Chronic traumatic encephalopathy in a professional American wrestler.
Chronic traumatic encephalopathy in a professional American wrestler.
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DOI：
10.1111/j.1939-3938.2010.01078.x
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发表时间：
2010-01-01
影响因子：
1
通讯作者：
Bailes, Julian
中科院分区：
文献类型：
--
作者：
Omalu, Bennet I;Fitzsimmons, Robert P;Bailes, Julian
在这个病例中，我们报告了一位美国职业摔跤手的载脂蛋白E(ApoE)基因分型的慢性创伤性脑病(CTE)的组织底物和法医证据。职业摔跤是一项接触性运动，运动员在职业生涯中反复脑震荡的风险是不可或缺的。此病例首次提供了美国职业摔跤手伴随CTE的神经病理异常的尸检证据。对一名40岁的高加索男子进行了全面的尸检，他在杀害妻子和儿子后意外死于自杀上吊。大脑没有萎缩，也没有新近或远处的挫伤或坏死。有轻度到中度的新皮质神经元脱落，没有任何淀粉样斑块。在新皮质、皮质下神经节和脑干核团，包括与CTE一致的黑质，可见弥漫的、稀疏到频繁的tau免疫反应神经原纤维缠结和神经束丝。ApoE基因分型为E3/E3。其他尸检结果包括心脏增大、左心室肥厚和双侧房室扩大；毒理学分析显示血液中有阿普唑仑和氢可酮，尿液中有外源性睾酮的证据。需要对职业接触运动运动员进行纵向研究，以确定患有CTE的运动员的区别特征，并制定干预策略。
We present in this case report the tissue substrates and forensic evidence for chronic traumatic encephalopathy (CTE) in a professional American wrestler with Apolipoprotein E (apoE) genotyping. Professional wrestling is a contact-sport, with an integral risk for players to sustain repeated concussions over their careers. This case provides the first autopsy evidence of neuropathological abnormalities that accompany CTE in professional American wrestlers. A complete autopsy was performed on a 40-year-old Caucasian male, after he died unexpectedly by suicidal hanging after he had killed his wife and son. The brain showed no atrophy and no recent or remote contusions or necrosis. There was a mild to moderate neocortical neuronal dropout without any amyloid plaques. There were diffuse, sparse to frequent tau-immunoreactive Neurofibrillary Tangles and Neuropil Threads in the neocortex, subcortical ganglia, and brainstem nuclei including the substantia nigra consistent with CTE. The apoE genotype was determined to be E3/E3. Other autopsy findings included cardiomegaly, left ventricular hypertrophy, and bilateral atrioventricular dilatation; toxicologic analyses showed alprazolam and hydrocodone in the blood, and evidence of exogenous testosterone in the urine. Longitudinal studies of professional contact-sport athletes are needed to identify the differentiating characteristics of athletes who develop CTE and devise strategies for intervention.