慢性创伤性脑病的临床表现。
Clinical presentation of chronic traumatic encephalopathy.
机构信息
From the Center for the Study of Traumatic Encephalopathy (R.A.S., D.H.D., C.M.B., D.R.S., P.H.M., D.O.R., N.G.F., J.M.S., C.A.R., T.D.S., V.E.A., C.J.N., R.C.C., A.C.M.), BU Alzheimer's Disease Center (R.A.S., T.D.S., L.E.G., A.E.B., N.W.K., A.C.M.), Departments of Neurology (R.A.S., C.M.B., D.R.S., V.E.A., A.E.B., N.W.K., A.C.M.), Neurosurgery (R.A.S., R.C.C.), and Pathology (T.D.S., N.W.K., A.C.M.), Molecular Genetics Core Facility (I.S.), Boston University School of Medicine; Sports Legacy Institute (L.M., C.J.N., R.C.C.), Waltham; VA Boston Healthcare System (T.D.S., V.E.A., A.E.B., N.W.K., A.C.M.); Departments of Psychiatry, Neurology, Pathology & Laboratory Medicine, Ophthalmology, Biomedical Engineering, and Electrical & Computer Engineering (L.E.G.), Boston University School of Medicine and College of Engineering; and Department of Neurosurgery (R.C.C.), Emerson Hospital, Concord, MA.
出版信息
Neurology. 2013 Sep 24;81(13):1122-9. doi: 10.1212/WNL.0b013e3182a55f7f. Epub 2013 Aug 21.
OBJECTIVE
The goal of this study was to examine the clinical presentation of chronic traumatic encephalopathy (CTE) in neuropathologically confirmed cases.
METHODS
Thirty-six adult male subjects were selected from all cases of neuropathologically confirmed CTE at the Boston University Center for the Study of Traumatic Encephalopathy brain bank. Subjects were all athletes, had no comorbid neurodegenerative or motor neuron disease, and had next-of-kin informants to provide retrospective reports of the subjects' histories and clinical presentations. These interviews were conducted blind to the subjects' neuropathologic findings.
RESULTS
A triad of cognitive, behavioral, and mood impairments was common overall, with cognitive deficits reported for almost all subjects. Three subjects were asymptomatic at the time of death. Consistent with earlier case reports of boxers, 2 relatively distinct clinical presentations emerged, with one group whose initial features developed at a younger age and involved behavioral and/or mood disturbance (n = 22), and another group whose initial presentation developed at an older age and involved cognitive impairment (n = 11).
CONCLUSIONS
This suggests there are 2 major clinical presentations of CTE, one a behavior/mood variant and the other a cognitive variant.
目的
本研究旨在检查经神经病理学证实的慢性创伤性脑病（CTE）病例的临床表现。
方法
从波士顿大学创伤性脑病研究中心的脑组织银行中所有经神经病理学证实的 CTE 病例中选择了 36 名成年男性受试者。所有受试者均为运动员，无合并神经退行性或运动神经元疾病，且有近亲提供对受试者病史和临床表现的回顾性报告。这些访谈是在不知道受试者神经病理学发现的情况下进行的。
结果
总体上，认知、行为和情绪障碍的三联征很常见，几乎所有受试者都有认知缺陷。有 3 名受试者在死亡时无症状。与早期拳击手的病例报告一致，出现了 2 种相对不同的临床表现，一组以较年轻年龄出现的行为和/或情绪障碍为初始特征（n=22），另一组以较年长年龄出现的认知障碍为初始特征（n=11）。
结论
这表明 CTE 有 2 种主要的临床表现，一种是行为/情绪变异，另一种是认知变异。
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