  Developing an accurate and reliable injury predictor is central to the
biomechanical studies of traumatic brain injury. State-of-the-art efforts
continue to rely on empirical, scalar metrics based on kinematics or
model-estimated tissue responses explicitly pre-defined in a specific brain
region of interest. They could suffer from loss of information. A single
training dataset has also been used to evaluate performance but without
cross-validation. In this study, we developed a deep learning approach for
concussion classification using implicit features of the entire voxel-wise
white matter fiber strains. Using reconstructed American National Football
League (NFL) injury cases, leave-one-out cross-validation was employed to
objectively compare injury prediction performances against two baseline machine
learning classifiers (support vector machine (SVM) and random forest (RF)) and
four scalar metrics via univariate logistic regression (Brain Injury Criterion
(BrIC), cumulative strain damage measure of the whole brain (CSDM-WB) and the
corpus callosum (CSDM-CC), and peak fiber strain in the CC). Feature-based deep
learning and machine learning classifiers consistently outperformed all scalar
injury metrics across all performance categories in cross-validation (e.g.,
average accuracy of 0.844 vs. 0.746, and average area under the receiver
operating curve (AUC) of 0.873 vs. 0.769, respectively, based on the testing
dataset). Nevertheless, deep learning achieved the best cross-validation
accuracy, sensitivity, and AUC (e.g., accuracy of 0.862 vs. 0.828 and 0.842 for
SVM and RF, respectively). These findings demonstrate the superior performances
of deep learning in concussion prediction, and suggest its promise for future
applications in biomechanical investigations of traumatic brain injury.
