Center for Brain Injury and Repair, Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Institute of Neuroscience and Psychology, University of Glasgow, Queen Elizabeth University Hospital, Glasgow, UK.
Acta Neuropathol Commun. 2021 Mar 1;9(1):32. doi: 10.1186/s40478-021-01122-9.
Efforts to characterize the late effects of traumatic brain injury (TBI) have been in progress for some time. In recent years much of this activity has been directed towards reporting of chronic traumatic encephalopathy (CTE) in former contact sports athletes and others exposed to repetitive head impacts. However, the association between TBI and dementia risk has long been acknowledged outside of contact sports. Further, growing experience suggests a complex of neurodegenerative pathologies in those surviving TBI, which extends beyond CTE. Nevertheless, despite extensive research, we have scant knowledge of the mechanisms underlying TBI-related neurodegeneration (TReND) and its link to dementia. In part, this is due to the limited number of human brain samples linked to robust demographic and clinical information available for research. Here we detail a National Institutes for Neurological Disease and Stroke Center Without Walls project, the COllaborative Neuropathology NEtwork Characterizing ouTcomes of TBI (CONNECT-TBI), designed to address current limitations in tissue and research access and to advance understanding of the neuropathologies of TReND. As an international, multidisciplinary collaboration CONNECT-TBI brings together multiple experts across 13 institutions. In so doing, CONNECT-TBI unites the existing, comprehensive clinical and neuropathological datasets of multiple established research brain archives in TBI, with survivals ranging minutes to many decades and spanning diverse injury exposures. These existing tissue specimens will be supplemented by prospective brain banking and contribute to a centralized route of access to human tissue for research for investigators. Importantly, each new case will be subject to consensus neuropathology review by the CONNECT-TBI Expert Pathology Group. Herein we set out the CONNECT-TBI program structure and aims and, by way of an illustrative case, the approach to consensus evaluation of new case donations.
一段时间以来，人们一直在努力描述创伤性脑损伤 (TBI) 的晚期影响。近年来，这项活动的大部分工作都集中在报告前接触性运动运动员和其他反复头部受创者的慢性创伤性脑病 (CTE)。然而，TBI 与痴呆风险之间的联系在接触性运动之外早已得到认可。此外，越来越多的经验表明，在那些幸存的 TBI 患者中存在一系列神经退行性病理，而不仅仅是 CTE。尽管进行了广泛的研究，但我们对 TBI 相关神经退行性变 (TReND) 的机制及其与痴呆症的联系知之甚少。部分原因是由于与可供研究使用的可靠人口统计学和临床信息相关的人脑样本数量有限。在这里，我们详细介绍了一个由美国国立神经病学和中风研究所无墙中心进行的项目，即合作神经病理学网络描述 TBI 的结果 (CONNECT-TBI)，旨在解决目前在组织和研究获取方面的限制，并推进对 TReND 神经病理学的理解。作为一个国际多学科合作组织，CONNECT-TBI 将来自 13 个机构的多个专家汇集在一起。通过这样做，CONNECT-TBI 将多个已建立的 TBI 研究性大脑档案的现有全面临床和神经病理学数据集联合起来，这些档案中的幸存者的存活时间从几分钟到几十年不等，涵盖了多种损伤暴露。这些现有的组织标本将通过前瞻性的大脑银行进行补充，并为研究人员提供集中获取人类组织进行研究的途径。重要的是，每个新病例都将由 CONNECT-TBI 专家病理学小组进行共识神经病理学审查。在这里，我们阐述了 CONNECT-TBI 计划的结构和目标，并通过一个说明性病例介绍了对新病例捐赠进行共识评估的方法。
