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神经影像学和先进的研究技术可能会改善患有创伤性脑损伤的军人的治疗效果。

Neuroimaging and advanced research techniques may lead to improved outcomes in military members suffering from traumatic brain injury.

作者信息

Moyron Ron B, Vallejos Paul A, Fuller Ryan N, Dean Natasha, Wall Nathan R

机构信息

Department of Basic Sciences, Loma Linda University, Loma Linda, California, USA.

Department of Biology, La Sierra University, Riverside, California, USA.

出版信息

Trauma Surg Acute Care Open. 2021 Jan 7;6(1):e000608. doi: 10.1136/tsaco-2020-000608. eCollection 2021.

Abstract

Recent military conflicts in Iraq and Afghanistan have resulted in the significant increase in blast-related traumatic brain injury (TBI), leading to increased Department of Defense interest in its potential long-term effects ranging from the mildest head injuries termed subconcussive trauma to the most debilitating termed chronic traumatic encephalopathy (CTE). Most patients with mild TBI will recover quickly while others report persistent symptoms called postconcussive syndrome. Repeated concussive and subconcussive head injuries result in neurodegenerative conditions that may hinder the injured for years. Fundamental questions about the nature of these injuries and recovery remain unanswered. Clinically, patients with CTE present with either affective changes or cognitive impairment. Genetically, there have been no clear risk factors identified. The discovery that microglia of the cerebral cortex discharged small extracellular vesicles in the injured and adjacent regions to a TBI may soon shed light on the immediate impact injury mechanisms. The combination of neuroimaging and advanced research techniques may, one day, fill critical knowledge gaps and lead to significant TBI research and treatment advancements.

摘要

近期伊拉克和阿富汗的军事冲突导致与爆炸相关的创伤性脑损伤(TBI)显著增加,这使得美国国防部对其潜在的长期影响越发关注,这些影响范围从最轻微的头部损伤(称为次震荡性创伤)到最使人衰弱的慢性创伤性脑病(CTE)。大多数轻度创伤性脑损伤患者会迅速康复,而其他患者则报告有称为脑震荡后综合征的持续症状。反复的震荡性和次震荡性头部损伤会导致神经退行性疾病,可能会在数年内影响伤者。关于这些损伤的性质和恢复的基本问题仍未得到解答。临床上,慢性创伤性脑病患者表现为情感变化或认知障碍。在基因方面,尚未确定明确的风险因素。大脑皮层的小胶质细胞在创伤性脑损伤的损伤区域和相邻区域释放小细胞外囊泡这一发现,可能很快会揭示即时冲击损伤机制。神经影像学和先进研究技术的结合,也许有一天能填补关键的知识空白,并带来创伤性脑损伤研究和治疗的重大进展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7594/7797256/ee0571b7b603/tsaco-2020-000608f01.jpg

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