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. 2021 Nov 9;11:21956. doi: 10.1038/s41598-021-00610-1

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© The Author(s) 2021

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

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Eight finite element models were created from FLAIR MRI with WMHs shown in red (top row). We simulated quasistatic ventricular expansion during peak loading to determine ventricular wall strain and ependymal cell stretch. The distribution of maximum principal strain (middle row) is consistent across all individuals, with peak strain localizing around the anterior and posterior horns of the lateral ventricles. Based on the deformation fields, we determine ependymal cell stretch along the ventricular wall. We calculate ependymal cell tension, which is tangential to the ependymal wall, and ependymal cell compression, which is perpendicular to the ependymal wall. We observe four distinct locations with maximum stretches along the wall. These coincide with the horns, as indicated by points A, B, C, and D. We report both stretch components for every point along the ependymal wall as shown in the ventricular representation in the legend.