Pierre Kevin, Dyson Kyle, Dagra Abeer, Williams Eric, Porche Ken, Lucke-Wold Brandon
College of Medicine, University of Florida, Gainesville, FL 32611, USA.
Department of Neurosurgery, University of Florida, Gainesville, FL 32608, USA.
Biomedicines. 2021 Apr 12;9(4):415. doi: 10.3390/biomedicines9040415.
Chronic traumatic encephalopathy is a disease afflicting individuals exposed to repetitive neurotrauma. Unfortunately, diagnosis is made by postmortem pathologic analysis, and treatment options are primarily symptomatic. In this clinical update, we review clinical and pathologic diagnostic criteria and recommended symptomatic treatments. We also review animal models and recent discoveries from pre-clinical studies. Furthermore, we highlight the recent advances in diagnosis using diffusor tensor imaging, functional magnetic resonance imaging, positron emission tomography, and the fluid biomarkers t-tau, sTREM2, CCL11, NFL, and GFAP. We also provide an update on emerging pharmaceutical treatments, including immunotherapies and those that target tau acetylation, tau phosphorylation, and inflammation. Lastly, we highlight the current literature gaps and guide future directions to further improve clinical diagnosis and management of patients suffering from this condition.
慢性创伤性脑病是一种折磨遭受重复性神经创伤个体的疾病。不幸的是，诊断需通过尸检病理分析，且治疗选择主要是对症治疗。在本次临床进展报告中，我们回顾了临床和病理诊断标准以及推荐的对症治疗方法。我们还回顾了动物模型和临床前研究的最新发现。此外，我们强调了使用扩散张量成像、功能磁共振成像、正电子发射断层扫描以及脑脊液生物标志物t-tau、sTREM2、CCL11、NFL和GFAP进行诊断的最新进展。我们还提供了新兴药物治疗的最新情况，包括免疫疗法以及针对tau蛋白乙酰化、tau蛋白磷酸化和炎症的治疗方法。最后，我们强调了当前文献中的空白，并为进一步改善患有这种疾病患者的临床诊断和管理指明未来方向。
