Identifying degenerative effects of repetitive head trauma with neuroimaging: a clinically-oriented review.
Identifying degenerative effects of repetitive head trauma with neuroimaging: a clinically-oriented review.
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DOI：
10.1186/s40478-021-01197-4
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发表时间：
2021-05-22
影响因子：
7.1
通讯作者：
Rabinovici GD
中科院分区：
文献类型：
--
作者：
Asken BM;Rabinovici GD
不同程度和频率的头部创伤可能导致动态的急性和慢性脑病理生理反应。对头部创伤，特别是重复性头部创伤的长期影响的高度关注，引发了最近确定潜在疾病过程的神经成像生物标志物的努力。结构磁共振成像（MRI）和正电子发射断层扫描（PET）等成像方式在临床上最适用于神经退行性疾病的诊断和鉴别。近年来，研究人员瞄准了重复性头部创伤队列，希望能够识别体内生物标志物，以确定潜在的生物学变化，从而最终提高对活着的人慢性创伤性脑病（CTE）的诊断。这些人群通常包括碰撞运动运动员（如美式橄榄球、拳击）和反复暴露在低水平爆炸中的退伍军人。我们基于结构MRI， FDG-PET， a - β- pet和tau-PET对重复性头部创伤队列的神经影像学数据进行了临床导向的回顾。我们补充了两例神经病理学证实的临床受损的既往重复性头部创伤成人患者的报告，他们在死亡前接受了结构MRI、FDG-PET、a - β- pet和tau-PET检查，并进行了全面的临床检查。与没有已知头部创伤的对照组相比，组水平的比较显示了不一致的区域体积差异，可能倾向于内侧颞叶、边缘和皮层下（丘脑、胼胝体）结构。与未暴露的对照组相比，在重复性头部创伤队列中观察到更大的频率和严重程度（即长度）透明隔腔（CSP）。目前尚不清楚CSP是否预示着一种特定的神经退行性过程，但CSP的存在应该增加人们的怀疑，即临床损伤至少部分归因于个体的头部创伤暴露（无论潜在疾病如何）。同样，PET成像也没有显示出与重复性头部创伤相关的典型代谢或分子模式，也没有基于最广泛研究的放射性示踪剂预测CTE。鉴于在既往有重复性头部创伤的成人中观察到的临床综合征和神经退行性病理的范围，结构MRI和PET成像可能仍然有助于鉴别诊断（例如，评估疑似阿尔茨海默病）。在线版本包含补充材料，可在10.1186/s40478-021-01197-4获得。
Varying severities and frequencies of head trauma may result in dynamic acute and chronic pathophysiologic responses in the brain. Heightened attention to long-term effects of head trauma, particularly repetitive head trauma, has sparked recent efforts to identify neuroimaging biomarkers of underlying disease processes. Imaging modalities like structural magnetic resonance imaging (MRI) and positron emission tomography (PET) are the most clinically applicable given their use in neurodegenerative disease diagnosis and differentiation. In recent years, researchers have targeted repetitive head trauma cohorts in hopes of identifying in vivo biomarkers for underlying biologic changes that might ultimately improve diagnosis of chronic traumatic encephalopathy (CTE) in living persons. These populations most often include collision sport athletes (e.g., American football, boxing) and military veterans with repetitive low-level blast exposure. We provide a clinically-oriented review of neuroimaging data from repetitive head trauma cohorts based on structural MRI, FDG-PET, Aβ-PET, and tau-PET. We supplement the review with two patient reports of neuropathology-confirmed, clinically impaired adults with prior repetitive head trauma who underwent structural MRI, FDG-PET, Aβ-PET, and tau-PET in addition to comprehensive clinical examinations before death. Group-level comparisons to controls without known head trauma have revealed inconsistent regional volume differences, with possible propensity for medial temporal, limbic, and subcortical (thalamus, corpus callosum) structures. Greater frequency and severity (i.e., length) of cavum septum pellucidum (CSP) is observed in repetitive head trauma cohorts compared to unexposed controls. It remains unclear whether CSP predicts a particular neurodegenerative process, but CSP presence should increase suspicion that clinical impairment is at least partly attributable to the individual’s head trauma exposure (regardless of underlying disease). PET imaging similarly has not revealed a prototypical metabolic or molecular pattern associated with repetitive head trauma or predictive of CTE based on the most widely studied radiotracers. Given the range of clinical syndromes and neurodegenerative pathologies observed in a subset of adults with prior repetitive head trauma, structural MRI and PET imaging may still be useful for differential diagnosis (e.g., assessing suspected Alzheimer’s disease). The online version contains supplementary material available at 10.1186/s40478-021-01197-4.
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影响因子：
3.2
作者：
Bieniek KF;Cairns NJ;Crary JF;Dickson DW;Folkerth RD;Keene CD;Litvan I;Perl DP;Stein TD;Vonsattel JP;Stewart W;Dams-O'Connor K;Gordon WA;Tripodis Y;Alvarez VE;Mez J;Alosco ML;McKee AC;TBI/CTE Research Group
通讯作者：
TBI/CTE Research Group
影响因子：
4
作者：
Chen, Stephen T.;Siddarth, Prabha;Small, Gary W.
通讯作者：
Small, Gary W.
DOI：
10.1007/s40279-017-0707-1
发表时间：
2017-07
期刊：
Sports medicine (Auckland, N.Z.)
影响因子：
--
作者：
Broglio SP;McCrea M;McAllister T;Harezlak J;Katz B;Hack D;Hainline B;CARE Consortium Investigators
通讯作者：
CARE Consortium Investigators
影响因子：
5
作者：
Bernick, Charles;Banks, Sarah;Modic, Michael
通讯作者：
Modic, Michael
影响因子：
3.4
作者：
Brett, Benjamin L.;Bobholz, Samuel A.;Rowson, Steven
通讯作者：
Rowson, Steven