Chronic traumatic encephalopathy (CTE): criteria for neuropathological diagnosis and relationship to repetitive head impacts.
Chronic traumatic encephalopathy (CTE): criteria for neuropathological diagnosis and relationship to repetitive head impacts.
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DOI：
10.1007/s00401-023-02540-w
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发表时间：
2023-04
影响因子：
12.7
通讯作者：
中科院分区：
文献类型：
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作者：
在过去的17年里，关于慢性创伤性脑病(CTE)的科学研究有了显著的增长。自2016年NINDS-NIBIB发布CTE神经病理诊断标准并于2021年完善诊断以来，已有数百名接触性运动运动员和其他人在尸检中被诊断为CTE。据报道，CTE发生在业余和专业运动员中，包括公牛骑手、拳击手、摔跤运动员，以及美国、加拿大和澳大利亚规则足球、橄榄球联盟、橄榄球联盟、足球和冰球运动员。CTE的病理是独特的，其特征是血管周围神经元型磷酸化tau(p-tau)沿着皮质沟深处的星形细胞聚集体不同地积聚，以及p-tau纤维的独特分子结构配置，不同于衰老、阿尔茨海默病或任何其他tau病的变化。计算三维和有限元模型预测了p-tau病变的血管周围和脑沟位置，因为这些脑区在头部撞击伤过程中经历了最大的机械变形。目前，CTE只有通过死后神经病理检查才能明确诊断，相应的临床症状称为创伤性脑病综合征(TES)。据报道，超过97%的CTE病例是已知暴露于重复头部撞击(RHI)的个人，包括脑震荡和非脑震荡，最常见的经历是通过参加接触性运动。虽然一些人认为RHI和CTE之间是否存在因果关系尚不确定，但证据的优势表明存在因果关系的可能性很高，这一结论因缺乏任何可信的替代假设的证据而得到加强。CTE和多年的美式足球比赛之间存在着牢固的剂量-反应关系，即使在严格考虑选择偏见的情况下，这种关系仍然是一致的。此外，最近的一项研究表明，选择偏差低估了观察到的风险。在这里，我们介绍了随着NINDS-NIBIB标准的发展而达到顶峰的CTE神经病理学诊断的进展，多项国际研究使用这些标准报告了数百名接触性运动运动员和其他人的CTE，以及RHI和CTE之间牢固的剂量-反应关系的证据。
Over the last 17 years, there has been a remarkable increase in scientific research concerning chronic traumatic encephalopathy (CTE). Since the publication of NINDS–NIBIB criteria for the neuropathological diagnosis of CTE in 2016, and diagnostic refinements in 2021, hundreds of contact sport athletes and others have been diagnosed at postmortem examination with CTE. CTE has been reported in amateur and professional athletes, including a bull rider, boxers, wrestlers, and American, Canadian, and Australian rules football, rugby union, rugby league, soccer, and ice hockey players. The pathology of CTE is unique, characterized by a pathognomonic lesion consisting of a perivascular accumulation of neuronal phosphorylated tau (p-tau) variably alongside astrocytic aggregates at the depths of the cortical sulci, and a distinctive molecular structural configuration of p-tau fibrils that is unlike the changes observed with aging, Alzheimer’s disease, or any other tauopathy. Computational 3-D and finite element models predict the perivascular and sulcal location of p-tau pathology as these brain regions undergo the greatest mechanical deformation during head impact injury. Presently, CTE can be definitively diagnosed only by postmortem neuropathological examination; the corresponding clinical condition is known as traumatic encephalopathy syndrome (TES). Over 97% of CTE cases published have been reported in individuals with known exposure to repetitive head impacts (RHI), including concussions and nonconcussive impacts, most often experienced through participation in contact sports. While some suggest there is uncertainty whether a causal relationship exists between RHI and CTE, the preponderance of the evidence suggests a high likelihood of a causal relationship, a conclusion that is strengthened by the absence of any evidence for plausible alternative hypotheses. There is a robust dose–response relationship between CTE and years of American football play, a relationship that remains consistent even when rigorously accounting for selection bias. Furthermore, a recent study suggests that selection bias underestimates the observed risk. Here, we present the advances in the neuropathological diagnosis of CTE culminating with the development of the NINDS–NIBIB criteria, the multiple international studies that have used these criteria to report CTE in hundreds of contact sports players and others, and the evidence for a robust dose–response relationship between RHI and CTE.
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影响因子：
3.2
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
通讯作者：
TBI/CTE Research Group
影响因子：
14.5
作者：
Arena, John D.;Smith, Douglas H.;Johnson, Victoria E.
通讯作者：
Johnson, Victoria E.
影响因子：
105.7
作者：
CRITCHLEY, M
通讯作者：
CRITCHLEY, M
影响因子：
7.1
作者：
Ameen-Ali KE;Bretzin A;Lee EB;Folkerth R;Hazrati LN;Iacono D;Keene CD;Kofler J;Kovacs GG;Nolan A;Perl DP;Priemer DS;Smith DH;Wiebe DJ;Stewart W;CONNECT-TBI Investigators
通讯作者：
CONNECT-TBI Investigators
影响因子：
3.5
作者：
Cloots, R. J. H.;van Dommelen, J. A. W.;Geers, M. G. D.
通讯作者：
Geers, M. G. D.