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慢性创伤性脑病在刑事法庭中的作用综述

A Review of the Role of Chronic Traumatic Encephalopathy in Criminal Court.

机构信息

Dr. Aaronson is Research Psychiatrist, Mental Health Service Line, Edward J. Hines VA Hospital, Hines, IL, and Assistant Professor, Department of Psychiatry, Northwestern University Feinberg School of Medicine, Chicago, IL. Dr. Bordelon is Psychiatrist, National Telemental Health Hub, Continental Region, U.S. Department of Veterans Affairs, Salt Lake City, UT, and Adjunct Faculty, Forensic Psychiatry Division, Northwestern University Feinberg School of Medicine, Chicago, IL. Mr. Brakel is Lecturer in Law, Northwestern University Feinberg School of Medicine, Chicago, IL. Dr. Morrison is Associate Professor, Forensic Psychiatry Division, Northwestern University Feinberg School of Medicine, Chicago, IL, and Nationally Certified Examiner for Compensation and Pension, Jesse Brown VA Hospital, Chicago, IL.

出版信息

J Am Acad Psychiatry Law. 2021 Mar;49(1):60-65. doi: 10.29158/JAAPL.200054-20. Epub 2020 Nov 24.

DOI:10.29158/JAAPL.200054-20
PMID:33234540
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7979483/
Abstract

Chronic traumatic encephalopathy (CTE) is believed to be a degenerative brain disease characterized by repetitive brain trauma resulting in a specific pattern of neuropathological changes, which some have linked to functional disturbance and aggression. The diagnosis has gained greater public attention after these same neuropathological changes were discovered in multiple deceased National Football League (NFL) players, many of whom had exhibited signs of aggression, impulsivity, and poor executive functioning, according to a widely publicized study. When an NFL player convicted of murder was found to have the neuropathological changes associated with CTE following his suicide, the editorial section asked whether CTE was a defense for murder. This idea raises an interesting legal and philosophical question about whether an individual's criminal actions can be determined by something outside their control, such as past head trauma. To begin to attempt an answer, this article reviews what is currently known about the neurobiology of traumatic brain injury, CTE, and morality. By looking at how U.S. criminal law courts have handled cases of dementia and traumatic brain injury in the past, we can better understand how to consider this postmortem diagnosis in its forensic context.

摘要

慢性创伤性脑病(CTE)被认为是一种退行性脑疾病,其特征是反复的脑创伤导致特定模式的神经病理学变化,一些人将其与功能障碍和攻击性联系起来。在对多名已故美国国家橄榄球联盟(NFL)球员的尸检中发现了同样的神经病理学变化后,这一诊断引起了更多公众的关注。这些球员中有许多人表现出攻击性、冲动和执行功能差的迹象。根据一项广泛宣传的研究。当一名被判谋杀罪的 NFL 球员在自杀后被发现患有与 CTE 相关的神经病理学变化时,社论部分质疑 CTE 是否可以作为谋杀的辩护。这个想法提出了一个有趣的法律和哲学问题,即一个人的犯罪行为是否可以由他们无法控制的因素决定,例如过去的头部创伤。为了开始尝试回答这个问题,本文回顾了目前已知的创伤性脑损伤、CTE 和道德的神经生物学知识。通过观察美国刑法法庭过去如何处理痴呆症和创伤性脑损伤的案件,我们可以更好地理解如何在法医背景下考虑这种死后诊断。

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本文引用的文献

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JAMA Neurol. 2017 Oct 1;74(10):1255-1262. doi: 10.1001/jamaneurol.2017.2396.
2
Clinicopathological Evaluation of Chronic Traumatic Encephalopathy in Players of American Football.美式橄榄球运动员慢性创伤性脑病的临床病理评估
JAMA. 2017 Jul 25;318(4):360-370. doi: 10.1001/jama.2017.8334.
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A systematic review of potential long-term effects of sport-related concussion.对与运动相关的脑震荡潜在长期影响的系统评价。
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Long-Term Cognitive and Neuropsychiatric Consequences of Repetitive Concussion and Head-Impact Exposure.重复性脑震荡和头部撞击暴露的长期认知和神经精神后果。
J Athl Train. 2017 Mar;52(3):309-317. doi: 10.4085/1062-6050-52.1.14.
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CMAJ Open. 2016 Dec 6;4(4):E746-E753. doi: 10.9778/cmajo.20160072. eCollection 2016 Oct-Dec.
6
The first NINDS/NIBIB consensus meeting to define neuropathological criteria for the diagnosis of chronic traumatic encephalopathy.首次由美国国立神经疾病和中风研究所(NINDS)/美国国立生物医学成像和生物工程研究所(NIBIB)召开的共识会议,旨在确定慢性创伤性脑病诊断的神经病理学标准。
Acta Neuropathol. 2016 Jan;131(1):75-86. doi: 10.1007/s00401-015-1515-z. Epub 2015 Dec 14.
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A critical review of chronic traumatic encephalopathy.慢性创伤性脑病的批判性评论。
Neurosci Biobehav Rev. 2015 Sep;56:276-93. doi: 10.1016/j.neubiorev.2015.05.008. Epub 2015 Jul 14.
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