Wang Huan, Wang Bonnie, Jackson Kevin, Miller Claire M, Hasadsri Linda, Llano Daniel, Rubin Rachael, Zimmerman Jarred, Johnson Curtis, Sutton Brad
Department of Neurosurgery, Carle Foundation Hospital, University of Illinois College of Medicine at Urbana-Champaign, Urbana, USA; Thermal Neuroscience Laboratory, Beckman Institute, University of Illinois at Urbana-Champaign, Urbana, USA.
Department of Internal Medicine, Carle Foundation Hospital, University of Illinois College of Medicine at Urbana-Champaign, Urbana, USA.
Transl Neurosci. 2015 Jan 14;6(1):20-31. doi: 10.1515/tnsci-2015-0004. eCollection 2015.
Emerging research on the long-term impact of concussions on athletes has allowed public recognition of the potentially devastating effects of these and other mild head injuries. Mild traumatic brain injury (mTBI) is a multifaceted disease for which management remains a clinical challenge. Recent pre-clinical and clinical data strongly suggest a destructive synergism between brain temperature elevation and mTBI; conversely, brain hypothermia, with its broader, pleiotropic effects, represents the most potent neuro-protectant in laboratory studies to date. Although well-established in selected clinical conditions, a systemic approach to accomplish regional hypothermia has failed to yield an effective treatment strategy in traumatic brain injury (TBI). Furthermore, although systemic hypothermia remains a potentially valid treatment strategy for moderate to severe TBIs, it is neither practical nor safe for mTBIs. Therefore, selective head-neck cooling may represent an ideal strategy to provide therapeutic benefits to the brain. Optimizing brain temperature management using a National Aeronautics and Space Administration (NASA) spacesuit spinoff head-neck cooling technology before and/or after mTBI in contact sports may represent a sensible, practical, and effective method to potentially enhance recover and minimize post-injury deficits. In this paper, we discuss and summarize the anatomical, physiological, preclinical, and clinical data concerning NASA spinoff head-neck cooling technology as a potential treatment for mTBIs, particularly in the context of contact sports.
关于脑震荡对运动员长期影响的新研究,使公众认识到这些损伤以及其他轻度头部损伤可能带来的毁灭性后果。轻度创伤性脑损伤(mTBI)是一种多方面的疾病,其治疗仍是一项临床挑战。最近的临床前和临床数据有力地表明,脑温升高与mTBI之间存在破坏性协同作用;相反,脑低温具有更广泛的多效性作用,是迄今为止实验室研究中最有效的神经保护剂。尽管在特定临床情况下已得到充分证实,但实现局部低温的全身方法在创伤性脑损伤(TBI)中未能产生有效的治疗策略。此外,尽管全身低温仍然是中重度TBI的一种潜在有效治疗策略,但对mTBI既不实用也不安全。因此,选择性头颈部降温可能是为大脑提供治疗益处的理想策略。在接触性运动中,在mTBI之前和/或之后使用美国国家航空航天局(NASA)衍生自航天服的头颈部降温技术优化脑温管理,可能是一种明智、实用且有效的方法,有可能促进恢复并最大程度减少损伤后缺陷。在本文中,我们讨论并总结了有关NASA衍生的头颈部降温技术作为mTBI潜在治疗方法的解剖学、生理学、临床前和临床数据,特别是在接触性运动的背景下。