Search

Chiari malformation is characterised by the herniation of the cerebellar tonsils through the foramen magnum. However, tonsillar herniation and other 2D morphometric measurements of the posterior cranial fossa (PCF) have a weak association with patients' symptoms and clinical outcomes. This study aimed to contrast current 2D metrics with a novel 3D shape analysis of the PCF and the hindbrain, to determine if 3D measurements provides further insight into the pathophysiology of Chiari. The cranium of 12 controls and 21 Chiari malformation patients with (N = 9) and without (N = 12) a syrinx were scanned. The morphology of the PCF was quantified with typical 2D measurements. Additionally, a correspondence-based shape model that normalised the PCF volume, was used to find 3D differences in the shape of the PCF, and the distance of the hindbrain from the inner surfaces of the PCF. Shape analysis showed that, compared to controls, the caudal (p = 0.007; 2.3 mm, IQR: 1.6-3.3 mm) and anterior (p = 0.027; 1.3 mm,IQR: 1.1-1.6 mm) surfaces of the hindbrain were closer to the PCF in patients with and without a syrinx, respectively. However, there were negligible differences in the shape of the PCF between patient groups (p 0.39). Current morphometric measures should be normalised for variation in PCF volume, so that shape measures are not biased. The reduced CSF space between the hindbrain and PCF will alter CSF dynamics, which may compress cerebellar vasculature and contribute to patient symptomatology.

Cerebrospinal fluid (CSF) enters nervous tissues through perivascular spaces. Flow through these pathways is important for solute transport and to prevent fluid accumulation. Syringomyelia is commonly associated with subarachnoid space obstructions such as Chiari I malformation. However, the mechanism of development of these fluid-filled cavities is unclear. Studies have suggested that changes in the arterial and CSF pressures could alter normal perivascular flow. This study uses an idealised model of the perivascular space to investigate how variation in the arterial pulse influences fluid flow. The model used simulated subarachnoid pressures from healthy controls (N = 9), Chiari patients with (N = 7) and without (N = 8) syringomyelia. A parametric analysis was conducted to determine how features of the arterial pulse altered flow. The features of interest included: the timing and magnitude of the peak displacement, and the area under the curve in the phases of uptake and decline. A secondary aim was to determine if the previously observed differences between subject groups were sensitive to variation in the arterial pulse wave. The study demonstrated that the Chiari patients without a syrinx maintained a significantly higher level of perivascular inflow over a physiologically likely range of pulse wave shapes. The analysis also suggested that age-related changes in the arterial pulse (i.e. increased late systolic pulse amplitude and faster diastolic decay), could increase resistance to perivascular inflow affecting solute transport.

Information on pediatric brain tissue mechanical properties and, more pertinently, how they change during postnatal development remains scarce despite its importance to investigate mechanisms of neural injury. The aim of this study is to determine whether brain mechanical properties change in-vivo during early postnatal development in a rat model. Rat brain viscoelastic properties were measured longitudinally in ten healthy Sprague Dawley rats at five different time points from postnatal week one to week six using magnetic resonance elastography at 800Hz. Myelination and cell density were assessed histologically at the same time points to understand how the underlying tissue microstructure may be associated with changes in mechanical properties at different brain regions. Longitudinal changes in each variable were assessed using a generalized linear model with pairwise comparisons of means between weeks. The brain shear modulus in the cortical gray matter at postnatal week one was 6.3±0.4kPa, and increased significantly from week one to week two (pairwise comparison, p

Characterising the passive anisotropic properties of soft tissues has been largely limited to the linear viscoelastic regime and shear loading is rarely done in the large deformation regime, despite the physiological significance of such properties. This paper demonstrates the use of eccentric rheology, which allows the anisotropy of skeletal muscle to be investigated. The large amplitude oscillatory strain properties of skeletal muscle were also investigated using Fourier Transform-rheology. Histology was used to qualitatively assess the microstructure changes induced by large strain. Results showed that skeletal muscle was strongly anisotropic in the linear regime. The storage and loss moduli were found to be significantly different (p

Syringomyelia is associated with Chiari I malformation, although the mechanistic link is unclear. Studies have suggested that cerebrospinal fluid enters the spinal cord via the perivascular spaces, and that changes in the timing of the subarachnoid pressures may increase flow into the spinal cord. This study aims to determine how Chiari malformation and syringomyelia alter the subarachnoid space pressures and hence perivascular flow. Subject-specific models of healthy controls (N = 9), Chiari patients with (N = 7) and without (N = 8) syringomyelia, were developed from magnetic resonance imaging (MRI), to simulate the subarachnoid pressures. These pressures were input to an idealised model of the perivascular space to evaluate potential differences in perivascular flow. Peak pressures in Chiari patients without a syrinx were higher than in controls (46% increase; p = .029) and arrived earlier in the cardiac cycle than both controls (2.58% earlier; p = .045) and syrinx patients (2.85% earlier; p = .045). The perivascular model predicted Chiari patients without a syrinx would have the greatest flow into the cord (p .05) if the arterial pulse delay was between 4 and 10% of the cardiac cycle. Using phase-contrast MRI the mean arterial delay for all subjects was similar, and was estimated as 4.7 ± 0.2%. The perivascular pumping rate showed a strong positive correlation (R

The pathogenesis of syringomyelia in association with Chiari malformation (CM) is unclear. Studies of patients with CM have shown alterations in the CSF velocity profile and these could contribute to syrinx development or enlargement. Few studies have considered the fluid mechanics of CM patients with and without syringomyelia separately. Three subject-specific CFD models were developed for a normal participant, a CM patient with syringomyelia and a CM patient without syringomyelia. Model geometries, CSF flow rate data and CSF velocity validation data were collected from MRI scans of the 3 subjects. The predicted peak CSF pressure was compared for the 3 models. An extension of the study performed geometry and flow substitution to investigate the relative effects of anatomy and CSF flow profile on resulting spinal CSF pressure. Based on 50 monitoring locations for each of the models, the CM models had significantly higher magnitude (p

Characterising soft biological tissues outside the linear viscoelastic regime is challenging due to their complex behaviour. In addition, the viscoelastic properties of tissues have been shown to be sensitive to sample preparation and loading regime resulting in inconsistent data varying by orders magnitude in the literature. This paper presents a novel technique to characterise the non-linear behaviour of tissues which uses Fourier Transformation to decompose the stress output waveform under large amplitude oscillatory shear (LAOS) into harmonic contributions. The effect of varying preload, the compressive strain exerted on a liver tissue specimen prior to shear testing to minimise slip, was also investigated. Results showed that in the linear regime, preload affects the viscoelastic response of liver. Histological analysis indicated that there were structural changes as a result of the preload that may be linked to the differences in observed behaviour. Fourier analysis was used to extract the first and third harmonic components of the shear moduli at large strain. At 50% shear strain, a change in the third harmonic component of the shear moduli was accompanied by a marked change in the micro-structural arrangement of the sinusoids. This paper demonstrates a method of efficiently characterising soft biological tissues under large amplitude oscillatory shear under combined loading.

Traditional magnetic resonance elastography (MRE) applies small amplitude vibration to tissues. Thus currently MRE measures only the small deformation behaviour of tissues. MRE has the potential to estimate the strain-varying shear modulus of soft tissues, if applied at different static strains, which may allow prediction of the large-strain behaviour of tissues. This study uses MRE of bovine liver specimens under various levels of static compressive pre-strain up to 30%. Storage and loss moduli measured using MRE increased non-linearly with static compressive pre-strain, and exponential models fit well to these data to describe this relationship (R(2)>0.93). Based on these models, a 10% linear compression of liver would result in a 47% overestimate of the 'true' storage modulus of the uncompressed tissue. The results of this study have implications for MRE transducer design and interpretation of results from in vivo MRE studies.

The cerebellum has never been mechanically characterised, despite its physiological importance in the control of motion and the clinical prevalence of cerebellar pathologies. The aim of this study was to measure the linear viscoelastic properties of the cerebellum in human volunteers using Magnetic Resonance Elastography (MRE).Coronal plane brain 3D MRE data was performed on eight healthy adult volunteers, at 80 Hz, to compare the properties of cerebral and cerebellar tissues. The linear viscoelastic storage (G') and loss moduli (G″) were estimated from the MRE wave images by solving the wave equation for propagation through an isotropic linear viscoelastic solid. Contributions of the compressional wave were removed via application of the curl-operator.The storage modulus for the cerebellum was found to be significantly lower than that for the cerebrum, for both white and grey matter. Cerebrum: white matter (mean±SD) G'=2.41±0.23 kPa, grey matter G'=2.34±0.22 kPa; cerebellum: white matter, G'=1.85±0.18 kPa, grey matter G'=1.77±0.24 kPa; cerebrum vs cerebellum, p0.001. For the viscous behaviour, there were differences in between regions and also by tissue type, with the white matter being more viscous than grey matter and the cerebrum more viscous than the cerebellum. Cerebrum: white matter G″=1.21±0.21 kPa, grey matter G″=1.11±0.03 kPa; cerebellum: white matter G″=1.1±0.23 kPa, grey matter G″=0.94±0.17 kPa.These data represent the first available data on the viscoelastic properties of cerebellum, which suggest that the cerebellum is less physically stiff than the cerebrum, possibly leading to a different response to mechanical loading. These data will be useful for modelling of the cerebellum for a range of purposes.

Several studies have measured the elastic properties of a single human muscle-tendon unit in vivo. However the viscoelastic behavior of single human muscles has not been characterized. In this study, we adapted QLV theory to model the viscoelastic behavior of human gastrocnemius muscle-tendon units in vivo. We also determined the influence of viscoelasticity on passive length-tension properties of human gastrocnemius muscle-tendon units. Eight subjects participated in the experiment, which consisted of two parts. First, the stress relaxation response of human gastrocnemius muscle-tendon units was determined at a range of knee and ankle angles. Subsequently, passive ankle torque and ankle angle were collected during cyclic dorsiflexion and plantarflexion at a range of knee angles. Viscous parameters were determined by fitting the stress relaxation experiment data with a two-term exponential function, and elastic parameters were estimated by fitting the QLV model and viscous parameters to the cyclic experiment data. The model fitted the experimental data well at slow speeds (RMSE: 1.7 ± 0.5N) and at fast speeds (RMSE: 1.9 ± 0.2N). Muscle-tendon units demonstrated a large amount of stress relaxation. Nonetheless, viscoelastic passive length-tension curves estimated with the QLV model were similar to elastic passive length-tension curves obtained using a model that ignored viscosity. There was little difference in the elastic passive length-tension curves at different loading rates. We conclude that (a) the QLV model can be used to quantify viscoelastic behaviors of relaxed human gastrocnemius muscle-tendon units in vivo, and (b) over the range of velocities we examined, the velocity of loading has little effect on the passive length-tension properties of human gastrocnemius muscle-tendon units.

To prevent spinal cord injury, optimize treatments for it, and better understand spinal cord pathologies such as spondylotic myelopathy, the interaction between the spinal column and the spinal cord during injury and pathology must be understood. The spinal cord is a complex and very soft tissue that changes properties rapidly after death and is difficult to model. Our objective was to develop a physical surrogate spinal cord with material properties closely corresponding to the in vivo human spinal cord that would be suitable for studying spinal cord injury under a variety of injurious conditions. Appropriate target material properties were identified from published studies and several candidate surrogate materials were screened, under uniaxial tension, in a materials testing machine. QM Skin 30, a silicone elastomer, was identified as the most appropriate material. Spinal cords manufactured from QM Skin 30 were tested under uniaxial tension and transverse compression. Rectangular specimens of QM Skin 30 were also tested under uniform compression. QM Skin 30 produced surrogate cords with a Young's modulus in tension and compression approximately matching values reported for in vivo animal spinal cords (0.25 and 0.20 MPa, respectively). The tensile and compressive Young's modulus and the behavior of the surrogate cord simulated the nonlinear behavior of the in vivo spinal cord.

The porous properties of brain tissue are important for understanding normal and abnormal cerebrospinal fluid flow in the brain. In this study, a poroviscoelastic model was fitted to the stress relaxation response of white matter in unconfined compression performed under a range of low strain rates. A set of experiments was also performed on the tissue samples using a no-slip boundary condition. Results from these experiments demonstrated that the rheological response of the white matter is primarily governed by the intrinsic viscoelastic properties of the solid phase. The permeability of white matter was found to be of the order of 10−12 m4/Ns.

Syringomyelia is a neurological disorder characterised by high pressure fluid-filled cysts within the spinal cord. As syringomyelia is associated with abnormalities of the central nervous system that obstruct cerebrospinal fluid (CSF) flow, it is thought that changes in CSF dynamics play an important role in its pathogenesis. Using three-dimensional computational models of the spinal subarachnoid space (SAS), this study aims to determine SAS obstructions, such as arachnoiditis, change in CSF dynamics in the SAS. The geometry of the SAS was reconstructed from a series of MRI images. CSF is modelled as an incompressible Newtonian fluid with a dynamic viscosity of 1 mPa s. Three computational models simulated CSF flow in either the unobstructed SAS, or with the SAS obstructed by a porous region simulating dorsal or circumferential arachnoiditis. The permeability of this porous obstruction was varied for the model with dorsal arachnoiditis. The results show that arachnoiditis increases flow resistance in the SAS and this is accompanied by a modest increase in magnitude and/or shift in timing (with respect to the cardiac cycle) of the CSF pressure drop across the region of arachnoiditis. This study suggests that syrinx formation may be related to a change in temporal CSF pulse pressure dynamics.

Comprehensive characterization of stress relaxation in musculotendinous structures is needed to create robust models of viscoelastic behavior. The commonly used quasi-linear viscoelastic (QLV) theory requires that the relaxation response be independent of tissue strain (length). This study aims to characterize stress relaxation in the musculotendinous and ligamentous structures crossing the human ankle (ankle-only structures and the gastrocnemius muscle-tendon unit, which crosses the ankle and knee), and to determine whether stress relaxation is independent of the length of these structures. Two experiments were conducted on 8 healthy subjects. The first experiment compared stress relaxation over 10 min at different gastrocnemius muscle-tendon unit lengths keeping the length of ankle-joint only structures fixed. The second experiment compared stress relaxation at different lengths of ankle-joint only structures keeping gastrocnemius muscle-tendon unit length fixed. Stress relaxation data were fitted with a two-term exponential function (T=G(0)+G(1)e(-lambda(1))(t)+G(2)e(-lambda(2))(t)). The first experiment demonstrated a significant effect of gastrocnemius muscle-tendon unit length on G(1), and the second experiment demonstrated an effect of the length of ankle-joint only structures on G(2), lambda(1) and lambda(2) (p0.05). Nonetheless, the size of effects on stress relaxation was small (DeltaG/G10%), similar to experimental variability. We conclude that stress relaxation in the relaxed human ankle is minimally affected by changing gastrocnemius muscle-tendon unit length or by changing the lengths of ankle-joint only structures. Consequently quasi-linear viscoelastic models of the relaxed human ankle can use a common stress relaxation modulus at different knee and ankle angles with minimal error.

A number of studies have investigated the mechanical properties of adult spinal cord under tension, however it is not known whether age has an effect on these properties. This is of interest to those aiming to understand the clinical differences between adults and children with spinal cord injury (e.g. severity and recovery), and those developing experimental or computational models for paediatric spinal cord injury. Entire spinal cords were freshly harvested from neonatal rats (14 days) and tested in vitro under uniaxial tension at a range of strain rates (0.2, 0.02, 0.002/s) to a range of strains (2%, 3.5%, 5%), with relaxation responses being recorded for 15 min. These mechanical properties were compared to previously reported data from similar experiments on adult rat spinal cords, and the peak stress and the stress after 15 min of relaxation were found to be significantly higher for spinal cords from adults than neonates (p

The interthalamic adhesion is a unique feature of the third ventricle in the brain. It differs in shape and size and its location varies between individuals. In this study, computational fluid dynamics was performed on 4 three-dimensional models of the cerebral ventricular system with the interthalamic adhesion modeled in different locations in the third ventricle. Cerebrospinal fluid (CSF) was modeled as incompressible Newtonian fluid and flow was assumed laminar. The periodic motion of CSF flow as a function of the cardiac cycle starting from diastole was prescribed as the inlet boundary condition at the foramen of Monroe. Results from this study show how the location of the interthalamic adhesion influences the pattern of pressure distribution in the cerebral ventricles. In addition, the highest CSF pressure in the third ventricle can vary by approximately 50% depending on the location of the interthalamic adhesion. We suggest that the interthalamic adhesion may have functional implications on the development of hydrocephalus and it is important to model this anatomical feature in future studies.

Freshly excised rat spinal cords were tested in uniaxial tension, in vitro, at strain rates ranging from 0.002 to 0.2 s-1. Stress relaxation tests were performed for a range of strains from 2% to 5%, with the relaxation behaviour being recorded for a period of at least 30 min. Samples exhibited a characteristic "J" shaped non-linear stress-strain response, with stiffness increasing with applied strain. The cords were labelled with rows of small markers and the uniaxial tension tests were recorded via video. Subsequent image analysis enabled the distribution of strain on the cord surface to be determined. Viscoelastic models were developed to model the mechanical behaviour of the specimens and were found to adequately describe the material behaviour.