Elenberger Jason, Kim Bohan, de Castro-Abeger Alexander, Rex Tonia S
From the Department of Ophthalmology & Visual Sciences (J.E., B.K., T.S.R.), Vanderbilt University; and Vanderbilt Eye Institute (A.d.C.-A., T.S.R.), Vanderbilt University Medical Center, Nashville, TN.
Neurology. 2020 Nov 3;95(18):826-833. doi: 10.1212/WNL.0000000000010830. Epub 2020 Sep 15.
The majority of patients with traumatic brain injury (TBI) are classified as having a mild TBI. Despite being categorized as mild, these individuals report ongoing and complex symptoms, which negatively affect their ability to complete activities of daily living and overall quality of life. Some of the major symptoms include anxiety, depression, sleep problems, headaches, light sensitivity, and difficulty reading. The root cause for these symptoms is under investigation by many in the field. Of interest, several of these symptoms such as headaches, ocular pain, light sensitivity, and sleep disturbances may overlap and share underlying circuitry influenced by the intrinsically photosensitive retinal ganglion cells (ipRGCs). These cells are light sensing, but non-image forming, and they influence corneal function, pupillary constriction, and circadian rhythm. In this review, we discuss these symptoms and propose a role of the ipRGCs as at least one underlying and unifying cause for such symptoms.
大多数创伤性脑损伤(TBI)患者被归类为轻度TBI。尽管被归类为轻度,但这些个体报告了持续且复杂的症状,这些症状对他们完成日常生活活动的能力和整体生活质量产生负面影响。一些主要症状包括焦虑、抑郁、睡眠问题、头痛、对光敏感以及阅读困难。该领域的许多人正在研究这些症状的根本原因。有趣的是,这些症状中的几种,如头痛、眼痛、对光敏感和睡眠障碍,可能相互重叠并共享受内在光敏视网膜神经节细胞(ipRGCs)影响的潜在神经回路。这些细胞具有感光功能,但不形成图像,它们影响角膜功能、瞳孔收缩和昼夜节律。在这篇综述中,我们讨论了这些症状,并提出ipRGCs至少是这些症状的一个潜在统一原因。