The Molecular Pathophysiology of Concussion.
The Molecular Pathophysiology of Concussion.
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DOI：
10.1016/j.csm.2020.08.001
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发表时间：
2021-01
影响因子：
2
通讯作者：
中科院分区：
文献类型：
--
作者：
脑震荡是一种轻度创伤性脑损伤（mTBI），经专家共识定义为头部创伤导致的复杂病理生理过程，并产生非特异性体征或症状和/或精神功能改变。对于诊断和管理脑震荡的临床医生来说，由于可用的临床工具有限，无法了解损伤后的缺陷，以及将体征和症状的潜在病理生理过程的知识转化为临床护理，因此决策可能具有挑战性和不精确性。虽然从21世纪初到2010年代中期，脑震荡的发病率有所上升，但最近的研究表明，在练习中持续发生的运动相关脑震荡有所下降，2013-2018年期间复发性脑震荡的发生率也有所下降。这些结果表明，脑震荡的医疗管理可能已经发展，使用最新的实践方法和预防策略可能有助于减少脑震荡的发生率。尽管取得了这些进展，但脑震荡体征和症状背后的生理过程、可靠诊断脑震荡的准确方法以及生理恢复的时间进程仍然难以辨别。目前，脑震荡仍然是一种临床诊断，很少有客观和广泛使用的评估来测量生理功能，部分原因是缺乏可用的范式来评估损伤的病理生理反应，以一种可行的临床可行的方式。一些方法，如高级神经成像、脑血流量评估或液体生物标志物分析，允许在临床观察到的恢复后检测持续的生物中断，6但这些技术在广泛的临床应用
Concussion, a type of mild traumatic brain injury (mTBI), has been defined through expert consensus as a complex pathophysiological process that is the result of head trauma, and produces an onset of non-specific signs or symptoms and/or changes in mental function. 1 For clinicians who diagnose and manage concussions, decision-making can be challenging and imprecise due to the limited clinical tools available to understand postinjury deficits, and the translation of knowledge from the underlying pathophysiological processes responsible for signs and symptoms to clinical care. 2 Although concussion incidence increased from the early 2000s to mid-2010’s, 3, 4 more recent research indicates that sport-related concussions sustained during practice have decreased, as well as recurrent concussion rates from 2013–2018. 5 These results suggest that perhaps medical management of concussion has evolved, and the use of updated practice approaches and preventative strategies may be helping to reduce concussion incidence. Despite these advancements, the physiological processes that underlie the signs and symptoms of concussion, accurate methods to reliably diagnose concussion, and the time course of physiologic recovery remain difficult to discern. 6Currently, concussion remains a clinical diagnosis with few objective and widely used assessments that measure physiological functions, 7 in part due to the lack of paradigms available to assess pathophysiological responses to injury in a feasible clinically-viable manner. Some approaches such as advanced neuroimaging, cerebral blood flow assessment, or fluid biomarker analysis allow for the detection of persistent biological disruptions after clinically observed recovery, 6 but the utility of these techniques within widespread clinical
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影响因子：
4.8
作者：
Chin, Esther Y.;Nelson, Lindsay D.;McCrea, Michael A.
通讯作者：
McCrea, Michael A.
影响因子：
4.7
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Fehily, Brooke;Bartlett, Carole A.;Fitzgerald, Melinda
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Fitzgerald, Melinda
影响因子：
2.9
作者：
FINEMAN, I;HOVDA, DA;BECKER, DP
通讯作者：
BECKER, DP
影响因子：
2.8
作者：
Cristofori, L;Tavazzi, B;Lazzarino, G
通讯作者：
Lazzarino, G
影响因子：
4.2
作者：
Ashwal, S;Holshouser, B;Kido, D
通讯作者：
Kido, D