Department of Psychiatry, Taipei Veterans General Hospital, Taiwan; Division of Psychiatry, School of Medicine, National Yang-Ming University, Taiwan; Brain Research Center, National Yang-Ming University, Taiwan.
Med Hypotheses. 2020 Jan;134:109422. doi: 10.1016/j.mehy.2019.109422. Epub 2019 Oct 10.
Chronic traumatic encephalopathy (CTE), a disease process well-recognized in boxers, American football players and military personnel, is a progressive neurodegenerative disease caused by repetitive blows to the head. Subjects with CTE can have a wide range of emotional, cognitive and physical symptoms. The cognitive group patients had a significantly higher probability of developing dementia in later years. Currently, there are no disease modifying regimen for CTE. Timely intervention of head blow could diminish the development of CTE. Low-intensity pulsed ultrasound (LIPUS) is a common adjunct used to promote bone healing for fresh fracture. Recent reports suggest that LIPUS can noninvasively modulate the cortical function and have neuroprotective effect in various animal models of traumatic brain injury, stroke, Alzheimer's disease and major depressive disorder. The multifunctional mechanisms of LIPUS neuroprotective effect include several trophic factor stimulations, anti-inflammatory properties and reduction of brain edema. From the above evidence, LIPUS intervention could be a strategy for the prevention of the clinical CTE sequelae of repetitive head blows. We hypothesized that due to its neuroprotective effects, the non-invasive and easy-to-use method of LIPUS brain stimulation could have a preventive effect on players who have head blows during the match. The development of a time sensitive protocol, resembling the therapeutic algorithm for traumatic brain injury, would potentially prevent the development of subsequent CTE adverse outcome. Further long-term longitudinal studies of LIPUS stimulation are warranted to verify the prevention efficacy of this intervention for CTE.
慢性创伤性脑病（CTE）是一种在拳击手、美式足球运动员和军人中被广泛认识的疾病，是一种由头部反复受到冲击而导致的进行性神经退行性疾病。患有 CTE 的患者可能会出现情绪、认知和身体等多方面的症状。认知障碍组患者在晚年发展为痴呆的概率明显更高。目前，针对 CTE 没有改变疾病进程的治疗方案。及时干预头部冲击可能会减缓 CTE 的发展。低强度脉冲超声（LIPUS）是一种常用于促进新鲜骨折愈合的常见辅助手段。最近的报告表明，LIPUS 可以非侵入性地调节皮质功能，并在各种创伤性脑损伤、中风、阿尔茨海默病和重度抑郁症的动物模型中具有神经保护作用。LIPUS 神经保护作用的多功能机制包括多种营养因子刺激、抗炎特性和脑水肿减少。从上述证据来看，LIPUS 干预可能是预防重复性头部冲击导致的临床 CTE 后遗症的一种策略。我们假设，由于其神经保护作用，这种非侵入性、易于使用的脑刺激方法可以对在比赛中头部受到冲击的运动员产生预防作用。制定一个时间敏感的方案，类似于创伤性脑损伤的治疗算法，可能会预防随后发生的 CTE 不良后果。进一步的 LIPUS 刺激长期纵向研究对于验证这种干预措施预防 CTE 的效果是必要的。
