Relationship of traumatic brain injury to chronic mental health problems and dementia in military veterans
Relationship of traumatic brain injury to chronic mental health problems and dementia in military veterans
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DOI：
10.1016/j.neulet.2019.134294
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发表时间：
2019-08-10
影响因子：
2.5
通讯作者：
Gandy, Sam
中科院分区：
文献类型：
--
作者：
Elder, Gregory A.;Ehrlich, Michelle E.;Gandy, Sam
创伤性脑损伤（TBI）是军事生活中不幸的常见事件。伊拉克和阿富汗的冲突提高了公众对军队中TBI的认识。某些损伤机制是相对独特的军事，最突出的是爆炸暴露。爆炸相关的轻度TBI（mTBI）一直特别关注，在最近的退伍军人，虽然仍然存在争议的分离与创伤后应激障碍mTBI相关的脑震荡后综合征。TBI也是神经退行性疾病包括慢性创伤性脑病（CTE）和阿尔茨海默病（AD）发展的风险因素。AD、TBI和CTE都与慢性炎症相关。全基因组关联研究（GWAS）已经确定了与AD相关的多个遗传基因座，这些基因座涉及炎症，特别是小胶质细胞，它们是AD和TBI相关退行性过程的关键调节剂。在分子水平上，最近的研究已经将TREM 2和TYROBP/DAP 12鉴定为将炎症和小胶质细胞与AD和可能的TBI的病理生理学联系起来的关键分子枢纽的组分。证据TBI慢性精神健康问题和痴呆症的关系进行审查的背景下，其相关性退伍军人。
Traumatic brain injury (TBI) is an unfortunately common event in military life. The conflicts in Iraq and Afghanistan have increased public awareness of TBI in the military. Certain injury mechanisms are relatively unique to the military, the most prominent being blast exposure. Blast-related mild TBI (mTBI) has been of particular concern in the most recent veterans although controversy remains concerning separation of the postconcussion syndrome associated with mTBI from post-traumatic stress disorder. TBI is also a risk factor for the development of neurodegenerative diseases including chronic traumatic encephalopathy (CTE) and Alzheimer's disease (AD). AD, TBI, and CTE are all associated with chronic inflammation. Genome wide association studies (GWAS) have identified multiple genetic loci associated with AD that implicate inflammation and - in particular microglia - as key modulators of the AD- and TBI-related degenerative processes. At the molecular level, recent studies have identified TREM2 and TYROBP/DAP12 as components of a key molecular hub linking inflammation and microglia to the pathophysiology of AD and possibly TBI. Evidence concerning the relationship of TBI to chronic mental health problems and dementia is reviewed in the context of its relevance to military veterans.