Department of Neurosurgery, David Geffen School of Medicine at UCLA, 10833 Le Conte Boulevard, Los Angeles, CA 90095, USA.
Clin Sports Med. 2011 Jan;30(1):33-48, vii-iii. doi: 10.1016/j.csm.2010.09.001.
Concussion or mild traumatic brain injury (mTBI) is a condition that affects hundreds of thousands of patients worldwide. Understanding the pathophysiology of this disorder can help manage its acute and chronic repercussions. Immediately following mTBI, there are several metabolic, hemodynamic, structural, and electric changes that alter normal cerebral function. These alterations can increase the brain's vulnerability to repeat injury and long-term disability. This review evaluates current studies from the bench to the bedside of mTBI. Acute and chronic effects of concussion are measured in both animal and clinical studies. Also, the effect of repeat concussions is analyzed. Concussion-induced pathophysiology with regards to glucose metabolism changes, mitochondrial dysfunction, axonal injury, and structural damage are evaluated. Translational studies such as functional magnetic resonance imaging, magnetic resonance spectroscopy and diffusion tensor imaging prove to be effective clinical tools for both prognostic and treatment parameters. Understanding the neurobiology of concussion will lead to development and validation of physiological biomarkers of this common injury. These biomarkers (eg, laboratory tests, imaging, electrophysiology) will then allow for improved detection, better functional assessment and evidence-based return to play recommendations.
脑震荡或轻度创伤性脑损伤（mTBI）是一种影响全球数十万人的疾病。了解这种疾病的病理生理学可以帮助管理其急性和慢性后果。在 mTBI 后，会有一些代谢、血液动力学、结构和电变化改变正常的大脑功能。这些变化会增加大脑对重复损伤和长期残疾的易感性。这篇综述评估了从 mTBI 的实验室到临床的当前研究。在动物和临床研究中都测量了急性和慢性脑震荡的影响。此外，还分析了重复脑震荡的影响。评估了与葡萄糖代谢变化、线粒体功能障碍、轴突损伤和结构损伤相关的脑震荡诱导的病理生理学。功能磁共振成像、磁共振波谱和弥散张量成像等转化研究被证明是预后和治疗参数的有效临床工具。了解脑震荡的神经生物学将导致这种常见损伤的生理生物标志物的开发和验证。这些生物标志物（例如，实验室测试、影像学、电生理学）将允许更好地检测、功能评估和基于证据的回归比赛建议。
