Gardner Raquel C, Hess Christopher P, Brus-Ramer Marcel, Possin Katherine L, Cohn-Sheehy Brendan I, Kramer Joel H, Berger Mitchel S, Yaffe Kristine, Miller Bruce, Rabinovici Gil D
1 Memory and Aging Center, Department of Neurology, University of California , San Francisco, San Francisco, California.
2 Department of Veterans Affairs, San Francisco Veterans Affairs Medical Center , San Francisco, California.
J Neurotrauma. 2016 Jan 1;33(1):157-61. doi: 10.1089/neu.2014.3805. Epub 2015 Jul 17.
Previous studies report that cavum septum pellucidum (CSP) is frequent among athletes with a history of repeated traumatic brain injury (TBI), such as boxers. Few studies of CSP in athletes, however, have assessed detailed features of the septum pellucidum in a case-control fashion. This is important because prevalence of CSP in the general population varies widely (2% to 85%) between studies. Further, rates of CSP among American pro-football players have not been described previously. We sought to characterize MRI features of the septum pellucidum in a series of retired pro-football players with a history of repeated concussive/subconcussive head traumas compared with controls. We retrospectively assessed retired American pro-football players presenting to our memory clinic with cognitive/behavioral symptoms in whom structural MRI was available with slice thickness ≤2 mm (n=17). Each player was matched to a memory clinic control patient with no history of TBI. Scans were interpreted by raters blinded to clinical information and TBI/football history, who measured CSP grade (0-absent, 1-equivocal, 2-mild, 3-moderate, 4-severe) and length according to a standard protocol. Sixteen of 17 (94%) players had a CSP graded ≥2 compared with 3 of 17 (18%) controls. CSP was significantly higher grade (p<0.001) and longer in players than controls (mean length±standard deviation: 10.6 mm±5.4 vs. 1.1 mm±1.3, p<0.001). Among patients presenting to a memory clinic, long high-grade CSP was more frequent in retired pro-football players compared with patients without a history of TBI.
以往的研究报告称，透明隔腔（CSP）在有反复创伤性脑损伤（TBI）病史的运动员中很常见，比如拳击手。然而，很少有关于运动员CSP的研究以病例对照的方式评估透明隔的详细特征。这一点很重要，因为不同研究中普通人群CSP的患病率差异很大（2%至85%）。此外，此前尚未描述过美国职业橄榄球运动员中CSP的发生率。我们试图描述一系列有反复震荡性/亚震荡性头部创伤病史的退役职业橄榄球运动员与对照组相比透明隔的MRI特征。我们回顾性评估了到我们记忆门诊就诊、有认知/行为症状且可获得层厚≤2毫米的结构MRI的退役美国职业橄榄球运动员（n = 17）。每位运动员都与一名无TBI病史的记忆门诊对照患者进行匹配。由对临床信息以及TBI/橄榄球病史不知情的评估人员解读扫描结果，他们根据标准方案测量CSP分级（0 - 无，1 - 不明确，2 - 轻度，3 - 中度，4 - 重度）和长度。17名运动员中有16名（94%）的CSP分级≥2，而17名对照组中有3名（18%）。运动员的CSP分级显著更高（p < 0.001），且长度比对照组更长（平均长度±标准差：10.6毫米±5.4 对比1.1毫米±1.3，p < 0.001）。在到记忆门诊就诊的患者中，与无TBI病史的患者相比，长的高级别CSP在退役职业橄榄球运动员中更常见。
