Priemer David S, Perl Daniel P
The Department of Defense/Uniformed Services University Brain Tissue Repository, Bethesda, MD, USA.
Department of Pathology, F. Edward Hébert School of Medicine, Uniformed Services University, Bethesda, MD, USA.
Free Neuropathol. 2022 Nov 15;3:26. doi: 10.17879/freeneuropathology-2022-4495. eCollection 2022 Jan.
The year 2021 was highlighted by many notable advancements in the field of neurotrauma and associated neuropathology. After a thorough review of the new literature, we call attention to what we feel are among the most impactful studies and publications. In brief, 2021 was marked by published consensus papers related to the diagnosis of chronic traumatic encephalopathy (CTE) and its clinical counterpart, traumatic encephalopathy syndrome. There was also progress toward our understanding of the impact of traumatic brain injury (TBI) on the general population, and how strongly CTE pathology may, or may not, commonly underlie long term clinical sequelae following TBI. Next, a critical new study has identified that acetylated tau protein, which has been found to be increased in the brains of Alzheimer's disease and CTE patients, can be induced by TBI, is neurotoxic, and that its reduction via already-existent therapeutics is neuroprotective. There are also several important updates that pertain to military and blast TBI, particularly as they pertain to establishing causality of interface astroglial scarring. In addition, and for the first time, a specific signature for diffuse axonal injury has been identified in tissues using multidimensional magnetic resonance imaging, providing promise for the clinical diagnosis of this lesion. Finally, several important radiologic studies from 2021 have highlighted long-standing structural reductions in a number of brain regions following both mild and severe TBI, emphasizing the need for neuropathologic correlation. We end by highlighting an editorial piece discussing how TBI is portrayed in entertainment media and how this impacts public perception of TBI and its consequences.
2021年,神经创伤及相关神经病理学领域取得了许多显著进展。在对新文献进行全面回顾后,我们提请大家关注我们认为最具影响力的研究和出版物。简而言之,2021年的标志是发表了有关慢性创伤性脑病(CTE)诊断及其临床对应病症——创伤性脑病综合征的共识文件。在了解创伤性脑损伤(TBI)对普通人群的影响以及CTE病理学在TBI长期临床后遗症中可能(或不可能)普遍作为基础的程度方面也取得了进展。接下来,一项重要的新研究发现,在阿尔茨海默病和CTE患者大脑中发现含量增加的乙酰化tau蛋白可由TBI诱导产生,具有神经毒性,并且通过现有疗法降低其含量具有神经保护作用。还有几项重要的更新涉及军事和爆炸导致的TBI,特别是在确定界面星形胶质细胞瘢痕形成的因果关系方面。此外,首次利用多维磁共振成像在组织中识别出弥漫性轴索损伤的特定特征,为该病变的临床诊断带来了希望。最后,2021年的几项重要放射学研究强调了轻度和重度TBI后多个脑区长期存在的结构缩小,强调了神经病理学相关性的必要性。我们最后强调一篇社论文章,该文章讨论了TBI在娱乐媒体中的呈现方式以及这如何影响公众对TBI及其后果的认知。