Saulle Michael, Greenwald Brian D
Touro College of Osteopathic Medicine, 230 West 125th Street, New York, NY 10027, USA.
Rehabil Res Pract. 2012;2012:816069. doi: 10.1155/2012/816069. Epub 2012 Apr 10.
Chronic traumatic encephalopathy (CTE) is a progressive neurodegenerative disease that is a long-term consequence of single or repetitive closed head injuries for which there is no treatment and no definitive pre-mortem diagnosis. It has been closely tied to athletes who participate in contact sports like boxing, American football, soccer, professional wrestling and hockey. Risk factors include head trauma, presence of ApoE3 or ApoE4 allele, military service, and old age. It is histologically identified by the presence of tau-immunoreactive NFTs and NTs with some cases having a TDP-43 proteinopathy or beta-amyloid plaques. It has an insidious clinical presentation that begins with cognitive and emotional disturbances and can progress to Parkinsonian symptoms. The exact mechanism for CTE has not been precisely defined however, research suggest it is due to an ongoing metabolic and immunologic cascade called immunoexcitiotoxicity. Prevention and education are currently the most compelling way to combat CTE and will be an emphasis of both physicians and athletes. Further research is needed to aid in pre-mortem diagnosis, therapies, and support for individuals and their families living with CTE.
慢性创伤性脑病（CTE）是一种进行性神经退行性疾病，是单次或重复性闭合性头部损伤的长期后果，目前尚无治疗方法，也无法在生前做出明确诊断。它与从事拳击、美式橄榄球、足球、职业摔跤和曲棍球等接触性运动的运动员密切相关。风险因素包括头部创伤、载脂蛋白E3或载脂蛋白E4等位基因的存在、兵役和老年。在组织学上，它通过tau免疫反应性神经原纤维缠结（NFTs）和神经原纤维（NTs）的存在来识别，有些病例还存在TDP-43蛋白病或β-淀粉样蛋白斑块。它具有隐匿的临床表现，始于认知和情绪障碍，并可发展为帕金森氏症状。然而，CTE的确切机制尚未明确界定，研究表明它是由一种称为免疫兴奋毒性的持续代谢和免疫级联反应所致。预防和教育是目前对抗CTE最具说服力的方法，也将是医生和运动员关注的重点。需要进一步研究以协助生前诊断、治疗，并为患有CTE的个人及其家庭提供支持。
