Department of Neurology, NYU School of Medicine, New York, NY, USA,
Neuropsychol Rev. 2013 Dec;23(4):350-60. doi: 10.1007/s11065-013-9243-4. Epub 2013 Nov 22.
It has been theorized that a career in contact sports may be associated with long-term neurodegenerative changes. This idea dates as far back as the 1920s, was initially reported in boxers, colloquially termed 'punch drunk,' later more formally termed dementia pugilistica (DP), and now coined chronic traumatic encephalopathy (CTE). Despite considerable ongoing interest on this topic, there is so far only limited evidence showing an association between sport-related concussion (SRC) and increased risk for late-life cognitive and neuropsychiatric impairment, with no causality or risk factors yet determined. The modern CTE description is nevertheless proposed as a unique tauopathy with characteristic pathological stages occurring in retired athletes who have experienced previous repetitive brain trauma. This review highlights the principal issues that so far preclude firm conclusions about the association of athletic head trauma and neurodegenerative diseases of any type. We consider alternative interpretations that may contribute to the clinical progressive neurological findings in some athletes and recommend carefully-controlled epidemiological work to overcome current limitations in this area of research and stimulate future research.
人们推测，从事接触性运动可能与长期神经退行性变化有关。这种观点可以追溯到 20 世纪 20 年代，最初在拳击手身上报道，俗称“拳击痴呆”，后来更正式地称为拳击性痴呆（DP），现在称为慢性创伤性脑病（CTE）。尽管人们对这个话题一直很感兴趣，但到目前为止，只有有限的证据表明运动相关性脑震荡（SRC）与晚年认知和神经精神障碍的风险增加之间存在关联，还没有确定因果关系或风险因素。尽管如此，现代 CTE 描述被认为是一种独特的 tau 病，在经历过先前反复脑创伤的退役运动员中出现特征性的病理阶段。本综述强调了迄今为止阻碍关于运动性头部创伤与任何类型的神经退行性疾病之间关联的主要问题。我们考虑了可能导致一些运动员出现临床进行性神经学发现的其他解释，并建议进行精心控制的流行病学研究，以克服该研究领域目前的局限性，并激发未来的研究。
