Lipsky Robert H, Witkin Jeffrey M, Shafique Hana, Smith Jodi L, Cerne Rok, Marini Ann M
Department of Neurology, Uniformed Services University of the Health Sciences, Bethesda, MD, United States.
Program in Neuroscience, and Molecular and Cellular Biology Program, Uniformed Services University of the Health Sciences, Bethesda, MD, United States.
Front Neurosci. 2024 Oct 4;18:1446076. doi: 10.3389/fnins.2024.1446076. eCollection 2024.
Traumatic brain injury (TBI) has reached epidemic proportions worldwide. The consequences of TBI can be severe even with repetitive mild trauma. If death and coma are avoided, the consequences of TBI in the long term typically involve dizziness, sleep disturbances, headache, seizures, cognitive impairment, focal deficits, depression, and anxiety. The severity of brain injury is a significant predictor of outcome. However, the heterogenous nature of the injury makes prognosis difficult. The present review of the literature focuses on the genetics of TBI including genome wide (GWAS) data and candidate gene associations, among them brain-derived neurotrophic factor (BDNF) with TBI and development of post-traumatic epilepsy (PTE). Molecular biomarkers of TBI are also discussed with a focus on proteins and the inflammatory protein IL1-β. The secondary medical sequela to TBI of cognitive impairment, PTE, headache and risk for neurodegenerative disorders is also discussed. This overview of TBI concludes with a review and discussion of the medical management of TBI and the medicines used for and being developed at the preclinical and clinical stages for the treatment of TBI and its host of life-debilitating symptoms.
创伤性脑损伤（TBI）在全球范围内已达到流行程度。即使是重复性轻度创伤，TBI的后果也可能很严重。若能避免死亡和昏迷，TBI的长期后果通常包括头晕、睡眠障碍、头痛、癫痫发作、认知障碍、局灶性缺陷、抑郁和焦虑。脑损伤的严重程度是预后的重要预测指标。然而，损伤的异质性使得预后难以判断。本综述聚焦于TBI的遗传学，包括全基因组（GWAS）数据和候选基因关联，其中包括脑源性神经营养因子（BDNF）与TBI以及创伤后癫痫（PTE）的发生。还讨论了TBI的分子生物标志物，重点是蛋白质和炎症蛋白IL1-β。还讨论了TBI导致的认知障碍、PTE、头痛和神经退行性疾病风险等继发性医学后遗症。本TBI综述最后回顾并讨论了TBI的医学管理以及在临床前和临床阶段用于治疗TBI及其一系列使人衰弱的症状的药物和正在研发的药物。
