Ma Junwei, Zhang Kai, Wang Zhimin, Chen Gang
Department of Neurosurgery & Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou 215006, China; Department of Neurosurgery, Suzhou Kowloon Hospital Affiliated Shanghai Jiao Tong University, Suzhou 266021, China.
Department of Neurosurgery & Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou 215006, China.
Neural Plast. 2016;2016:9746313. doi: 10.1155/2016/9746313. Epub 2016 Dec 19.
The current work reviews the concept, pathological mechanism, and process of diagnosing of DAI. The pathological mechanism underlying DAI is complicated, including axonal breakage caused by axonal retraction balls, discontinued protein transport along the axonal axis, calcium influx, and calpain-mediated hydrolysis of structural protein, degradation of axonal cytoskeleton network, the changes of transport proteins such as amyloid precursor protein, and changes of glia cells. Based on the above pathological mechanism, the diagnosis of DAI is usually made using methods such as CT, traditional and new MRI, biochemical markers, and neuropsychological assessment. This review provides a basis in literature for further investigation and discusses the pathological mechanism. It may also facilitate improvement of the accuracy of diagnosis for DAI, which may come to play a critical role in breaking through the bottleneck of the clinical treatment of DAI and improving the survival and quality of life of patients through clear understanding of pathological mechanisms and accurate diagnosis.
当前的研究综述了弥漫性轴索损伤（DAI）的概念、病理机制及诊断过程。DAI的病理机制较为复杂，包括轴突回缩球导致的轴突断裂、沿轴突轴的蛋白质运输中断、钙内流、钙蛋白酶介导的结构蛋白水解、轴突细胞骨架网络的降解、淀粉样前体蛋白等转运蛋白的变化以及神经胶质细胞的变化。基于上述病理机制，DAI的诊断通常采用CT、传统及新型MRI、生化标志物和神经心理学评估等方法。本综述为进一步研究提供了文献依据，并探讨了病理机制。它还可能有助于提高DAI诊断的准确性，通过清晰了解病理机制和准确诊断，这可能在突破DAI临床治疗瓶颈以及提高患者生存率和生活质量方面发挥关键作用。
