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慢性创伤性脑病:临床生物标志物相关性及发病机制的当前概念

Chronic traumatic encephalopathy: clinical-biomarker correlations and current concepts in pathogenesis.

作者信息

Gandy Sam, Ikonomovic Milos D, Mitsis Effie, Elder Gregory, Ahlers Stephen T, Barth Jeffrey, Stone James R, DeKosky Steven T

机构信息

Departments of Neurology, Icahn School of Medicine at Mount Sinai, One Gustave L Levy Place, New York, NY 10029, USA.

出版信息

Mol Neurodegener. 2014 Sep 17;9:37. doi: 10.1186/1750-1326-9-37.

Abstract

BACKGROUND

Chronic traumatic encephalopathy (CTE) is a recently revived term used to describe a neurodegenerative process that occurs as a long term complication of repetitive mild traumatic brain injury (TBI). Corsellis provided one of the classic descriptions of CTE in boxers under the name "dementia pugilistica" (DP). Much recent attention has been drawn to the apparent association of CTE with contact sports (football, soccer, hockey) and with frequent battlefield exposure to blast waves generated by improvised explosive devices (IEDs). Recently, a promising serum biomarker has been identified by measurement of serum levels of the neuronal microtubule associated protein tau. New positron emission tomography (PET) ligands (e.g., [18 F] T807) that identify brain tauopathy have been successfully deployed for the in vitro and in vivo detection of presumptive tauopathy in the brains of subjects with clinically probable CTE.

METHODS

Major academic and lay publications on DP/CTE were reviewed beginning with the 1928 paper describing the initial use of the term CTE by Martland.

RESULTS

The major current concepts in the neurological, psychiatric, neuropsychological, neuroimaging, and body fluid biomarker science of DP/CTE have been summarized. Newer achievements, such as serum tau and [18 F] T807 tauopathy imaging, are also introduced and their significance has been explained.

CONCLUSION

Recent advances in the science of DP/CTE hold promise for elucidating a long sought accurate determination of the true prevalence of CTE. This information holds potentially important public health implications for estimating the risk of contact sports in inflicting permanent and/or progressive brain damage on children, adolescents, and adults.

摘要

背景

慢性创伤性脑病(CTE)是一个最近重新启用的术语,用于描述作为重复性轻度创伤性脑损伤(TBI)的长期并发症而发生的神经退行性过程。科塞尔利斯以“拳击员痴呆症”(DP)之名对拳击手中的CTE给出了经典描述之一。最近,CTE与接触性运动(足球、英式足球、曲棍球)以及在战场上频繁暴露于简易爆炸装置(IED)产生的冲击波之间的明显关联引起了广泛关注。最近,通过测量血清中神经元微管相关蛋白tau的水平,已鉴定出一种有前景的血清生物标志物。已成功部署了用于识别脑tau病变的新型正电子发射断层扫描(PET)配体(例如,[18F]T807),用于在体外和体内检测临床疑似CTE患者大脑中的推定tau病变。

方法

从1928年马尔特兰首次使用CTE这一术语的论文开始,对有关DP/CTE的主要学术和大众出版物进行了综述。

结果

总结了当前在DP/CTE的神经学、精神病学、神经心理学、神经影像学和体液生物标志物科学方面的主要概念。还介绍了血清tau和[18F]T807 tau病变成像等最新成果,并解释了它们的意义。

结论

DP/CTE科学的最新进展有望阐明长期以来寻求的准确确定CTE真实患病率的方法。这些信息对于估计接触性运动对儿童、青少年和成人造成永久性和/或进行性脑损伤的风险可能具有重要的公共卫生意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2435/4249716/3de332061005/13024_2013_546_Fig1_HTML.jpg

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