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慢性创伤性脑病目前是否存在独特的神经精神特征?

Does a Unique Neuropsychiatric Profile Currently Exist for Chronic Traumatic Encephalopathy?

作者信息

Hanlon Faith M, McGrew Christopher A, Mayer Andrew R

机构信息

1The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM; 2Department of Family and Community Medicine, University of New Mexico School of Medicine, Albuquerque, NM; 3Department of Orthopedics and Rehabilitation, Sports Medicine Division, University of New Mexico School of Medicine, Albuquerque, NM; 4Departments of Neurology and Psychiatry, University of New Mexico School of Medicine, Albuquerque, NM; 5Department of Psychology, University of New Mexico, Albuquerque, NM.

出版信息

Curr Sports Med Rep. 2017 Jan/Feb;16(1):30-35. doi: 10.1249/JSR.0000000000000324.

Abstract

There is evidence that repetitive mild traumatic brain injury leads to specific patterns of neuropathological findings, labeled chronic traumatic encephalopathy (CTE). However, questions remain about whether these neuropathological changes produce changes in behavior, cognition, and emotional status that are associated with a unique neuropsychiatric profile that can be assessed using currently available clinical tools. Our review of the literature indicates that insufficient evidence currently exists to suggest a distinct neuropsychiatric profile for CTE. Major limitations to the field presently include the relatively nascent nature of the topic, reliance on retrospective next-of-kin reporting, the lack of prospective studies, and similarities in neuropsychiatric symptoms between CTE, other neurodegenerative disorders and forms of psychopathology. Clinicians and researchers alike have a responsibility to adopt a cautious and balanced approach for antemortem assessments to minimize the potential unintended negative consequences of both overdiagnosing and underdiagnosing a clinical entity that has yet to be clearly established.

摘要

有证据表明,重复性轻度创伤性脑损伤会导致特定模式的神经病理学发现,称为慢性创伤性脑病(CTE)。然而,这些神经病理学变化是否会导致行为、认知和情绪状态的改变,这些改变是否与一种独特的神经精神特征相关,而这种特征可以使用现有的临床工具进行评估,这些问题仍然存在。我们对文献的综述表明,目前没有足够的证据表明CTE有独特的神经精神特征。该领域目前的主要局限性包括该主题相对较新、依赖回顾性的近亲报告、缺乏前瞻性研究,以及CTE、其他神经退行性疾病和精神病理学形式之间神经精神症状的相似性。临床医生和研究人员都有责任在生前评估中采取谨慎和平衡的方法,以尽量减少过度诊断和漏诊一个尚未明确确定的临床实体可能产生的意外负面后果。

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