Julien J, Joubert S, Ferland M-C, Frenette L C, Boudreau-Duhaime M M, Malo-Véronneau L, de Guise E
Département de psychologie, université de Montréal, H7N 0B6 Laval, Canada; Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR), H2H 2N8 Montréal, Canada.
Département de psychologie, université de Montréal, H7N 0B6 Laval, Canada; Centre de recherche de l'institut universitaire de gériatrie de Montréal (CRIUGM), H3W 1W4 Montréal, Canada.
Ann Phys Rehabil Med. 2017 Sep;60(5):347-356. doi: 10.1016/j.rehab.2017.03.009. Epub 2017 May 11.
Inconsistencies regarding the risk of developing Alzheimer disease after traumatic brain injury (TBI) remain in the literature. Indeed, why AD develops in certain TBI patients while others are unaffected is still unclear.
The aim of this study was to performed a systematic review to investigate whether certain variables related to TBI, such as TBI severity, loss of consciousness (LOC) and post-traumatic amnesia (PTA), are predictors of risk of AD in adults.
From 841 citations retrieved from MEDLINE via PubMed, EMBASE, PSYINFO and Cochrane Library databases, 18 studies were eligible for the review.
The review revealed that about 55.5% of TBI patients may show deteriorated condition, from acute post-TBI cognitive deficits to then meeting diagnostic criteria for AD, but whether TBI is a risk factor for AD remains elusive.
Failure to establish such a link may be related to methodological problems in the studies. To shed light on this dilemma, future studies should use a prospective design, define the types and severities of TBI and use standardized AD and TBI diagnostic criteria. Ultimately, an AD prediction model, based on several variables, would be useful for clinicians detecting TBI patients at risk of AD.
关于创伤性脑损伤（TBI）后发生阿尔茨海默病风险的研究结果在文献中并不一致。事实上，为何某些TBI患者会患上AD而其他患者却未受影响仍不清楚。
本研究旨在进行一项系统评价，以调查某些与TBI相关的变量，如TBI严重程度、意识丧失（LOC）和创伤后遗忘（PTA），是否为成人AD风险的预测因素。
通过PubMed、EMBASE、PSYINFO和Cochrane图书馆数据库从MEDLINE检索到841篇文献，其中18项研究符合纳入本评价的标准。
该评价显示，约55.5%的TBI患者病情可能会恶化，从TBI后的急性认知缺陷发展到符合AD诊断标准，但TBI是否为AD的危险因素仍不明确。
未能建立这种联系可能与研究中的方法学问题有关。为阐明这一困境，未来的研究应采用前瞻性设计，明确TBI的类型和严重程度，并使用标准化的AD和TBI诊断标准。最终，基于多个变量的AD预测模型将有助于临床医生识别有AD风险的TBI患者。
