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慢性创伤性脑病——困惑与争议。

Chronic traumatic encephalopathy - confusion and controversies.

机构信息

Department of Neurosurgery, Penn Center for Brain Injury and Repair, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.

Department of Pathology and Laboratory Medicine, Institute on Aging, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.

出版信息

Nat Rev Neurol. 2019 Mar;15(3):179-183. doi: 10.1038/s41582-018-0114-8.

Abstract

The term chronic traumatic encephalopathy (CTE) has recently entered public consciousness via media reports and even a Hollywood movie. However, in contrast to general impressions, the incidence of CTE is unknown, the clinical diagnostic criteria have not been agreed upon and the current neuropathological characterization of CTE is acknowledged as preliminary. Additionally, few studies have compared the pathologies of CTE with those of other neurodegenerative disorders or of age-matched controls. Consequently, disagreement continues about the neuropathological aspects that make CTE unique. Furthermore, CTE is widely considered to be a consequence of exposure to repeated head blows, but evidence suggests that a single moderate or severe traumatic brain injury can also induce progressive neuropathological changes. These unresolved aspects of CTE underlie disparate claims about its clinical and pathological features, leading to confusion among the public and health-care professionals alike.

摘要

术语慢性创伤性脑病(CTE)最近通过媒体报道甚至一部好莱坞电影进入公众视野。然而,与普遍印象相反,CTE 的发病率未知,临床诊断标准尚未达成一致,目前对 CTE 的神经病理学特征的认识也被认为是初步的。此外,很少有研究比较 CTE 的病理学与其他神经退行性疾病或年龄匹配对照的病理学。因此,关于使 CTE 具有独特性的神经病理学方面仍存在分歧。此外,CTE 被广泛认为是反复头部冲击的结果,但有证据表明,单次中度或重度创伤性脑损伤也可引起进行性神经病理学变化。这些尚未解决的 CTE 问题是其临床和病理特征存在差异的原因,导致公众和医疗保健专业人员都感到困惑。

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