de Souza Daniel N, Jarmol Mitchell, Bell Carter A, Marini Christina, Balcer Laura J, Galetta Steven L, Grossman Scott N
Department of Neurology, New York University Grossman School of Medicine, New York, NY 10017, USA.
Department of Ophthalmology, New York University Grossman School of Medicine, New York, NY 10017, USA.
Brain Sci. 2023 Sep 21;13(9):1352. doi: 10.3390/brainsci13091352.
Mitigating the substantial public health impact of concussion is a particularly difficult challenge. This is partly because concussion is a highly prevalent condition, and diagnosis is predominantly symptom-based. Much of contemporary concussion management relies on symptom interpretation and accurate reporting by patients. These types of reports may be influenced by a variety of factors for each individual, such as preexisting mental health conditions, headache disorders, and sleep conditions, among other factors. This can all be contributory to non-specific and potentially misleading clinical manifestations in the aftermath of a concussion. This review aimed to conduct an examination of the existing literature on emerging approaches for objectively evaluating potential concussion, as well as to highlight current gaps in understanding where further research is necessary. Objective assessments of visual and ocular motor concussion symptoms, specialized imaging techniques, and tissue-based concentrations of specific biomarkers have all shown promise for specifically characterizing diffuse brain injuries, and will be important to the future of concussion diagnosis and management. The consolidation of these approaches into a comprehensive examination progression will be the next horizon for increased precision in concussion diagnosis and treatment.
减轻脑震荡对公众健康造成的重大影响是一项特别艰巨的挑战。部分原因在于脑震荡是一种极为普遍的病症，且诊断主要基于症状。当代脑震荡管理的许多方面都依赖于患者的症状解读和准确报告。对于每个个体而言，这类报告可能会受到多种因素的影响，比如既往存在的心理健康状况、头痛疾病以及睡眠状况等诸多因素。这一切都可能导致脑震荡后出现非特异性且可能具有误导性的临床表现。本综述旨在对现有关于客观评估潜在脑震荡的新兴方法的文献进行审视，并突出当前在理解方面存在的差距，即哪些方面还需要进一步研究。对视觉和眼球运动性脑震荡症状的客观评估、专门的成像技术以及特定生物标志物的组织浓度，都已显示出在特异性表征弥漫性脑损伤方面具有前景，并且对于脑震荡诊断和管理的未来发展至关重要。将这些方法整合为一个全面的检查流程将是提高脑震荡诊断和治疗精度的下一个目标。
