Neuroimaging assessment of early and late neurobiological sequelae of traumatic brain injury: implications for CTE.
Neuroimaging assessment of early and late neurobiological sequelae of traumatic brain injury: implications for CTE.
复制标题
神经影像学评估脑损伤的早期和晚期神经生物学后遗症：对CTE的影响。
DOI：
10.3389/fnins.2015.00334
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发表时间：
2015
影响因子：
4.3
通讯作者：
Morey RA
中科院分区：
文献类型：
--
作者：
Sundman M;Doraiswamy PM;Morey RA
创伤性脑损伤（TBI）已越来越多地被认为是神经退行性疾病发病率和死亡率的主要外部危险因素。最近的证据表明，头部创伤后产生的慢性神经生物学后遗症可能至少部分导致一种病理学上不同的疾病，称为慢性创伤性脑病（CTE）。 CTE 的临床表现多种多样，但这种进行性疾病的症状包括记忆和认知受损、情感障碍（即冲动、攻击性、抑郁、自杀等）和运动控制能力减弱。值得注意的是，越来越多的证据表明，导致 CTE 的病理可能是由于头部反复遭受亚震荡性撞击而引起的，即使对于那些没有临床明显头部损伤史的人也是如此。鉴于数以百万计的运动员和军事人员可能遭受重复性脑震荡和创伤性脑损伤，CTE 是一个重要的公共卫生问题。然而，其发病率和病理机制仍然很大程度上未知，这主要是由于没有体内诊断工具。本手稿的主要目的是解决这一局限性，并讨论可能能够通过检测 tau 和其他已知病理特征来诊断体内 CTE 的潜在神经影像学模式。此外，我们将讨论 TBI 研究的挑战，概述已知的 CTE 病理学（重点是 Tau），回顾当前的神经影像学模式以评估体内诊断的潜在途径，并讨论 CTE 研究的未来方向。
Traumatic brain injury (TBI) has been increasingly accepted as a major external risk factor for neurodegenerative morbidity and mortality. Recent evidence indicates that the resultant chronic neurobiological sequelae following head trauma may, at least in part, contribute to a pathologically distinct disease known as Chronic Traumatic Encephalopathy (CTE). The clinical manifestation of CTE is variable, but the symptoms of this progressive disease include impaired memory and cognition, affective disorders (i.e., impulsivity, aggression, depression, suicidality, etc.), and diminished motor control. Notably, mounting evidence suggests that the pathology contributing to CTE may be caused by repetitive exposure to subconcussive hits to the head, even in those with no history of a clinically evident head injury. Given the millions of athletes and military personnel with potential exposure to repetitive subconcussive insults and TBI, CTE represents an important public health issue. However, the incidence rates and pathological mechanisms are still largely unknown, primarily due to the fact that there is no in vivo diagnostic tool. The primary objective of this manuscript is to address this limitation and discuss potential neuroimaging modalities that may be capable of diagnosing CTE in vivo through the detection of tau and other known pathological features. Additionally, we will discuss the challenges of TBI research, outline the known pathology of CTE (with an emphasis on Tau), review current neuroimaging modalities to assess the potential routes for in vivo diagnosis, and discuss the future directions of CTE research.