Long-Term Consequences of Traumatic Brain Injury: Current Status of Potential Mechanisms of Injury and Neurological Outcomes
Long-Term Consequences of Traumatic Brain Injury: Current Status of Potential Mechanisms of Injury and Neurological Outcomes
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DOI：
10.1089/neu.2014.3352
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发表时间：
2015-12-01
影响因子：
4.2
通讯作者：
Dietrich, W. Dalton
中科院分区：
文献类型：
--
作者：
Bramlett, Helen M.;Dietrich, W. Dalton
创伤性脑损伤（TBI）是一个重要的临床问题，很少有治疗干预成功转化为临床。在实验和临床文献中，越来越重视脑外伤的进行性和长期后果。因此，有必要更好地了解创伤性脑损伤的慢性后果，最终目标是开发新的治疗干预措施来治疗脑损伤的破坏性后果。在轻度、中度和重度TBI模型中，组织病理学和行为学研究强调了初始创伤性损伤的进行性和多种病理生理机制的参与，包括导致长期运动和认知缺陷的持续损伤级联反应。最近，年龄依赖性神经退行性疾病在这一患者群体中的发病率也有所增加。在创伤性脑损伤的急性和长期后果中，被认为是活跃的病理机制包括兴奋性毒性、细胞凋亡、炎症事件、癫痫发作、脱髓鞘、白质病理以及神经发生减少。本文将回顾这些病理生理机制，这些机制可能是限制创伤性脑损伤慢性后果的重要目标。
Traumatic brain injury (TBI) is a significant clinical problem with few therapeutic interventions successfully translated to the clinic. Increased importance on the progressive, long-term consequences of TBI have been emphasized, both in the experimental and clinical literature. Thus, there is a need for a better understanding of the chronic consequences of TBI, with the ultimate goal of developing novel therapeutic interventions to treat the devastating consequences of brain injury. In models of mild, moderate, and severe TBI, histopathological and behavioral studies have emphasized the progressive nature of the initial traumatic insult and the involvement of multiple pathophysiological mechanisms, including sustained injury cascades leading to prolonged motor and cognitive deficits. Recently, the increased incidence in age-dependent neurodegenerative diseases in this patient population has also been emphasized. Pathomechanisms felt to be active in the acute and long-term consequences of TBI include excitotoxicity, apoptosis, inflammatory events, seizures, demyelination, white matter pathology, as well as decreased neurogenesis. The current article will review many of these pathophysiological mechanisms that may be important targets for limiting the chronic consequences of TBI.