Deng Hansen, Ordaz Angel, Upadhyayula Pavan S, Gillis-Buck Eva M, Suen Catherine G, Melhado Caroline G, Mohammed Nebil, Lam Troy, Yue John K
Department of Neurological Surgery, University of California San Francisco, San Francisco, CA 94122, USA.
Department of Neurological Surgery, University of California San Diego, San Diego, CA 92093, USA.
Med Sci (Basel). 2018 Sep 14;6(3):78. doi: 10.3390/medsci6030078.
The annual incidence of mild traumatic brain injury (MTBI) is 3.8 million in the USA with 10⁻15% experiencing persistent morbidity beyond one year. Chronic traumatic encephalopathy (CTE), a neurodegenerative disease characterized by accumulation of hyperphosphorylated tau, can occur with repetitive MTBI. Risk factors for CTE are challenging to identify because injury mechanisms of MTBI are heterogeneous, clinical manifestations and management vary, and CTE is a postmortem diagnosis, making prospective studies difficult. There is growing interest in the genetic influence on head trauma and development of CTE. Apolipoprotein epsilon 4 () associates with many neurologic diseases, and consensus on the ε4 allele as a risk factor is lacking. This review investigates the influence of on MTBI and CTE. A comprehensive PubMed literature search (1966 to 12 June 2018) identified 24 unique reports on the topic (19 MTBI studies: 8 athletic, 5 military, 6 population-based; 5 CTE studies: 4 athletic and military, 1 leucotomy group). genotype is found to associate with outcomes in 4/8 athletic reports, 3/5 military reports, and 5/6 population-based reports following MTBI. Evidence on the association between and CTE from case series is equivocal. Refining modalities to aid CTE diagnosis in larger samples is needed in MTBI.
在美国，轻度创伤性脑损伤（MTBI）的年发病率为380万例，其中10%-15%的患者在一年后仍有持续的发病率。慢性创伤性脑病（CTE）是一种以过度磷酸化tau蛋白积累为特征的神经退行性疾病，可发生于重复性MTBI后。由于MTBI的损伤机制具有异质性，临床表现和治疗方法各不相同，且CTE是一种死后诊断，因此难以进行前瞻性研究，CTE的危险因素也难以确定。人们对基因对头外伤和CTE发展的影响越来越感兴趣。载脂蛋白ε4（）与许多神经系统疾病相关，但对于ε4等位基因作为危险因素尚无共识。本综述研究了对MTBI和CTE的影响。通过全面的PubMed文献检索（1966年至2018年6月12日），确定了24篇关于该主题的独特报告（19项MTBI研究：8项关于运动员的研究、5项关于军人的研究、6项基于人群的研究；5项CTE研究：4项关于运动员和军人的研究、1项关于脑白质切断术组的研究）。在MTBI后的4/8项运动员报告、3/5项军人报告和5/6项基于人群的报告中，发现基因型与结果相关。来自病例系列的关于与CTE之间关联的证据并不明确。在MTBI中，需要改进方法以在更大样本中辅助CTE诊断。
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