Department of Neurology, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1137, New York, NY 10029, USA.
Psychiatr Clin North Am. 2010 Dec;33(4):905-13. doi: 10.1016/j.psc.2010.09.003.
Patients who have sustained a mild traumatic brain injury (TBI) from both civilian and military populations exhibit clinical symptoms of varying severity with minimal to profound impact on their daily functioning. Although most patients make a full recovery, a subgroup of mild TBI patients develop cognitive, somatic, and neurobehavioral sequelae that generally resolve over 3 to 6 months; a smaller subgroup develop persisting symptoms. The reason why a mild TBI results in varying clinical symptoms is currently unknown. Based on evidence that microRNA species in peripheral blood mononuclear cells (PBMCs) may reflect molecular alterations in neurodegenerative disorders, it can be hypothesized that at early, preclinical phases of the disease, PBMC may provide an ideal and clinically assessable "window" into the brain. Thus, it is conceivable that changes in the expression profile of clinically accessible biological indices (biomarkers), such as microRNA in PBMC, may reflect molecular alterations following TBI that contribute to the onset and progression of TBI phenotypes including chronic traumatic encephalopathy. It is possible that the availability of TBI biomarkers may provide potential elements with clinical relevance to prevention, prognosis, and treatment of postconcussive disorders.
从平民和军人中遭受轻度创伤性脑损伤 (TBI) 的患者表现出不同严重程度的临床症状，对其日常功能的影响从轻微到严重不等。尽管大多数患者完全康复，但一小部分轻度 TBI 患者会出现认知、躯体和神经行为后遗症，这些症状通常会在 3 到 6 个月内得到缓解；一小部分患者则会持续出现症状。轻度 TBI 导致不同临床症状的原因目前尚不清楚。基于外周血单个核细胞 (PBMC) 中 microRNA 种类可能反映神经退行性疾病中分子改变的证据，可以假设在疾病的早期、临床前阶段，PBMC 可能为大脑提供一个理想的、可临床评估的“窗口”。因此，可以想象，临床可及的生物指标（生物标志物），如 PBMC 中的 microRNA 的表达谱的变化，可能反映 TBI 后的分子改变，这些改变导致 TBI 表型的发生和进展，包括慢性创伤性脑病。TBI 生物标志物的可用性可能为预防、预后和治疗脑震荡后障碍提供具有临床相关性的潜在因素。
