Department of Geriatrics, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario "Agostino Gemelli", IRCCS, Rome, Italy.
UOC Geriatria, Disturbi Cognitivi e Demenze, Ausl Modena, Carpi, Italy.
Rev Recent Clin Trials. 2022;17(4):245-249. doi: 10.2174/1574887117666220811090608.
Head trauma and delirium are two common conditions in the elderly population. They both carry a heavy burden in terms of mortality and morbidity and are associated with one another through several environmental and clinical factors, such as comorbidities, age, and sex. One factor that may play a role in both these conditions is inflammation, which might also represent a link between them. In particular, head trauma can cause both systemic and neuroinflammation, while delirium appears to be precipitated by inflammatory conditions, while also involving a number of inflammatory pathways in its pathogenesis. Interleukin 6 and tumor necrosis factor α are only two of the main actors in this crosstalk, which also involves microglia and immune cells. An indirect proof is that anti-inflammatory drugs have proven effective in reducing post-traumatic delirium, thus demonstrating the importance of inflammation in the pathophysiology of this disease. In this paper, we have revised the available literature exploring the links between inflammation, head trauma and delirium and we will discuss the mechanisms of this relationship, paying particular attention to the possible future implications.
头部创伤和谵妄是老年人群中两种常见的病症。它们在死亡率和发病率方面都带来了沉重的负担，并且通过几种环境和临床因素相互关联，例如合并症、年龄和性别。可能在这两种病症中都起作用的一个因素是炎症，炎症也可能是它们之间的联系。具体而言，头部创伤可引起全身和神经炎症，而谵妄似乎是由炎症状态引发的，同时在其发病机制中也涉及许多炎症途径。白细胞介素 6 和肿瘤坏死因子-α仅是这种相互作用的主要参与者中的两个，其中还涉及小胶质细胞和免疫细胞。间接证据是，抗炎药已被证明可有效减少创伤后谵妄，从而证明了炎症在该疾病病理生理学中的重要性。在本文中，我们回顾了探讨炎症、头部创伤和谵妄之间联系的现有文献，并将讨论这种关系的机制，特别注意可能的未来影响。
