The Second NINDS/NIBIB Consensus Meeting to Define Neuropathological Criteria for the Diagnosis of Chronic Traumatic Encephalopathy.

The Second NINDS/NIBIB Consensus Meeting to Define Neuropathological Criteria for the Diagnosis of Chronic Traumatic Encephalopathy.
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DOI:
10.1093/jnen/nlab001
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发表时间:
2021-02-22
影响因子:
3.2
通讯作者:
TBI/CTE Research Group
TBI/CTE Research Group
中科院分区:
医学4区
文献类型:
--
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

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慢性创伤性脑病(CTE)是一种与头部创伤相关的神经退行性疾病。2015年,由NINDS/NIBIB资助的一个神经病理学家小组根据对25例tau蛋白病病例的审查,将CTE的初步共识神经病理学标准定义为“神经元和星形胶质细胞中异常过度磷酸化tau蛋白(p-tau)的积累,分布在皮质沟深处的小血管周围,并以不规则的模式”。2016年,共识小组再次开会审查和完善初步标准,考虑了诊断的最低阈值和拟议病理分期方案的可重复性。8名神经病理学家评估了27例tau蛋白病(17例CTE),对临床和人口统计学信息不知情。广义估计方程分析显示,在设盲(OR = 72.11,95%CI = 19.5-267.0)和非设盲(OR = 256.91,95%CI = 63.6-1558.6)两轮中,评分者与CTE诊断之间存在统计学显著相关性。基于CTE分期的挑战,专家组提出了一个工作方案,包括CTE诊断的最低阈值和用于评估CTE严重程度为“低CTE”或“高CTE”的算法,以用于未来的临床、病理和分子研究。
Chronic traumatic encephalopathy (CTE) is a neurodegenerative disorder associated with exposure to head trauma. In 2015, a panel of neuropathologists funded by the NINDS/NIBIB defined preliminary consensus neuropathological criteria for CTE, including the pathognomonic lesion of CTE as “an accumulation of abnormal hyperphosphorylated tau (p-tau) in neurons and astroglia distributed around small blood vessels at the depths of cortical sulci and in an irregular pattern,” based on review of 25 tauopathy cases. In 2016, the consensus panel met again to review and refine the preliminary criteria, with consideration around the minimum threshold for diagnosis and the reproducibility of a proposed pathological staging scheme. Eight neuropathologists evaluated 27 cases of tauopathies (17 CTE cases), blinded to clinical and demographic information. Generalized estimating equation analyses showed a statistically significant association between the raters and CTE diagnosis for both the blinded (OR = 72.11, 95% CI = 19.5–267.0) and unblinded rounds (OR = 256.91, 95% CI = 63.6–1558.6). Based on the challenges in assigning CTE stage, the panel proposed a working protocol including a minimum threshold for CTE diagnosis and an algorithm for the assessment of CTE severity as “Low CTE” or “High CTE” for use in future clinical, pathological, and molecular studies.
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