Office of the Dean and Department of Neurology, University of Virginia School of Medicine, P. O. Box 800793, Charlottesville, VA 22908, USA.
Nat Rev Neurol. 2013 Apr;9(4):192-200. doi: 10.1038/nrneurol.2013.36.
Over the past decade, public awareness of the long-term pathological consequences of traumatic brain injury (TBI) has increased. Such awareness has been stimulated mainly by reports of progressive neurological dysfunction in athletes exposed to repetitive concussions in high-impact sports such as boxing and American football, and by the rising number of TBIs in war veterans who are now more likely to survive explosive blasts owing to improved treatment. Moreover, the entity of chronic traumatic encephalopathy (CTE)--which is marked by prominent neuropsychiatric features including dementia, parkinsonism, depression, agitation, psychosis, and aggression--has become increasingly recognized as a potential late outcome of repetitive TBI. Annually, about 1% of the population in developed countries experiences a clinically relevant TBI. The goal of this Review is to provide an overview of the latest understanding of CTE pathophysiology, and to delineate the key issues that are challenging clinical and research communities, such as accurate quantification of the risk of CTE, and development of reliable biomarkers for single-incident TBI and CTE.
在过去的十年中，公众对创伤性脑损伤 (TBI) 的长期病理后果的认识有所提高。这种认识主要是由于以下报告的刺激：在拳击和美式足球等撞击性运动中反复遭受脑震荡的运动员出现进行性神经功能障碍，以及由于治疗方法的改进，创伤性脑损伤退伍军人的数量不断增加。此外，慢性创伤性脑病 (CTE) 的实体——其特征是明显的神经精神特征，包括痴呆、帕金森病、抑郁、烦躁、精神病和攻击性——已越来越被认为是重复 TBI 的潜在晚期后果。发达国家每年约有 1%的人口经历临床上相关的 TBI。本综述的目的是提供对 CTE 病理生理学的最新认识，并阐明挑战临床和研究界的关键问题，例如 CTE 风险的准确量化，以及用于单次创伤性脑损伤和 CTE 的可靠生物标志物的开发。
