Omalu Bennet
University of California, Davis, Medical Center, Sacramento, Calif., and San Joaquin General Hospital and San Joaquin County Coroner's Division, French Camp, Calif., USA.
Prog Neurol Surg. 2014;28:38-49. doi: 10.1159/000358761. Epub 2014 Jun 6.
Chronic traumatic encephalopathy (CTE) is a progressive neurodegenerative syndrome, which is caused by single, episodic, or repetitive blunt force impacts to the head and transfer of acceleration-deceleration forces to the brain. CTE presents clinically as a composite syndrome of mood disorders and behavioral and cognitive impairment, with or without sensorimotor impairment. Symptoms of CTE may begin with persistent symptoms of acute traumatic brain injury (TBI) following a documented episode of brain trauma or after a latent period that may range from days to weeks to months and years, up to 40 years following a documented episode of brain trauma or cessation of repetitive TBI. Posttraumatic encephalopathy is distinct from CTE, can be comorbid with CTE, and is a clinicopathologic syndrome induced by focal and/or diffuse, gross and/or microscopic destruction of brain tissue following brain trauma. The brain of a CTE sufferer may appear grossly unremarkable, but shows microscopic evidence of primary and secondary proteinopathies. The primary proteinopathy of CTE is tauopathy, while secondary proteinopathies may include, but are not limited to, amyloidopathy and TDP proteinopathy. Reported prevalence rates of CTE in cohorts exposed to TBI ranges from 3 to 80% across age groups.
慢性创伤性脑病(CTE)是一种进行性神经退行性综合征,由头部单次、偶发或重复性钝器撞击以及加速-减速力传递至脑部所致。CTE临床上表现为情绪障碍以及行为和认知障碍的综合综合征,可伴有或不伴有感觉运动障碍。CTE的症状可能始于有记录的脑外伤事件后急性创伤性脑损伤(TBI)的持续症状,或在可能从数天到数周、数月甚至数年的潜伏期之后出现,最长可达有记录的脑外伤事件或重复性TBI停止后40年。创伤后脑病与CTE不同,可与CTE合并存在,是脑外伤后脑组织局灶性和/或弥漫性、肉眼和/或显微镜下破坏所诱发的一种临床病理综合征。CTE患者的大脑在肉眼上可能并无明显异常,但显示出原发性和继发性蛋白病的微观证据。CTE的原发性蛋白病是tau蛋白病,而继发性蛋白病可能包括但不限于淀粉样蛋白病和TDP蛋白病。在遭受TBI的人群中,各年龄组CTE的报告患病率在3%至80%之间。