Starkstein Sergio E, Jorge Ricardo
School of Psychiatry and Clinical Neurosciences, University of Western Australia, Fremantle Hospital, Western Australia, Australia.
Int Psychogeriatr. 2005;17 Suppl 1:S93-107. doi: 10.1017/s1041610205001973.
Early retrospective studies suggested that individuals with a history of a traumatic brain injury (TBI) had a higher risk for dementia than those without a history of TBI. Two meta-analyses demonstrated that the risk for dementia is higher among men, but not women, with a history of TBI. More recent prospective studies, however, are providing discrepant findings, probably due to important methodological differences. TBI is usually associated with significant neuropsychological deficits, primarily in the domains of attention, executive functioning and memory. These deficits may not improve with time. TBI may also lower the threshold for the clinical expression of dementia among predisposed individuals, and the onset of Alzheimer's disease (AD)-like neuropathological and biochemical changes immediately after severe TBI may play an important role in this mechanism.
早期的回顾性研究表明，有创伤性脑损伤（TBI）病史的个体患痴呆症的风险高于没有TBI病史的个体。两项荟萃分析表明，有TBI病史的男性患痴呆症的风险更高，但女性并非如此。然而，最近的前瞻性研究给出了不一致的结果，这可能是由于重要的方法学差异所致。TBI通常与显著的神经心理缺陷相关，主要表现在注意力、执行功能和记忆领域。这些缺陷可能不会随时间改善。TBI还可能降低易感个体中痴呆症临床症状出现的阈值，严重TBI后立即出现的阿尔茨海默病（AD）样神经病理和生化变化可能在这一机制中起重要作用。
