of Variation (CV) defined as RMSE
Next, it was necessary to establish a relationship normalized by the mean of the dependent variable.
between physical injury metrics CSDM, maximum The CV was used to compare the goodness of fit
pressure and MPS with kinematic parameters, such between the MPS data for which regression through
as linear and angular head accelerations and the origin (RTO) formulation was used and CSDM
velocities. For this purpose, a series of pendulum data for which the ordinary least square (OLS) model
tests at various impact angles and energies were was applied (Eisenhauer, 2003). This was necessary
conducted on several ATDs Hybrid III 50th male, due to different formulations used by RTO and OLS
Hybrid III 5th female, THOR 50th male, ES-2re, SID- to compute R2:
IIs, WorldSID 50th male, and WorldSID 5th female.
These tests were conducted using a hydraulic linear ( )2 ( )2
2 = ()2 = 1 ( )2
, for OLS
impactor (23.4 kg projectile mass with 4 inch
diameter spherical impactor face) with impact speeds
designed to generate HIC15 values ranging from 200 2

to 1800 in both padded and unpadded conditions. 2 = 2 , for RTO,

For the padded condition a one inch thick piece of
gray Ensolite SCC foam was affixed to the head at
the impact location. The height of the impact where is the ith dependent variable (or value), is
location was at the level where the nose bridge meets the ith fitted value, and is the mean of the dependent
the forehead or an equivalent relative height with variable.
respect to the head for dummies without a nose
(Figure 4). The equations above indicate that it is meaningless to
compare R2 values between CSDM and MPS based
charts, and instead CV should be used (Eisenhauer,
2003). To compare the ATDs data within the MPS
(e.g. max angular velocity versus MPS for each
dummy) and CSDM (e.g. max angular velocity
versus CSDM for each dummy) groups, both the R2
coefficient of determination and CV were used. SAS
software (SAS, Version 9.3, Cary, NC) was used to
run regression (for both RTO & OLS) and obtain R2,
RMSE, and CV values for all datasets.

Development and Scaling of Risk Curves

It was assumed that at the higher severity range of


injury spectrum (AIS 4+) animal subjects would
experience anatomic brain injuries similar to those
Figure 4. Pendulum test setup. The head and neck that would be observed from a human under the
assembly of the HIII 50th percentile male ATD is equivalent loading conditions. The equivalent loading
shown for a frontal (0 degrees), unpadded impact at conditions are defined through the application of the
the head center of gravity. equal stress equal velocity scaling relationship
between animals and humans.
The line of contact force was directed through the
impact height at 0 or 30 degrees relative to the
midsagittal plane for frontal impact dummies, and 60
or 90 degrees relative to the midsagittal plane for side
Takhounts et al. / Stapp Car Crash Journal 57 (November 2013) 243-266 247

The risk curves for CSDM and MPS were have direct one-to-one coding or severity level
constructed using survival analysis (Weibull changes between AIS 1998 and AIS 2008 were
distribution, left/right censored data): adjusted appropriately. Where there had been one
code (e.g., 140652.4 cerebrum hematoma, subdural,

= 1 (
)
, (1) small) in AIS 1998 that is now represented by two
codes in AIS 2008 (140652.4 and 140651.3 for
where is scale and k is shape parameter for Weibull small and now tiny subdural) both a low and
distribution. high estimate was done. The low estimate took
all such one (AIS 1998)-to-many (AIS 2008) codes
This injury risk curve (Eq. 1) would correspond to when translating from AIS 1998 to 2008 and
AIS 4+ brain injury according to the recently assigned the lowest possible AIS score. In this case,
published AIS scale (AAAM, 2008) for anatomic all AIS 1998 coded small cerebrum subdurals that
brain injuries. To obtain other levels of the were coded as 140652.4 in AIS 1998 are coded as
abbreviated injury scale, the risk curves for HIC were 140651.3 for AIS 2008. This same translation or
used (NHTSA, 1995), assuming equal severity ratios recoding was done for all one code to many code
between corresponding risk curves for HIC and scenarios. The high estimate on the other hand
CSDM at 50% risks. For example, to obtain AIS 3+ assigned the highest possible AIS severity code in
risk curve for CSDM, the ratio (34) of AIS 3+/AIS making the translation from AIS 1998 to 2008, which
4+ risk curves at 50% for HIC was found, and then in the example of the cerebrum subdural means
AIS4+ risk curve for CSDM at 50% was multiplied retaining the 140652.4 code.
by this ratio to find 50% risk point for the AIS3+
CSDM: Development of BrIC

CSDM AIS 3+ (50%) = 34 * CSDM AIS 4+ (50%). To test the second hypothesis, the test data from these
(2) pendulum impact tests was then combined with the
available NCAP and frontal offset tests (223 NCAP
Using equations 1 and 2 together, the CSDM risk and frontal offset tests) with 7 ATDs to develop BrIC
curve for AIS 3+ was found, while keeping the shape for all ATDs. To do that, first, CSDM/MPS values
parameter k of the Weibull distribution constant. were calculated for each test. This was accomplished
Other risk curves for CSDM were found in the by scaling the load curves for each ATD (based on
similar fashion (Takhounts et al. 2011). Similar the ATDs head geometry) using equal stress equal
procedure was followed for scaling MPS risk curves. velocity scaling relationship and applying them to
both head models SIMon and GHBMC. The best
Alternatively, crash data from NASS-CDS may also linear fit between CSDM and BrIC was obtained in
be used to develop relative differences between AIS the form of equation (3) using critical value of max
3+, AIS 4+, and AIS 5+ BrIC risk curves. For this resultant angular velocity cr such that BrIC = 1
purpose, the NASS-CDS frontal (GAD1=F) cases when CSDM = 0.49 (50% probability of AIS 4+).
were investigated from 1997 to 2011 with known Similar process was used with the MPS in place of
crash delta V (i.e., change in velocity), belted, age CSDM. Maximum resultant angular velocity was
15+ occupants seated in the drivers or right front initially selected for BrIC_R (the letter R here stands
passengers position for model year 1998 or newer for resultant) formulation as it was the best
vehicles. Simple binary logistic regression was done correlate to both CSDM and MPS (see Appendix I).
to assess the association between delta V, occupant

age, percent overlap (e.g., full frontal versus partial _ = , (3)

overlap), vehicle model year, and principal direction
of force (PDOF) and the dependent outcomes of It was observed, however, that different critical
interest; AIS 3+, 4+ and 5+ anatomic brain injuries. values of maximum angular velocity were achieved
Predictors with p values < 0.10 were retained for use when the models were exercised rotationally in
in creating a multivariable model using stepwise different directions (rotation about X-, Y-, or Z-axis)
logistic regression. Using weighted data, three sets using generated loading conditions similar to that
of AIS 3+, 4+, and 5+ risk curves were produced for shown in Figure 5.
anatomic brain injuries. The first was based on the
injuries as coded in AIS 1998 (AAAM, 1998). The This directional dependence of the critical angular
next two sets were based on AIS 2008 coding velocity was incorporated into a new formulation for
(AAAM, 2008). To accomplish this using injuries BrIC as shown in equation (4) below:
coded in NASS-CDS using AIS 1998, injuries that
248 Takhounts et al. / Stapp Car Crash Journal 57 (November 2013) 243-266

2 than 40 g. To determine resultant angular velocity,


2 2
= + + , (4) angular acceleration about each individual axis of the

head was numerically integrated throughout the
entire acceleration trace. Resultant angular velocity
where x, y, and z are maximum angular velocities was then calculated. Each impact was visually
about X-, Y-, and Z-axes respectively, and xC, yC, inspected so that the angular acceleration (and
and zC are the critical angular velocities in their resulting angular velocity) pulse of interest could be
respective directions. Two approaches to calculate examined and peak values identified. Once peak
maximum angular velocities were investigated (1) angular acceleration and peak angular velocity were
maxima in each direction irrespective of time the determined for each impact, a linear regression
maxima have occurred; and (2) values in each analysis was performed using a least squares
direction at the time that the max x-, y- or z- technique. The regression model was constrained so
component of angular velocity contributes most to that an angular acceleration of 0 rad/s2 resulted in an
BrIC (i.e. the component values at the time at which angular velocity of 0 rad/s. Although none of the 6
the max /c occurs). Correlations between BrIC_R DOF impacts resulted in brain or other head injury,
(equation 3) and CSDM/MPS for all ATDs CSDM and BrIC curves were computed to assess the
combined, and between BrIC (equation 4) and potential for TBI.
CSDM/MPS for all ATDs combined were then
compared using R2 and CV. Similar to above, concussive data was obtained from
college football players using the commercially
available 5 DOF HIT System (Simbex, Lebanon,
70
NH). This head acceleration device consisted of 6
Angular Velocity, Rad/s

60 accelerometers and measure resultant linear


50 acceleration of the head. This device is limited in
that only peak angular acceleration can be estimated
40
from an assumed pivot point in the neck. Resultant
30 angular velocities for concussive data points were
20 estimated from resultant angular accelerations using a
10 regression model. Details of the methods used for
data collection can be found in the literature (Duma
0
0 0.005 0.01 0.015 0.02 0.025 0.03
et al, 2005, Duma et al, 2009). Using the HIT
Time, s System, head acceleration data were recorded for 6
concussions between 2003 and 2008 (Duma et al,
Figure 5. Loading curve for the models in each 2009). These 6 concussions were combined with
direction. Note: The span and magnitudes of the concussive data collected from published studies that
curve were altered to generate various magnitudes of utilized identical data collection methods (Broglio et
CSDM and MPS. al, 2010, Guskiewicz et al, 2007). This resulted in a
dataset of 32 concussions. Using this data, Rowson et
Similarly to the procedure above, BrIC was evaluated al. (2012) constructed injury risk curves for
based on translational and rotational data obtained concussion using rotational acceleration and
from the college football players. Between 2007 and rotational velocity as independent variables.
2008, the helmets of 19 Virginia Tech football
players were instrumented with a custom 6 degree of RESULTS
freedom (6DOF) head acceleration measurement Comparison of the SIMon and GHBMC FE Head
device (Rowson et al, 2009). The measurement Models
device consisted of 12 accelerometers and recorded
linear and angular acceleration about each axis of the Figures 6 and 7 demonstrate the correlation between
head using a novel algorithm (Chu et al, 2006 ). Any results of GHBMC and SIMon models for CSDM
time an accelerometer exceeded 10 g during play, and MPS using animal tests. Pendulum tests show
data acquisition was automatically triggered and data similar high correlation between results of the two
were collected for 40 ms (including 8 ms of pre- models. Figure 8 shows the receiver-operator
trigger data). Once data collection was complete, characteristic (ROC) curve for both models using
data were wirelessly transmitted to a computer on the CSDM (0.25) as the injury criterion. The value of
sideline. Linear and angular head accelerations were 0.25 in parenthesis indicates the strain threshold for
recorded for a total of 4709 head impacts of which computing CSDM (Takhounts et al. 2008). The
362 had peak resultant linear accelerations greater SIMon model had an area under the ROC curve equal
Takhounts et al. / Stapp Car Crash Journal 57 (November 2013) 243-266 249

to 0.83 while the GHBMC model was slightly better 2.5


at 0.86. Using MPS as an injury criterion reduced the y = 0.93x
R = 0.99
area under the ROC curve to 0.78 for both models CV = 10.30%
2
(Figure 9). It should be noted that these values of area
under ROC curves are not the maximum obtainable
values for CSDM (Appendix 0, Figure 0.1). For 1.5

GHBMC
example, strain threshold of 0.10 gave the highest
value of the area under ROC curve (0.89) when these
1
strain thresholds were varied from 0.10 to 0.30 with
0.05 intervals. In choosing the strain threshold of
0.25 for CSDM calculations, area under ROC curves 0.5

as well as a set of statistical fit parameters for risk


curves evaluation, were considered. Statistical fit 0
parameters were best for strain thresholds of 0.25 and 0 0.25 0.5 0.75 1 1.25 1.5 1.75 2 2.25 2.5
0.30 (Appendix 0, Figures 0.2 - 0.6) that degraded SIMon

sharply for smaller and higher strain thresholds.


Hence, the strain threshold of 0.25 was chosen for Figure 7. Comparison of MPSs in animal tests
calculation of CSDM, which was the best between GHBMC and SIMon models.
compromise between the area under the ROC curve
and statistical fit parameters.

The risk curves for CSDM are given in Figure 10 and


for MPS in Figure 11. The CSDM value that
maximized sensitivity and specificity was equal to
0.65, which corresponded to approximately 69% risk
in Figure 10. The MPS value that maximized
sensitivity and specificity was equal to 0.97, which
corresponded to approximately 55% risk in Figure
11. While CSDM had better ROC for both models
and smaller error range for the Weibull shape
parameter (Table 1), MPS had better risk curves as
measured by the confidence intervals (Figure 11),
and its value that maximized the sensitivity and
specificity was closer to 50% risk. Max Log
Likelihood and the error ranges in the Weibull scale
parameters (Table 1) were comparable between the Figure 8. ROC curves for CSDM in animal tests for
two measures with slight variations depending on the GHBMC and SIMon models.
model.
1
y = 0.91x
0.9 R = 0.99
CV = 9.49%
0.8

0.7

0.6
GHBMC

0.5

0.4

0.3

0.2

0.1

0
0 0.2 0.4 0.6 0.8 1
SIMon

Figure 6. Comparison of CSDMs in animal tests Figure 9. ROC curves for MPS in animal tests for
between GHBMC and SIMon models. GHBMC and SIMon models.
250 Takhounts et al. / Stapp Car Crash Journal 57 (November 2013) 243-266

resultant angular acceleration, and max resultant


angular velocity) for each dummy in pendulum tests
are given in Appendix I (Figures I.1 through I.12).
Max pressure correlated best with max resultant
linear acceleration (R2 = 0.97, CV = 18.85%, Figure
I.2). CSDM correlated best with max resultant
angular velocity (R2 = 0.91, CV = 28.26%, Figure
I.8). MPS correlated best with max resultant angular
velocity (R2 = 0.98, CV = 14.39%, Figure I.12). The
R2 and CV values above are given when the data
from all dummies is lumped together.

The correlation between physical and kinematic


parameters was reduced when NCAP and frontal
offset data was added as shown in Figure 12 and
Table 2 below.
Figure 10. Risk of AIS 4+ anatomic brain injuries in
2
animal tests as a function of CSDM.
BrIC_R = 1.00*CSDM + 0.51
1.8 R = 0.64
CV = 21.86%
1.6

1.4

BrIC_R 1.2

0.8

0.6

0.4

0.2

0
0 0.2 0.4 0.6 0.8 1
CSDM

(a)

2
Figure 11. Risk of AIS 4+ anatomic brain injuries in BrIC_R = 1.12 * MPS
animal tests as a function of MPS. 1.8 R = 0.96
CV = 22.51%
1.6
Table 1. Weibull parameters for CSDM and MPS for
1.4
GHBMC and SIMon models along with the standard
errors (in parentheses) and Max Log Likelihood. 1.2
BrIC_R

1
Max Weibull Scale (Std Weibull Shape (Std
Case 0.8
LL Error) Error)

GHBMC-CSDM -36.88 0.53 (0.08) 1.19 (0.55) 0.6

SIMon-CSDM -34.26 0.60 (0.06) 1.80 (0.74) 0.4

GHBMC-MPS -35.90 0.92 (0.07) 2.32(0.74) 0.2


SIMon-MPS -34.90 1.01 (0.06) 2.84 (0.89) 0
0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1 1.1 1.2 1.3 1.4 1.5 1.6
Max Principal Strain

Pendulum Tests to Correlate Physical and


(b)
Kinematic Parameters
Figure 12. Correlation between (a) BrIC_R and
Correlations of physical (max pressure, CSDM, and CSDM and (b) BrIC_R and MPS for all dummies in
max principal strain) and kinematic parameters available tests (413 data points) where BrIC was
(HIC15, max resultant linear acceleration, max constructed using equation 3.
Takhounts et al. / Stapp Car Crash Journal 57 (November 2013) 243-266 251

Table 2. Calculated critical angular velocities using 0.9


RotX RotY
equation 3 for each dummy and combined for all 0.8 RotZ cut-off
dummies.
0.7

Dummy/ Critical Max Critical Max 0.6


Human Resultant R2 ( CV %) Resultant R2 (CV %)
(All Angular BrIC_R vs Angular BrIC_R. vs 0.5

CSDM
Available Velocity Based CSDM Velocity Based MPS
Tests) on CSDM, Rad/s on MPS, Rad/s
0.4
HIII-50 57.96 5.68 0.65 (17.47) 53.35 6.88 0.96 (21.15)
0.3
HIII-5 54.41 5.98 0.84 (13.18) 54.54 6.86 0.98 (15.08)
0.2
THOR 44.35 6.24 0.69 (16.81) 47.59 7.51 0.96 (20.24)
0.1
ES2 50.09 10.15 0.48 (26.29) 50.62 10.94 0.93 (28.33)
0
0 10 20 30 40 50 60 70 80
SID-IIs 62.44 6.71 0.72 (16.99) 59.23 5.77 0.98 (14.59)
Max Angular Velocity, Rad/s
WS-50 65.34 4.61 0.78 (8.41) 67.38 3.95 1.00 (7.20)

WS-5 69.63 4.05 0.89 (6.24) 68.4 5.55 0.99 (8.56)


(b)
VT-
45.18 4.91 0.82 (20.15) 37.19 2.06 0.99 (8.44)
Football
Figure 13. a) Risk of AIS 4+ anatomic brain injury
Combined 54.19 8.74 0.64 (21.86) 54.85 9.00 0.96 (22.51)
versus CSDM from SIMon model with the cut-off at
50% risk corresponding to CSDM value of 0.49; b)
CSDM versus max angular velocity relationships
Development of BrIC demonstrating that the same risk (at CSDM = 0.49) is
achieved at different max angular velocities in
The directional CSDM versus max angular velocity
different directions.
curves for the loading conditions shown in Figure 5
of the Methods section are given in Figure 13 b) Critical max angular velocities for each direction are
below, where critical max angular velocity for each given in Table 3.
direction was calculated such that it corresponded to
50% probability of AIS 4+ anatomic brain injuries Table 3. Critical max angular velocities in each
(this corresponded to CSDM = 0.49 in the SIMon direction based on CSDM, MPS, and their average.
model as shown in Figure 13 a)). Similar procedure Note: the values are the same for all ATDs (and
was followed to find MPS based critical max angular humans).
velocities in each direction, where MPS = 0.89 in the
SIMon model corresponded to 50% probability of
AIS 4+ anatomic brain injuries. Rad/s
Critical Max Rad/s Rad/s
(Average of
Angular Velocity (CSDM Based) (MPS Based)
CSDM and MPS)
1
x 66.20 66.30 66.25
0.9
Cut-Off
y
Probability of AIS 4+ Brain Injury

59.10 53.80 56.45


0.8 SIMon
z 44.25 41.50 42.87
0.7

0.6

0.5 These critical max angular velocities were then


0.4 evaluated for each tested dummy in both pendulum
0.3 tests described above and the available NCAP and
frontal offset tests (those equipped with either nine
0.2
accelerometer array or angular rate sensors). Using
0.1
the CSDM based critical angular velocities given in
0 Table 3 the critical values for BrIC at CSDM of 0.49
0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1
(50% probability of AIS 4+ anatomic brain injury)
CSDM
were computed to assess the possible error (e.g. how
much the calculated critical BrIC value deviated from
(a) the value of 1.0). Similar procedure was followed for
MPS. To reconcile the difference between CSDM
based and MPS based critical angular velocity values,
252 Takhounts et al. / Stapp Car Crash Journal 57 (November 2013) 243-266

the average was taken and critical value of BrIC was 2


BrIC = 1.08*CSDM + 0.52
also evaluated for both CSDM and MPS datasets 1.8 R = 0.84
based on these average values. Table 4 lists these CV = 13.18%
1.6
BrIC values for each ATD (and humans from the
1.4
college football players dataset) and for all the ATDs
combined. The difference between 1.0 and the values 1.2

in BrIC columns of Table 4 for each ATD gives an

BrIC
1
error associated with the use of the same critical
0.8
values of angular velocities. For example, the CSDM
0.6
based BrIC values for THOR, ES2 and Human are
equal to 1.0 (zero error), while those for SID-IIs and 0.4
WS-5 are 1.14 and 1.12 giving 14% and 12% errors 0.2
respectively. For all ATDs combined this error is 5%
0
for CSDM based BrIC (last row, BrIC = 1.05), and 0 0.2 0.4 0.6 0.8 1
6% for MPS based BrIC (last row, BrIC = 1.06). CSDM
Figure 14 (a) shows the correlation between BrIC and
CSDM, while Figure 14 (b) shows the correlation (a)
between BrIC and MPS. Note: the first approach in
2
calculating BrIC was adapted where max angular BrIC = 1.19*MPS
velocity in each direction was calculated irrespective 1.8 R = 0.98
CV = 15.27%
of the time it has occurred as the second approach did 1.6
not improve the correlation between BrIC and CSDM 1.4
(and MPS).
1.2
BrIC

Table 4. Calculated BrIC values for each dummy and 1

combined for all ATDs (and humans). 0.8

0.6

BrIC 2
R (CV %) 0.4
R2 (CV %) BrIC
(Average ( Average
( Average ( Average 0.2
ATD critical values, critical
critical values, critical values,
CSDM values, MPS
CSDM dataset ) MPS dataset ) 0
dataset) dataset )
HIII- 0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1 1.1 1.2 1.3 1.4 1.5 1.6
1.09 0.73 (13.86) 1.03 0.97 (17.95)
50th Max Principal Strain

HIII-5th 1.08 0.88 (12.30) 1.08 0.98 (14.75)

THOR 1.00 0.80 (15.99) 1.05 0.97 (19.09)


(b)

ES2 1.00 0.75 (13.73) 1.04 0.98 (16.11) Figure 14. Correlation between (a) BrIC and CSDM
and (b) BrIC and MPS for all dummies in available
SID-IIs 1.14 0.92 (7.37) 1.10 0.99 (7.83)
tests (413 data points) using formulation given in
WS-50 1.05 0.83 (7.10) 1.09 1.00 (5.40)
equation 4.

WS-5 1.12 0.98 (2.10) 1.10 1.00 (4.54) Development and Scaling of Risk Curves
Human 1.00 0.85 (19.63) 0.80 1.00 (7.44) The ratios i4, where i is the level of AIS of interest
All
1.05 0.84 (13.18) 1.06 0.98 (15.27)
based on equation 2, are given in Table 5 (reproduced
ATDs
from Takhounts et al., 2011).

Table 5. Ratios for computing risk curves for AIS1+,


2+, 3+, and 5+ based on known risk curve for AIS4+.

14 24 34 54
0.10 0.50 0.82 1.04

Using alternative method for calculating coefficients


where NASS-CDS data was used, three sets of
models associated respectively with AIS 3+, 4+, and
Takhounts et al. / Stapp Car Crash Journal 57 (November 2013) 243-266 253

5+ anatomic brain injuries were produced. In all Table 7. Ratios for expanding respective AIS 3+, 4+,
cases, occupant age, delta V, and percent overlap 5+ Injury Risk Curves.
were included in the models. Vehicle model year and
PDOF were not found to be significant predictors of Ratio - AIS Ratio - AIS Ratio - AIS
Curve Expansion Method
AIS 3+, 4+ or 5+ brain injuries. Table 6 lists the 4+ to 2+ 4+ to 3+ 4+ to 5+

model coefficients and the area under the ROC curve Current NASS-CDS Regression
NA 0.61 2.79
for the respective models. Note the area under the Models - AIS 1998
Current NASS-CDS Regression
ROC curve in all cases had values of 0.81 or greater. Models - AIS 2008, Low
NA 0.61 2.72

Current NASS-CDS Regression


NA 0.46 2.13
Models - AIS 2008, High
Table 6. AIS 3+, 4+, and 5+ Anatomic Brain Injury
Takhounts et al. (2011) - Expanded
Risk Models Frontal Crashes, NASS-CDS. HIC
0.5 0.82 1.04

NHTSA - Expanded Prasad-Mertz


0.41 0.67 1.29
HIC
Model Coefficients ROC
Curve
Model
(area
Intercept DV Age Overlap under)
The risk curves for CSDM, MPS and BrIC below are
AIS3+ -7.0798 0.0619 0.0258 -0.0254 0.87
scaled based on the same ratios as in Takhounts et al.
AIS
1998
AIS4+ -6.6144 0.0522 0.0205 -0.0291 0.87 (2011) given in Table 5. However, other expansions
AIS5+ -11.837 0.0975 0.0394 -0.0131 0.82 given in Table 7 may also be utilized.
AIS3+ -7.0798 0.0619 0.0258 -0.0254 0.87
To construct a risk curve for CSDM based on SIMon
AIS
2008 - AIS4+ -6.611 0.0525 0.0204 -0.0292 0.87 model one would have to use equation 1 along with
Low
the data given in the second row of Table 1 (this risk
AIS5+ -11.689 0.0974 0.0387 -0.0144 0.82
curve is given in Figure 10 for AIS 4+ anatomic brain
AIS3+ -6.8694 0.0581 0.0247 -0.0253 0.87 injuries). Figure 15 gives the set of risk curves for
AIS
2008 - AIS4+ -6.1674 0.041 0.0195 -0.0315 0.84 CSDM, where AIS 1+, 2+, 3+, and 5+ risk curves
High were obtained by scaling the AIS 4+ risk curve at a
AIS5+ -11.454 0.0925 0.0427 -0.0191 0.81
level of 50% probability of injury using coefficients
from Table 5. Similar procedure was used to obtain
risk curves based on MPS (Figure 16).
The models from Table 6 allow for estimates of the
difference in risk of AIS 3+, 4+ and 5+ anatomic AIS1 AIS2 AIS3
brain injury given a set of values of delta V, occupant AIS4 AIS5 95% CI AIS 4
1
age, and percent overlap. For example, if age is set
0.9
to 45 or roughly the average of the driving
population, and delta V and percent overlap values 0.8
Probability of Brain Injury

are representative of a frontal New Car Assessment 0.7


Program (NCAP) test at 60 kph and 100%, 0.6
respectively. The resulting AIS 3+, 4+ and 5+ 0.5
percent risk of anatomic brain injury is predicted to
0.4
be 0.86%, 0.4% and 0.42%, respectively, based on
0.3
AIS 1998 models. The average age, delta V, and
percent overlap of the AIS 3+ anatomic brain injury 0.2

cases was 48 years, 53 kph, 55%, respectively. The 0.1

AIS 3+, 4+ and 5+ predicted risk using these average 0


0 0.2 0.4 0.6 0.8 1
values was 1.9%, 1.1% and 0.4%, respectively CSDM

Table 7 compares the current AIS 3+, 4+, and 5+ Figure 15. CSDM based risk of brain injuries for
differences in risk as estimated at the average age, various severities.
delta V, and percent overlap values noted above
versus the 50% risk values from the expanded HIC
curves used by Takhounts et al. (2011) and the
expanded Prasad-Mertz HIC curves previously
described by NHTSA (NHTSA, 1995). It can be
seen that the percent difference varies significantly
depending on the method chosen with the ratio of
AIS 4+ to 3+ injury ranging from roughly 0.4 to 0.8.
254 Takhounts et al. / Stapp Car Crash Journal 57 (November 2013) 243-266

AIS1 AIS2 AIS3 AIS 1 AIS 2 AIS 3


AIS4 AIS5 95% CI AIS4 AIS 4 AIS 5 95% CI AIS4
1 1

0.9 0.9

0.8 0.8

Probability of Brain Injury


Probability of Brain Injury

0.7 0.7

0.6 0.6

0.5 0.5

0.4
0.4
0.3
0.3
0.2
0.2
0.1
0.1
0
0 0.5 0.75 1 1.25 1.5
0 0.5 1 1.5 2 BrIC
Max Principal Strain
Figure 18. BrIC based on CSDM and formulation
Figure 16. MPS based risk of brain injuries for given by equation 4 (average critical angular
various severities. velocities from Table 3).
AIS 1 AIS 2 AIS 3
The CSDM and MPS based BrIC risk curves for AIS AIS 4 AIS 5 95% CI AIS 4
4+ anatomic brain injuries were then obtained from 1
the linear relationships between CSDM 0.9
BrIC/BrIC_R, and MPS BrIC/BrIC_R respectively. 0.8
Prabability of Brain Injury

AIS 5+, 3+, 2+ and 1+ are obtained in the manner 0.7


similar to CSDM described above. Figures 17 and 19 0.6
show the Combined (Table 2) BrIC_R risk curves 0.5
with the use of Figure 12 and Equation 3. Figures 18
0.4
and 20 give the All ATDs (Table 4) BrIC risk
0.3
curves with the use of Figure 14 and Equation 4.
0.2
Appendix III gives equations for all the risk curves in
Figures 15 20 (Tables III.1 III.6). 0.1

0
AIS 1 AIS 2 AIS 3 0 0.5 1 1.5 2 2.5 3

AIS 4 AIS 5 95% CI AIS 4 BrIC_R


1

0.9
Figure 19. BrIC_R based on MPS and formulation
given by equation 3.
0.8
Probability of Brain Injury

AIS 1 AIS 2 AIS 3


0.7
AIS 4 AIS 5 95% CI AIS 4
0.6 1

0.5 0.9

0.4 0.8
Prabability of Brain Injury

0.3 0.7

0.2 0.6

0.1 0.5

0 0.4
0.5 0.75 1 1.25 1.5
0.3
BrIC_R
0.2

0.1
Figure 17. BrIC_R based on CSDM and formulation
0
given by equation 3. 0 0.5 1 1.5 2 2.5 3
BrIC

Figure 20. BrIC based on MPS and formulation given


by equation 4 (average critical angular velocities
from Table 3).
Takhounts et al. / Stapp Car Crash Journal 57 (November 2013) 243-266 255

DISCUSSION would translate to the injury severity in humans given


equivalent loading conditions.
The importance of head rotational kinematics as a
mechanism for brain injuries has been discussed in The second approach was adapted in this paper where
the scientific literature since the 1940s (Holbourn, already developed and validated finite element
1943, Gennarelli et al. 1972, Ueno and Melvin 1995). models of human head SIMon and GHBMC were
More recently, Hardy et al. 2001 and 2007, in the employed along with the injury criteria for DAI
experiments describing the motion of brain with CSDM and/or MPS. It should be noted that the term
respect to the overall motion of the skull, noted that DAI used in this paper is a generic term for a
angular velocity was the most convenient measure severe anatomic brain injury in the animal data. In
in describing relationship between brain and skull some cases it just corresponded to AIS 4+ brain
kinematics. Takhounts et al (2008) described that one injury (no skull fracture), in others it corresponded to
of the ways to deform/strain a soft, nearly a severe concussion in animals expressed in the
incompressible material (brain) contained within an length of unconsciousness (over 15 minutes for
almost undeformable shell (skull) is to rotate the miniature pigs and monkeys), or severe hematoma.
shell. It is assumed that at the equivalent severity level of
anatomic brain injury (AIS 4+) between humans and
Despite the overwhelming evidence of the head
animals, the equivalent kinetic inputs necessary to
rotational kinematics to be a mechanism for brain
produce these injuries in both species will scale
injuries, the difficulty was in relating animal injury
according to the equal stress equal velocity scaling
data (Abel et al. 1978; Gennarelli et al. 1982;
relationship (see Takhounts et al., 2003 and 2008 for
Stalnaker et al. 1977; Nusholtz et al. 1984; Stalnaker
detail on scaling). This is the only inter-species
et al. 1977; Meaney et al. 1993, Ommaya, 1985) to
assumption made herein, as opposed to Takhounts et
the potential for brain injuries in humans. One way to
al. (2003) where individual injury types in the
accomplish this is to find injury criteria for animals
animals (DAI, acute subdural hematomas, focal
and scale it to humans using various scaling
lesion, etc.) were linked to similar injury types in
relationships (Ommaya, 1985). The advantage of this
humans using the same scaling relationship. In other
approach is in its simplicity it is straightforward
words, the current approach assumes that the
and a criterion is easily computed. The disadvantage
relationship between anatomic brain injuries in
of the approach is also in its simplicity as it doesnt
humans and animals exists at the rather high end of
necessarily address the equivalency of the brain
the severity spectrum, e.g. AIS 4+. The advantage of
deformations (believed to be the primary cause of
this assumption is that once the link between
TBI) inside the brains of animals and humans.
humans and animals is given, the other levels of
Another approach for relating animal injury data to
severity (AIS 1+, 2+, 3+, and 5+) for humans may be
humans is to develop FE models of animals and
derived by other means that will involve only human
humans, find a scaling relationship between the two
data (intra-species scaling). Different approaches to
(Takhounts et al, 2003), and then develop a
accomplish this are given below when the severity
deformation/strain based criterion (CSDM or MPS)
scaling is discussed.
that would be equally applicable for both animals and
humans. The advantage of this approach is that it The same animal data was used to compare the
gives a link between deformation fields inside the CSDM and MPS computed by the two head models
brains of animals and humans and thus may be more SIMon and GHBMC. As figures 6 and 7 illustrate,
physically/biomechanically justifiable. Also, this CSDMs computed using SIMon and GHBMC
approach allows for introduction of new correlated to each other with R2 = 0.99 (CV =
information/data in addition to animal injury data, 9.49%), while MPSs correlated to each other with the
e.g. human data on brain material properties, brain R2 = 0.99 (CV = 10.30%) (Figures 6 and 7). The
deformations data neutral density target data, area under the ROC curve for CSDM using SIMon
pressure data, college football data, etc. This new model was 0.83 while it was slightly higher (0.86)
information not only allows for establishing of the when GHBMC model was used (Figure 8). The area
mechanisms of brain injury, but also synthesizes all under the ROC curve for MPS were equal to 0.78 for
the available information into one, physically both models (Figure 9) indicating that CSDM may be
meaningful criterion. The disadvantage of the a slightly better predictor of DAI in animal tests.
approach is that it requires a powerful computer and However, when risk curves were built for CSDM and
several hours of run time to calculate CSDM and/or MPS, MPS had narrower confidence intervals (and a
MPS. Both approaches, however, suffer from the lack better shape) than CSDM for both models (Figures
of knowledge of how the injury severity in animals 10 and 11). The Max Log Likelihoods for both
256 Takhounts et al. / Stapp Car Crash Journal 57 (November 2013) 243-266

models and injury measures (CSDM and MPS) were tests. R2 is only 0.22, and CV = 114.63%. However,
comparable (Table 1). Since there were no when each impact type was isolated where only
significant differences between the results of the two impact severity was varied, the correlations between
models all subsequent calculations were made using the two variables became very good (most R2 are
only SIMon model to save computer time and for the greater than 0.90, and CVs are substantially lower).
sake of consistency with the previous publications on For example, Figure II.2 demonstrates that for the
the subject (Takhounts et al., 2003, 2008, and 2011). padded pendulum impact at the head center of gravity
It should be noted, however, that only pressures, with 0 degrees angle (basically straight impact to the
CSDM and MPS were compared between the two nose) the correlation between CSDM and HIC15 is
models, and since the resolution of the GHBMC head quite high (R2 = 0.92, CV= 17.78%). Similar values
model is much greater than that of the SIMon model of the correlation coefficients were observed in all
it is expected that the difference between the models the other impact conditions (Figures II.3 -II.6) with
may be more pronounced when local strains and the exception of the 30 degrees padded impacts at
stresses are investigated. head CG (Figure II.7) where correlation coefficient
was R2 = 0.25 (CV = 37.04%), spoiled by one test.
Next, it was necessary to establish relationship This example demonstrates that for similar test
between the physical parameters (CSDM, MPS and conditions (impact angles, location, padding, etc.)
max pressure) with the kinematic parameters: HIC15, there is high correlation between two seemingly
max resultant linear acceleration, max resultant linear different head/brain injury criteria HIC and CSDM.
velocity, max resultant angular accelerations and max Similarly, correlations between CSDM and max
resultant angular velocity. Previously (Takhounts et linear acceleration and even max angular acceleration
al., 2011) this was done using available NCAP test were improved when restrained to a specific testing
data where good correlations was hard to establish mode, although these correlations were not as good
due to limited range of impact severities. To fill this as the one with HIC.
gap in impact severities, lab controlled pendulum
impacts to the heads of various dummies at different Pendulum tests demonstrated that max resultant
impact locations and angles (padded and unpadded) angular acceleration did not correlate to any physical
were conducted, where impact severities were parameter CSDM, MPS, or max pressure, and
controlled by varying calculated HIC15 values (from hence should be excluded from the BrIC formulation
200 to 1,800). Appendix I demonstrates the described in Takhounts et al. (2011) and only max
relationships between CSDM, MPS, and max resultant angular velocity should be retained in the
pressure with the kinematic parameters for all new formulation (equation 3). Furthermore, between
dummies combined. It is clear that both CSDM and the two physical parameters (CSDM and MPS), MPS
MPS correlated best with the max resultant angular correlated to max resultant angular velocity better (R2
velocity with MPS having better correlation (R2 = = 0.98, CV = 14.39%) than CSDM (R2 = 0.91, CV =
0.98, CV = 14.39%, Figure I.12) than CSDM (R2 = 28.26%,). However, when NCAP and frontal offset
0.91, CV = 28.26%, Figure I.8). Max pressure test data were added to the pendulum tests, the
correlated better with the max resultant linear correlation between max resultant angular velocity
acceleration (R2 = 0.97, CV = 18.85%, Figure I.2) and CSDM dropped from 0.91 to 0.64 (CV improved
and HIC15 (R2 = 0.93, CV = 28.84%, Figure I.1). It from 28.26% to 21.86%, Figure 12 (a)), and with
is worthwhile noticing that max resultant angular MPS from 0.98 to 0.96 (CV dropped from 14.39% to
acceleration didnt correlate to any physical 22.51%, Figure 12 (b)). This drop in correlation was
parameter with CV values ranging from 42.61% for thought due to the mostly in plane motion of the head
max pressure to 91.61% for CSDM. in pendulum impacts, while head motion in most
NCAP and frontal offset tests were more complicated
Interesting observations were made regarding the resulting in 3-dimensional head motion. This is
correlation between CSDM and HIC15. As Figure I.5 important because there may be difference in
of Appendix I illustrates, when the data from all the tolerance levels of the brain (as expressed via CSDM
dummies are combined there is no correlation and MPS) in different directions. This hypothesis was
between the two variables (R2 = 0.08, CV = 88.23%). tested using BrIC formulation expressed by equation
The test data from the HIII 50th male dummy was (4), where different critical values of angular
then further investigated (there were more data points velocities were derived for different directions using
for this dummy, and it was tested at more impact procedure described in the Introduction and Methods.
locations and angles, padded/unpadded). Figure II.1 Two approaches were used for calculating BrIC from
of Appendix II shows the correlation between CSDM equation (4): (1) max angular velocity in each
and HIC15 for all HIII 50th male pendulum dummy direction was calculated irrespective of the time they
Takhounts et al. / Stapp Car Crash Journal 57 (November 2013) 243-266 257

have occurred, and (2) the time of the max said, the scaling ratios may not be final as the NASS-
component of angular velocity that contributes to the CDS method may be refined in the future, which is
BrIC the most was noted and the other two the subject of another, more in depth, research on the
components calculated at that time. Using the first subject.
approach the correlation between BrIC and CSDM
improved from 0.64 (CV = 21.86%) to 0.84 (CV = Once CSDM and MPS risk curves were obtained and
13.18%) as shown in Figures 12(a) and 14 (a), and scaled for various AIS levels (using the same method
between BrIC and MPS from 0.96 (CV = 22.51%) to as in Takhounts et al., 2011), BrIC risk curves were
0.98 (CV = 15.27%) as shown in Figures 12(b) and obtained using formulations given by equations 3
14(b). The second approach did not improve this (Figure 12) and 4 (Figure 14), where BrIC was set to
correlation, and the first approach was adapted where the value of 1.0 to correspond to 50% probability of
max angular velocity in each direction was calculated AIS 4+ injury. The risk curves for equation (3)
irrespective of the time it has occurred. There were formulation were necessary to compare with the
two sets of the max critical angular velocity previously published data for concussion in college
components one is derived using CSDM, the other football players (Rowson et al., 2012) and in scaled
using MPS (Table 3). Although the trend is similar, monkey data (Ommaya, 1985) as the resultant max
e.g. both sets have the lowest value for z-direction angular velocity was used in the these studies.
and highest in x-direction, there are still differences However, it is recommended that the equation (4)
nevertheless. To reconcile these differences, the based formulation of BrIC and the corresponding risk
average of the two critical values in each direction curves are used in the future as this formulation
was also tested and the correlation between the BrIC provides better correlation with both CSDM and
and CSDM and BrIC and MPS did not change. MPS.

Next, scaling of the risk curves for CSDM and MPS Rowson et al. (2012) gave a risk curve for
from AIS 4+ up to AIS 5+ and down to AIS 3+, 2+ concussions in college football players based on the
and 1+ was performed based on the process described max resultant angular velocity. Based on their
in Takhounts et al. (2011). This process was based on estimate, 50% probability of concussions was at max
the assumption that BrIC severity ratios would be resultant angular velocity value of 28.3 rad/s.
similar to those derived for HIC (NHTSA, 1995) at a Assuming that these concussions are represented by
50% probability of injury. There may be other ways the AIS2+ risk curve (Figure 19), BrIC value at 50%
to scale risk curves for different severities. One of probability of AIS2+ is 0.50. Since this risk curve
them is to use NASS-CDS data to estimate the risk of was derived from combined dataset, the critical value
anatomic brain injuries at various severities. This for max resultant angular velocity for combined
process is complicated, however, when translating dataset is 54.85 rad/s (last row of Table 2 for MPS).
AIS 1998 codes to the latest AIS 2008 codes for Multiplying BrIC of 0.50 by the critical value of
anatomic brain injuries resulting in two possible sets 54.85 rad/s will give the value of the max resultant
of scaling parameters (Table 7), especially for scaling angular velocity for the 50% probability of AIS2+
from AIS4+ to AIS5+. Another observation is that brain injury. This value is 27.43 rad/s, which is
the scaling ratios for AIS 4+ to AIS 3+ varied comparable to the similar risk of concussion in
substantially depending on the method used. At one college football players.
end of the range are the two HIC-based scaling ratios
(last two rows in Table 7) with this ratio varying Ommaya (1985) gave an overview of the rotational
from 0.67 to 0.82, while NASS-CDS based method injury tolerance values for the onset of concussion
gave the range of 0.46 to 0.61 (first 3 rows of Table based on the research conducted on rhesus monkeys
7). It was decided to provide the risk curves based on and chimpanzees. The human rotational tolerances
the Takhounts et al. (2011) the method based on the were obtained using a mass scaling relationship for
existing HIC ratios, for two reasons (although risk angular accelerations (inversely proportional to the
curves based on the other methods could also be two-thirds power of the brain mass) giving angular
obtained based on the information given within body velocity and acceleration tolerances for human of 20
of this paper): 1) NASS-CDS method did not provide 30 rad/s and 1,800 rad/s2 respectively. Inserting
a reliable scaling ratio for AIS 2+ (and AIS 1+) risk these tolerance values into equation (3) and using
curve, which was used to relate to the concussion critical value for MPS from the last row of Table 2
data (see discussion below); 2) ratio for calculating will give BrIC values between 0.36 (for angular
AIS 3+ risk curve based on the NASS-CDS method velocity of 20 rad/s) and 0.55 (for angular velocity of
(rows 1-3 in Table 7) are smaller than that for AIS 2+ 30 rad/s). Referring to the AIS2+ risk curve for MPS
ratio based on HIC-scaling (row 4 in Table8). That (Figure 19) will give a risk of concussion ranging
258 Takhounts et al. / Stapp Car Crash Journal 57 (November 2013) 243-266

from 25% - 59% depending on the chosen tolerance accuracy of these values may be questioned. In
value of angular velocity. addition, clinical assessment of concussion is not
well standardized that may contribute to additional
In both examples above the formulation of BrIC measuring errors.
based on MPS was chosen. This is due to the fact that
BrIC and BrIC_R risk curves based on MPS (Figures Fifth, regarding scaling of the animal
19 and 20) start at (0, 0) point while the BrIC and tolerances to those of humans, it is interesting to give
BrIC_R risk curves based on CSDM dont (Figures a quote from Ommaya (1985): It should be
17 and 18). This is due to the nature of CSDM reemphasized that this information (rotational
calculation that starts at a non-zero value of angular tolerances) is considered to be reliable for the
velocity. Because of this feature of CSDM, it was Rhesus, sketchy for the chimpanzee, and completely
deemed more appropriate to use MPS-derived risk speculative for man. He then suggests revising the
curves for BrIC. human rotational tolerances when the data from
accident reconstruction in humans become available.
There are many limitations in this study, most of College football data may be considered as one of
which have been discussed above. These are: these accident reconstruction data.
First, all the limitations that were applicable Finally, BrIC is a rotational injury criterion
in the development and validation of SIMon finite (see second limitation), while HIC is a translational
element head model (Takhounts et al, 2003, 2008) injury criterion (calculated using translational
are applicable to this paper as well. In addition, accelerations only), and combining the two may
correlation between CSDM/MPS and BrIC is not better capture head injuries. However, a human head
perfect and will add additional errors to the injury is rarely experiencing just rotational or just
risk estimates. It should be noted, however, that translational motion. It usually is experiencing both.
similar limitations are applicable to any research Furthermore, when direct impact to the head is
computational and/or experimental. present, skull deformation may play a role in brain
injuries (Nusholtz et al. 1984), especially for a
Second, only DAI type anatomic brain younger population. This paper does not address this
injuries in animals were investigated in this study. combination of both modes of motion (rotational and
Inclusion of other types of TBI, such as focal lesions, translational) and corresponding (combined) injury
contusions, etc. may change the relationship for mechanisms. Neither does it address possible injuries
BrIC, especially at the lower severity of injury due to skull deformation. These will have to be
spectrum. However, BrIC is not an ultimate head investigated in the future.
injury criterion that captures all possible brain
injuries and skull fractures, but rather a correlate to a Despite the limitations that are inherent in any
subset of TBI with head rotation believed to be a research, this paper provides valuable information on
primary injury mechanism. the importance of limiting rotational kinematics of
the human head that may be beneficial to both
Third, deriving CSDM, MPS and BrIC risk athletes and the general driving population.
curves for various AIS levels based on ratios between
50% risks for different AIS levels for HIC assumes It should be noted that the primary purpose of this
that rotationally induced injury severities change manuscript was to present the development of BrIC
proportionally to those induced translationally (which and the associated injury risk functions. The value of
on their own may not be accurate see other possible BrIC = 1.0 is not proposed as an Injury Assessment
methods of deriving these ratios). This assumption Reference Value (IARV) at this time. More work is
may or may not be correct, but due to lack of any necessary before an IARV can be proposed. Among
data on rotational based changes in injury severity other things, this work includes reviewing the field
this assumption provides a first approximation of data, simulating some of the cases from the field,
these changes. Other methods of such severity examining potential countermeasures, and evaluating
scaling should be investigated in the future the benefits when a restraint system is optimized for
BrIC alone, HIC alone, or BrIC and HIC combined.
Fourth, although very valuable, the college
football data has its own limitations: athletes are CONCLUSIONS
trained to sustain higher loads, the average concussed
angular velocity and acceleration were calculated Following are the conclusions of the paper:
from the 5 DOF measuring system rather than
measured directly by the 6 DOF system, thus the
Takhounts et al. / Stapp Car Crash Journal 57 (November 2013) 243-266 259

Two different validated human head/brain Conference, pp. 145-163. Society of Automotive
finite element models were used in the Engineers, Warrendale, PA.
developments of BrIC SIMon and Broglio, S.P., Schnebel, B., Sosnoff, J.J., Shin, S.,
GHBMC. Both models showed similar Fend, X., He, X., and Zimmerman, J. (2010)
results. Biomechanical properties of concussions in high
Angular velocity correlated to two physical school football. Med Sci Sports Exerc, 42(11):
parameters CSDM and MPS, and is the 2064-71.
only component of BrIC. Angular CDC, National Center for Injury Prevention and
acceleration did not correlate well to any Control (2003) Traumatic Brain Injury Facts,
physical parameter and hence was excluded http://www.cdc.gov/ncipc/factsheets/tbi.htm.
from the BrIC formulation. Chu, J. J., Beckwith, J. G., Crisco, J. J., and
The critical values for angular velocity are Greenwald, R. (2006) A Novel Algorithm to
directionally dependent, and are independent Measure Linear and Rotational Head Acceleration
of the ATD used for measuring them. Using Single-Axis Accelerometers. in World
MPS based risk curves are recommended to Congress of Biomechanics, Munich, Germany.
use for BrIC based on the formulation given Duma, S.M., Manoogian, S.J., Bussone, W.R.,
by equation (4) (Figure 20 and Table III.6 of Brolinson, P.G., Goforth, M.W., Donnenwerth,
Appendix III). J.J., Greenwald, R.M., Chu, J.J., and Crisco, J.J.
(2005) Analysis of real-time head accelerations in
ACKNOWLEDGMENTS collegiate football players. Clin J Sport Med,
The views and opinions expressed in this manuscript 15(1): 3-8.
are those of the authors only and not necessarily of Duma, S.M. and Rowson, S. (2009) Every newton
NHTSA. The authors would like to acknowledge hertz: A macro to micro approach to investigating
Scott Gayzik of the Wake Forest University and brain injury. Conf Proc IEEE Eng Med Biol Soc, 1:
Liying Zhang of the Wayne State University for their 1123-6.
help with the GHBMC head model.
Eigen, A. M. and Martin, P. G. (2005) Identification
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On the Development of the SIMon Finite Element 1


CSDM_0.10
Head Model. Stapp Car Crash Journal 47: 107-133. 0.9

Probability of AIS 4+ Anatomic Brain Injury


95% CI
Takhounts, E.G., Crandall, J.R., Darvish, K.K. 0.8

(2003b) On the importance of nonlinearity of brain 0.7


tissue under large deformations. Stapp Car Crash 0.6
Journal 47:79-92.
0.5

Takhounts, E.G., Hasija, V., Ridella, S.A., Tannous, 0.4


R.E., Campbell, J.Q., Malone, D., Danelson, K., 0.3
Stitzel, J., Rowson, S., Duma, S, (2008)
0.2
Investigation of Traumatic Brain Injuries Using the
Next Generation of Simulated Injury Monitor 0.1

(SIMon) Finite Element Head Model. Stapp Car 0


0 0.2 0.4 CSDM 0.6 0.8 1
Crash Journal 52: 1-32.
Takhounts, E.G., Hasija, V., Ridella, S.A., Rowson, Figure 0.2. Risk of AIS 4+ anatomic brain injuries in
S, Duma, S.M. (2011) Kinematic Rotational Brain animal tests as a function of CSDM (strain threshold
Injury Criterion (BRIC). Proc. 22nd ESV = 0.10).
Conference. 1
CSDM_0.15
0.9

Probability of AIS 4+ Anatomic Brain Injury


Trosseille, X., et al. (1992) Development of a F.E.M. 95% CI

of the Human Head According to a Specific Test 0.8

Protocol, 36th Stapp Car Crash Conference 0.7


Proceedings, SAE Paper No.922527. 0.6

Ueno, K., and Melvin, J.W. (1995) Finite element 0.5

model study of head impact based on hybrid III 0.4


head acceleration: The effects of rotational and 0.3
translational accelerations. J. Biomech Eng.
0.2
117(3): 319-328.
0.1

APPENDIX 0 0
0 0.2 0.4 0.6 0.8 1
CSDM
1

0.9
Figure 0.3. Risk of AIS 4+ anatomic brain injuries in
animal tests as a function of CSDM (strain threshold
0.8
= 0.15).
0.7
1
0.6
Sensitivity

CSDM_0.20
0.9
Probability of AIS 4+ Anatomic Brain Injury

0.5 95% CI

CSDM_0.10, A=0.89 0.8


0.4
CSDM_0.15, A=0.88 0.7
0.3
CSDM_0.20, A=0.86 0.6
0.2
CSDM_0.25, A=0.83
0.1 0.5
CSDM_0.30, A=0.80
0 0.4
0 0.2 0.4 0.6 0.8 1
1-Specificity 0.3

0.2
Figure 0.1. ROC curves for various thresholds of
0.1
CSDM with associated areas under the ROC curve.
0
0 0.2 0.4 0.6 0.8 1
CSDM

Figure 0.4. Risk of AIS 4+ anatomic brain injuries in


animal tests as a function of CSDM (strain threshold
= 0.20).
262 Takhounts et al. / Stapp Car Crash Journal 57 (November 2013) 243-266

1 500
CSDM_0.25 y = 0.23x
0.9 450 R = 0.93
Probability of AIS 4+ Anatomic Brain Injury

95% CI
CV=28.84%
0.8 400

0.7 350

Max Pressure, Kpa


300
0.6
250
0.5
200
0.4
150
0.3
100
0.2
50
0.1
0
0 0 200 400 600 800 1000 1200 1400 1600 1800 2000
0 0.2 0.4 0.6 0.8 1 HIC 15
CSDM

Figure 0.5. Risk of AIS 4+ anatomic brain injuries in Figure I.1. Max Pressure versus HIC15.
animal tests as a function of CSDM (strain threshold
500
= 0.25). y = 0.90x
450 R = 0.97
CV=18.85%
1 400
CSDM_0.30
0.9 95% CI
350
Probability of AIS 4+ Anatomic Brain Injury

Max Pressure, Kpa


0.8 300

0.7 250

0.6 200

0.5 150

0.4 100

0.3 50

0.2 0
0 50 100 150 200 250 300 350 400 450 500
0.1 Max Resultant Linear Acceleration, G

0
0 0.2 0.4 0.6 0.8 1
CSDM
Figure I.2. Max Pressure versus Max Resultant
Linear Acceleration.
Figure 0.6. Risk of AIS 4+ anatomic brain injuries in
700
animal tests as a function of CSDM (strain threshold y = 0.01x
= 0.30). 600
R = 0.84
CV=42.61%

APPENDIX I 500
Max Pressure, Kpa

Below are correlation figures between physical (max


400
pressure, CSDM, and max principal strain) and
kinematic parameters (HIC15, max resultant linear 300
acceleration, max resultant angular acceleration, and
max resultant angular velocity) for pendulum tests for 200
all ATDs - Hybrid III 50th Male, Hybrid III 5th
Female, THOR 50th Male, ES-2re, SID-IIs, 100
WorldSID 50th Male, and WorldSID 5th Female.
0
0 10000 20000 30000 40000
Max Resultant Angular Acceleration, Rad/s2

Figure I.3. Max Pressure versus Max Resultant


Angular Acceleration.
Takhounts et al. / Stapp Car Crash Journal 57 (November 2013) 243-266 263

500 0.7
y = 3.92x
450 R = 0.73
CV=54.81% 0.6
400
y = -2E-06x + 0.22
0.5
350 R = 0.00
CV=91.61%
Max Pressure, Kpa

300 0.4

CSDM
250
0.3
200
0.2
150

100 0.1

50
0
0 0 5000 10000 15000 20000 25000 30000 35000 40000
0 10 20 30 40 50 60 70 80 90 100
-0.1
Max Resultant Angular Velocity, Rad/s Max Resultant Angular Acceleration, Rad/s2

Figure I.4. Max Pressure versus Max Resultant Figure I.7. CSDM versus Max Resultant Angular
Angular Velocity. Acceleration.

0.7 0.9
y = 0.0001x + 0.09 y = 0.01x - 0.30
R = 0.08 0.8 R = 0.91
0.6 CV=88.23% CV=28.26%
0.7
0.5
0.6

0.4 0.5
CSDM

0.4
CSDM

0.3
0.3
0.2 0.2

0.1 0.1

0
0 0 20 40 60 80 100
0 500 1000 1500 2000 -0.1

-0.1 -0.2
HIC15 Max Resultant Angular Velocity, Rad/s

Figure I.5. CSDM versus HIC15. Figure I.8. CSDM versus Max Resultant Angular
Velocity.
0.7
1.8
y = -0.0001x + 0.22 y = 0.0007x
0.6 1.6
R = 0.00 R = 0.84
CV=91.74% CV=41.90%
1.4
0.5
1.2
0.4
Max Principal Strain

1
CSDM

0.3 0.8

0.6
0.2
0.4

0.1 0.2

0
0 0 200 400 600 800 1000 1200 1400 1600 1800 2000
0 50 100 150 200 250 300 350 400 450 500 -0.2
-0.1
Max Resultant Linear Acceleration, G -0.4
HIC15

Figure I.6. CSDM versus Max Resultant Linear Figure I.9. MPS versus HIC15.
Acceleration.
264 Takhounts et al. / Stapp Car Crash Journal 57 (November 2013) 243-266

1.6 APPENDIX II
y = 0.0026x
1.4 R = 0.87 0.6
CV=36.95%
y = 0.0002x - 0.03
1.2 R = 0.22
0.5
CV=114.63%
Max Principal Strain

1 0.4

0.8 0.3

CSDM
0.6 0.2

0.4
0.1

0.2
0
0 500 1000 1500 2000
0
0 100 200 300 400 500 -0.1
Max Resultant Linear Acceleration, G
-0.2
HIC 15
Figure I.10. MPS versus Max Resultant Linear
Acceleration.
Figure II.1. CSDM vs. HIC 15 for HIII 50th percentile
2
male ATD (all impact conditions).
1.8 y = 4E-05x
R = 0.77 0.6
CV=49.81% y = 0.0002x + 0.05
1.6 R = 0.92
CV=17.78%
1.4 0.5
Max Principal Strain

1.2
0.4
1
CSDM

0.8 0.3
0.6

0.4 0.2

0.2
0.1
0
0 5000 10000 15000 20000 25000 30000 35000 40000
Max Resultant Angular Acceleration, Rad/s2 0
0 500 1000 1500 2000
HIC 15
Figure I.11. MPS versus Max Resultant Angular
Acceleration.
Figure II.2. CG, 0 degrees, padded.
1.4
y = 0.01x
R = 0.98 0.045
1.2 CV=14.39% y = 2E-05x - 0.01
0.04 R = 0.96
CV=17.52%
0.035
1
Max Principal Strain

0.03
0.8 0.025

0.02
CSDM

0.6
0.015

0.4 0.01

0.005
0.2
0
0 500 1000 1500 2000
0 -0.005
0 20 40 60 80 100
Max Resultant Angular Velocity, Rad/s -0.01
HIC15

Figure I.12. MPS versus Max Resultant Angular


Figure II.3. CG, 0 degrees, unpadded.
Velocity.
Takhounts et al. / Stapp Car Crash Journal 57 (November 2013) 243-266 265

0.045 0.6
y = 3E-05x - 0.01 y = 0.0001x + 0.19
0.04 R = 0.92 R = 0.25
CV=22.16% CV=37.04%
0.035 0.5

0.03
0.4
0.025

CSDM
0.02
CSDM

0.3
0.015

0.01 0.2

0.005
0.1
0
0 500 1000 1500 2000
-0.005
0
-0.01 0 500 1000 1500 2000
HIC15 HIC15

Figure II.4. Forehead, 0 degrees, unpadded. Figure II.7. CG, 30 degrees, padded.

0.3
y = 0.0001x + 0.01

0.25
R = 0.90
CV=18.08%
APPENDIX III

0.2
Table III.1. Risk curve equations for Figure 15.
CSDM

0.15
1.8
( 1) = 1 0.060
0.1
1.8
( 2) = 1 0.300
0.05
1.8
( 3) = 1 0.490
0 1.8
0 500 1000
HIC15
1500 2000
( 4) = 1 0.600
1.8
Figure II.5. Forehead, 0 degrees, padded. ( 5) = 1 0.624

0.09 Table III.2. Risk curve equations for Figure 16.


y = 9E-05x - 0.02
0.08 R = 0.96
CV=9.82% 2.84
0.07 ( 1) = 1 0.101
2.84
0.06
( 2) = 1 0.505
0.05 2.84
CSDM

( 3) = 1 0.828
0.04
2.84
0.03 ( 4) = 1 1.010
2.84
( 5) = 1 1.050
0.02

0.01

0
0 200 400 600 800 1000 1200
HIC15

Figure II.6. CG, 30 degrees, unpadded.


266 Takhounts et al. / Stapp Car Crash Journal 57 (November 2013) 243-266

Table III.3. Risk curve equations for Figure 17. Table III.5. Risk curve equations for Figure 19.

0.51 1.8 2.84


( 1) = 1 0.060

( 1) = 1 0.113
0.51 1.8 2.84
( 2) = 1 0.301

( 2) = 1 0.567
0.51 1.8 2.84
( 3) = 1 0.493

( 3) = 1 0.929
0.51 1.8 2.84
( 4) = 1 0.601

( 4) = 1 1.134
0.51 1.8 2.84
( 5) = 1 0.625

( 5) = 1 1.179

Table III.4. Risk curve equations for Figure 18. Table III.6. Risk curve equations for Figure 20.

0.523 1.8 2.84


( 1) = 1 0.065

( 1) = 1 0.120
0.523 1.8 2.84
( 2) = 1 0.324

( 2) = 1 0.602
0.523 1.8 2.84
( 3) = 1 0.531

( 3) = 1 0.987
0.523 1.8 2.84
( 4) = 1 0.647

( 4) = 1 1.204
0.523 1.8 2.84
( 5) = 1 0.673

( 5) = 1 1.252