Analysis of dynamic system compliance for the therapy of Normal Pressure Hydrocephalus

常压脑积水治疗的动态系统顺应性分析

• 批准号: 274362184
• 负责人: Professor Dr.-Ing. Steffen Leonhardt
• 金额: --
• 依托单位: Lehrstuhl für Medizinische Informationstechnik (MedIT)
• 依托单位国家: 德国
• 项目类别: Research Grants
• 财政年份: 2015
• 资助国家: 德国
• 起止时间: 2014-12-31 至 2019-12-31
• 项目状态: 已结题
• 来源: https://gepris.dfg.de/gepris/projekt/274362184?language=en
• 关键词: Analysis; dynamic; system; compliance; therapy

The number of patients suffering from Normal Pressure Hydrocephalus (NPH), a pathological enlargement of the inner cerebrospinal fluid (CSF) spaces without accompanying pressure rise, has increased in recent years. Currently the pathophysiology is not completely understood, but it is known that reduced intracranial compliance plays an important role in the pathogenesis. Therefore, this research project aims to investigate the intracranial compliance especially concerning its dynamics, which has only been insufficiently analyzed in its relation to NPH, and to develop new therapeutic and diagnostic options for this disease. In order to understand the underlying mechanism leading to a reduced intracranial compliance better, this project initially focuses on the modeling of parameters so far not investigated to perform a sensitivity analysis. Since existing models reproduce the dynamic compliance insufficiently and simplify the reabsorption of cerebrospinal fluid and the formation of the pulse wave, the dynamics of the entire system are distorted. Against this background, a new model will be created, which maps the craniospinal system with a morphologically and functionally justified dynamic compliance. In a finite element model the coupling of the arterial pulse wave over large cranial arteries to the CSF will be modeled, based on the structural mechanical behavior of the different arterial wall layers of connective tissue, and the influence of age-related changes of connective tissue will be analyzed in simulation. Parameter studies should shed light on the influence of various factors on the compliance, on tissue-damaging dynamic loads on the parenchyma and thus on the formation of NPH. On the basis of these findings from the parameter studies an existing real-time capable model with concentrated parameters of the craniospinal system including autoregulation and dynamic spinal compliance will be adapted accordingly. In this model in particular age-related or pathologically altered outflow resistance at the spinal reabsorption sites caused by an age-related shortening of the spinal cord and other effects will be taken into account. Based on an improved understanding of the influencing parameters and a correspondingly extended modeling an artificial compliance and a bioimpedance measuring catheter aiming at an improved therapy will be developed. The real-time model serves to configure the artificial compliance, the newly developed finite element model to design the bioimpedance catheter. Using bioimpedance to measure the ventricular size and the change in size conclusions can be drawn on the overall compliance, which subsequently can be used to control the existing drainage system when necessary. Parallel to the investigation, a modular phantom model will be developed in order to validate the correlations shown in bioelectrical and biomechanical simulation as well as to test both the artificial compliance and the bioimpedance catheter.

近年来，患有正常压力脑积水（NPH）的患者数量有所增加，NPH 是脑脊液内部空间的病理性扩大，但不伴随压力升高。目前其病理生理学尚不完全清楚，但已知颅内顺应性降低在发病机制中起着重要作用。因此，本研究项目旨在研究颅内顺应性，特别是其动态，其与 NPH 的关系尚未得到充分分析，并为该疾病开发新的治疗和诊断方案。为了更好地了解导致颅内顺应性降低的潜在机制，该项目最初侧重于迄今为止尚未研究的参数建模以进行敏感性分析。由于现有模型不能充分再现动态顺应性并简化脑脊液的重吸收和脉搏波的形成，因此整个系统的动力学被扭曲。在此背景下，将创建一个新模型，该模型以形态和功能上合理的动态顺应性来映射颅脊髓系统。在有限元模型中，将根据结缔组织不同动脉壁层的结构力学行为以及结缔组织与年龄相关的变化的影响，对大颅动脉上的动脉脉搏波与脑脊液的耦合进行建模将在仿真中进行分析。参数研究应揭示各种因素对柔顺性、实质上组织损伤性动态载荷以及 NPH 形成的影响。根据参数研究的这些结果，将相应地调整现有的实时模型，该模型具有颅脊髓系统的集中参数，包括自动调节和动态脊柱顺应性。在该模型中，将特别考虑由年龄相关的脊髓缩短引起的脊髓重吸收部位的年龄相关或病理改变的流出阻力以及其他影响。基于对影响参数的更好理解和相应扩展的建模，将开发旨在改进治疗的人工顺应性和生物阻抗测量导管。实时模型用于配置人工顺应性，新开发的有限元模型用于设计生物阻抗导管。利用生物阻抗测量心室大小，通过大小变化得出整体顺应性结论，必要时可用于控制现有引流系统。与研究并行，将开发模块化体模模型，以验证生物电和生物力学模拟中显示的相关性，并测试人工顺应性和生物阻抗导管。

项目成果

Enhanced in vitro model of the CSF dynamics

增强的脑脊液动力学体外模型

• DOI: 10.1186/s12987-019-0131-z
• 发表时间: 2019
• 期刊: Fluids and Barriers of the CNS
• 影响因子: 7.3
• 作者: Benninghaus; Anne;Balédent; Olivier;Lokossou; Armelle;Castelar; Carlos;Leonhardt; Steffen;Radermacher; Klaus
• 通讯作者: Klaus

The Role of a Dynamic Craniospinal Compliance in NPH—A Review and Future Challenges

动态颅脊髓顺应性在 NPHâA 审查和未来挑战中的作用

• DOI: 10.1109/rbme.2016.2620493
• 发表时间: 2017
• 期刊: IEEE Reviews in Biomedical Engineering
• 影响因子: 17.6
• 作者: Goffin; Christine;Leonhardt; Steffen;Radermacher; Klaus
• 通讯作者: Klaus