Epidemiology of mild traumatic brain injury and neurodegenerative disease.
Epidemiology of mild traumatic brain injury and neurodegenerative disease.
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DOI：
10.1016/j.mcn.2015.03.001
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发表时间：
2015-05
期刊：
影响因子：
--
通讯作者：
Yaffe K
中科院分区：
文献类型：
--
作者：
Gardner RC;Yaffe K
据估计，全球每年有4200万人遭受轻度创伤性脑损伤（MTBI）或脑震荡。更严重的创伤性脑损伤（TBI）是多种神经退行性疾病（包括阿尔茨海默病、帕金森病和肌萎缩侧索硬化症（ALS））的公认的危险因素。最近，大型流行病学研究还将MTBI确定为痴呆症的危险因素。MTBI在PD或ALS风险中的作用尚不明确。重复性MTBI和重复性亚震荡性头部创伤与各种神经退行性疾病（包括慢性创伤性脑病（CTE））的风险增加有关。CTE是一种独特的神经退行性tau蛋白病，首先在拳击手中描述，但最近在各种接触性运动员，退伍军人和暴露于重复MTBI的平民中描述。重复性MTBI和CTE的研究受到以下因素的限制：转诊偏倚、缺乏CTE的共识临床标准、量化MTBI暴露的挑战以及潜在的混淆。CTE的患病率尚不清楚，产生CTE所需的MTBI或亚震荡创伤暴露量也不清楚。本次审查将总结有关MTBI，TBI后痴呆和帕金森病，CTE的流行病学的现有文献，同时强调在这一领域的研究方法的挑战和关键的未来方向。
Every year an estimated 42 million people worldwide suffer a mild traumatic brain injury (MTBI) or concussion. More severe traumatic brain injury (TBI) is a well-established risk factor for a variety of neurodegenerative diseases including Alzheimer's disease, Parkinson's disease, and amyotrophic lateral sclerosis (ALS). Recently, large epidemiological studies have additionally identified MTBI as a risk factor for dementia. The role of MTBI in risk of PD or ALS is less well established. Repetitive MTBI and repetitive sub-concussive head trauma has been linked to increased risk for a variety of neurodegenerative diseases including chronic traumatic encephalopathy (CTE). CTE is a unique neurodegenerative tauopathy first described in boxers but more recently described in a variety of contact sport athletes, military veterans, and civilians exposed to repetitive MTBI. Studies of repetitive MTBI and CTE have been limited by referral bias, lack of consensus clinical criteria for CTE, challenges of quantifying MTBI exposure, and potential for confounding. The prevalence of CTE is unknown and the amount of MTBI or sub-concussive trauma exposure necessary to produce CTE is unclear. This review will summarize the current literature regarding the epidemiology of MTBI, post-TBI dementia and Parkinson's disease, and CTE while highlighting methodological challenges and critical future directions of research in this field.
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