Department of Biological Anthropology, University of Szeged, Szeged, Hungary.
Department of Anthropology, National Museum of Natural History, Smithsonian Institution, Washington, District of Columbia, United States of America.
PLoS One. 2021 Mar 19;16(3):e0249020. doi: 10.1371/journal.pone.0249020. eCollection 2021.
Abnormally pronounced digital impressions (APDIs) on the endocranial surface develop secondary to a prolonged rise in the intracranial pressure. This can result from a number of pathological conditions, including hydrocephalus due to tuberculous meningitis (TBM). APDIs have been described with relation to TBM not only in the modern medical literature but also in several paleopathological studies. However, APDIs are not pathognomonic for TBM and their diagnostic value for identifying TBM in past human populations has not been evaluated in identified pre-antibiotic era skeletons. To assess the diagnostic value of APDIs for the first time, a macroscopic investigation was performed on skeletons from the Terry Collection (Smithsonian Institution, Washington, DC, USA). Our material consisted of 234 skeletons with tuberculosis (TB) as the cause of death (TB group) and 193 skeletons with non-tuberculous (NTB) causes of death (NTB group). The macroscopic examination focused on the stage of the prominence and frequency of APDIs in the TB group and NTB group. To determine the significance of difference (if any) in the frequency of APDIs between the two groups, χ2 testing of our data was conducted. We found that APDIs were twice as common in the TB group than in the NTB group. The χ2 comparison of the frequencies of APDIs revealed a statistically significant difference between the two groups. In addition, APDIs with more pronounced stages were recorded more frequently in the TB group. Our results indicate that APDIs can be considered as diagnostic criteria for TBM in the paleopathological practice. With suitable circumspection, their utilization provides paleopathologists with a stronger basis for identifying TB and consequently, with a more sensitive means of assessing TB frequency in past human populations.
脑内表面异常的颅骨压迹（APDIs）是由于颅内压长时间升高而继发形成的。这可能由多种病理情况引起，包括结核性脑膜炎（TBM）导致的脑积水。APDIs 不仅在现代医学文献中与 TBM 有关，而且在几项古病理学研究中也有描述。然而，APDIs 并非 TBM 的特异性表现，其在过去人类群体中识别 TBM 的诊断价值在已鉴定的抗生素前时代骨骼中尚未得到评估。为了首次评估 APDIs 的诊断价值，我们对来自 Terry 收藏（美国华盛顿特区史密森学会）的骨骼进行了宏观研究。我们的材料包括 234 具因结核病（TB）而死亡的骨骼（TB 组）和 193 具因非结核性（NTB）原因而死亡的骨骼（NTB 组）。宏观检查侧重于 TB 组和 NTB 组中 APDIs 的突出阶段和频率。为了确定两组之间 APDIs 频率差异（如有）的意义，我们对数据进行了卡方检验。我们发现，TB 组中 APDIs 的发生率是 NTB 组的两倍。两组之间 APDIs 频率的卡方比较显示出统计学上的显著差异。此外，在 TB 组中，更明显阶段的 APDIs 记录更为频繁。我们的结果表明，APDIs 可被视为古病理学实践中 TBM 的诊断标准。在适当的谨慎考虑下，它们的利用为古病理学家提供了识别 TB 的更有力依据，从而为评估过去人类群体中 TB 的频率提供了更敏感的手段。
