Boston University Alzheimer's Disease and CTE Centers, Department of Neurology, Boston University School of Medicine, Boston, Massachusetts.
Department of Neurosurgery, Boston University School of Medicine, Boston, Massachusetts.
Semin Neurol. 2020 Aug;40(4):439-449. doi: 10.1055/s-0040-1713633. Epub 2020 Jul 16.
Chronic traumatic encephalopathy (CTE) is a progressive neurodegenerative disease that has been neuropathologically diagnosed in contact and collision sport athletes, military veterans, and others with a history of exposure to repetitive head impacts (RHI). Identifying methods to diagnose and prevent CTE during life is a high priority. Timely diagnosis and implementation of treatment and preventative strategies for neurodegenerative diseases, including CTE, partially hinge upon early and accurate risk characterization. Here, we propose a framework of risk factors that influence the neuropathological development of CTE. We provide an up-to-date review of the literature examining cumulative exposure to RHI as the environmental trigger for CTE. Because not all individuals exposed to RHI develop CTE, the direct and/or indirect influence of nonhead trauma exposure characteristics (e.g., age, sex, race, genetics) on the pathological development of CTE is reviewed. We conclude with recommendations for future directions, as well as opinions for preventative strategies that could mitigate risk.
慢性创伤性脑病（CTE）是一种进行性神经退行性疾病，已在接触性和碰撞性运动运动员、退伍军人以及其他有反复头部冲击（RHI）暴露史的人群中通过神经病理学诊断。确定在有生之年诊断和预防 CTE 的方法是当务之急。及时诊断和实施针对神经退行性疾病（包括 CTE）的治疗和预防策略部分取决于早期和准确的风险特征描述。在这里，我们提出了一个影响 CTE 神经病理学发展的危险因素框架。我们对研究累积 RHI 暴露作为 CTE 环境触发因素的文献进行了最新综述。由于并非所有接触 RHI 的人都会发展为 CTE，因此我们还回顾了非头部创伤暴露特征（例如年龄、性别、种族、遗传）对 CTE 病理发展的直接和/或间接影响。最后，我们提出了未来研究方向的建议，以及减轻风险的预防策略的观点。
