Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden.
National Institutes of Health (NIH), Bethesda, Maryland.
Semin Neurol. 2020 Aug;40(4):411-419. doi: 10.1055/s-0040-1715095. Epub 2020 Aug 2.
Chronic traumatic encephalopathy (CTE) is a neuropathological condition that has been described in individuals who have been exposed to repetitive head impacts, including concussions and subconcussive trauma. Currently, there is no fluid or imaging biomarker for diagnosing CTE during life. Based on retrospective clinical data, symptoms of CTE include changes in behavior, cognition, and mood, and may develop after a latency phase following the injuries. However, these symptoms are often nonspecific, making differential diagnosis based solely on clinical symptoms unreliable. Thus, objective biomarkers for CTE pathophysiology would be helpful in understanding the course of the disease as well as in the development of preventive and therapeutic measures. Herein, we review the literature regarding fluid biomarkers for repetitive concussive and subconcussive head trauma, postconcussive syndrome, as well as potential candidate biomarkers for CTE. We also discuss technical challenges with regard to the current fluid biomarkers and potential pathways to advance the most promising biomarker candidates into clinical routine.
慢性创伤性脑病（CTE）是一种在经历过反复头部撞击（包括脑震荡和亚临床脑震荡）的个体中描述的神经病理学状况。目前，尚无用于在生命期间诊断 CTE 的液体或成像生物标志物。基于回顾性临床数据，CTE 的症状包括行为、认知和情绪的改变，并且可能在受伤后的潜伏期后发展。然而，这些症状通常是非特异性的，仅基于临床症状进行鉴别诊断不可靠。因此，CTE 病理生理学的客观生物标志物将有助于了解疾病的进程以及预防和治疗措施的发展。在此，我们回顾了关于反复脑震荡和亚临床头部创伤、脑震荡后综合征的液体生物标志物的文献，以及 CTE 的潜在候选生物标志物。我们还讨论了当前液体生物标志物的技术挑战以及将最有前途的生物标志物候选物推进临床常规的潜在途径。
