Risky Business: Traumatic Brain Injury and Epilepsy.
Risky Business: Traumatic Brain Injury and Epilepsy.
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DOI：
10.1177/15357597211005746
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发表时间：
2021-07
影响因子：
3.6
通讯作者：
Terman SW
中科院分区：
文献类型：
--
作者：
Terman SW
反复创伤性脑损伤与癫痫风险：丹麦全国性队列研究，Lolk K，Dreier JW，Christensen J.Brain。2021年；等待448。DOI：10.1093/Brain/waa448创伤性脑损伤与癫痫风险增加有关，但反复创伤性脑损伤的重要性尚未确定。我们对1977年至2016年期间出生在丹麦的2476905人进行了一项基于人口的全国队列研究。我们使用COX和竞争风险回归分别估计了创伤性脑损伤后癫痫的危险比(HRs)和累积发生率。为了估计非创伤性脑损伤人群中癫痫的累积发病率，我们为每个有创伤性脑损伤的受试者在出生年份、性别和脑损伤日期上匹配了10名对照组。在队列中，167 051人(女性71 162人，男性95 889人)遭受创伤性脑损伤，37 200人发生癫痫(女性17 905人，男性19 295人)。与无颅脑损伤的受试者相比，首次颅脑损伤后癫痫的相对危险度增加(HR：2.04，95%可信区间：1.96~2.13)，二次颅脑损伤后癫痫的相对危险性增加(HR：4.45，95%CI：4.09~4.84)。这种风险随着第一次和第二次创伤性脑损伤的严重程度而增加，尤其是在严重的创伤性脑损伤之后。轻度颅脑损伤后女性较男性更易发生癫痫(HR：2.13，95%CI：2.00~2.28 vs HR：1.77，95%CI：1.66~1.88；P<；0.0001)，而男性较女性更易在重型颅脑损伤后发生癫痫(HR：5.00，95%CI：4.31~5.80 vs HR：3.21，95%CI：2.56~4.03；P=.0012)。在创伤性脑损伤后的几十年里，这种风险一直在增加。这一知识可能有助于预防创伤后癫痫的发展。
Repeated Traumatic Brain Injury and Risk of Epilepsy: A Danish Nationwide Cohort Study Lolk K, Dreier JW, Christensen J. Brain. 2021;awaa448. doi:10.1093/brain/awaa448 Traumatic brain injury is associated with increased risk of epilepsy, but the importance of repeated traumatic brain injuries has not yet been established. We performed a nationwide population-based cohort study of 2 476 905 individuals born in Denmark between 1977 and 2016. We estimated hazard ratios (HRs) and the cumulative incidence of epilepsy following traumatic brain injury using Cox and competing risk regression, respectively. To estimate the cumulative incidence of epilepsy in the population without traumatic brain injury, we matched 10 controls for each subject with traumatic brain injury on year of birth, sex, and date of brain insult in the index person. In the cohort, traumatic brain injury was sustained by 167 051 subjects (71 162 females and 95 889 males), and 37 200 individuals developed epilepsy (17 905 females and 19 295 males). Compared with subjects without traumatic brain injury, the relative risk of epilepsy increased after a first traumatic brain injury (HR: 2.04, 95% confidence interval (CI): 1.96-2.13) and even more after a second traumatic brain injury (HR: 4.45, 95% CI: 4.09-4.84). The risk increased with the severity of the first and the second traumatic brain injury, most notably after severe traumatic brain injuries. Females were more likely than males to develop epilepsy after mild traumatic brain injury (HR: 2.13, 95% CI: 2.00-2.28 vs HR: 1.77, 95% CI: 1.66-1.88; P < .0001); in contrast, males were more likely than females to develop epilepsy after severe traumatic brain injury (HR: 5.00, 95% CI: 4.31-5.80 vs HR: 3.21, 95% CI: 2.56-4.03; P = .0012). The risk remained increased for decades after the traumatic brain injury. This knowledge may inform efforts to prevent the development of post-traumatic epilepsy.
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