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运动员、选手、拳击手和军人中的慢性创伤性脑病:系统评价

Chronic traumatic encephalopathy in athletes, players, boxers and military: systematic review.

作者信息

de Sena Barbosa Mateus Gonçalves, Francisco Ghaspar Gomes de Oliveira Alves, de Souza Rafaela Luiza Vilela, de Souza João Marcos Alcântara, Almeida Carneiro Rafael, Rabelo Nicollas Nunes, Chaurasia Bipin

机构信息

Department of Neurosurgery, Atenas University Center, Passos, MG, Brazil.

Department of Neurosurgery, University of São Paulo, SP, Brazil.

出版信息

Ann Med Surg (Lond). 2024 Oct 24;86(12):7238-7247. doi: 10.1097/MS9.0000000000002693. eCollection 2024 Dec.

Abstract

The objective of the study was to demonstrate whether athletes, players, boxers and military personnel can really be victims of Chronic traumatic encephalopathy (CTE), and to elucidate this pathology. In 53 articles, 14 were selected for qualitative synthesis in the results table that addresses CTE in football, soccer and rugby players, boxers and the military. Neuropathologically, CTE shows cerebral atrophy, a pelvic septum cavity with fenestrations, dense diffuse immunoreactive inclusions and a TDP-43 proteinopathy. Microscopically, there are extensive neurofibrillary tangles and spindle-shaped neurites throughout the brain. Thus, CTE is characterized by being a distinct tauopathy and with a clear environmental etiology. American football players, boxers and the military are more likely to trigger CET, due to the constant mechanical shocks from their heads. The most frequent clinical manifestations were: headache, aggressiveness, dementia, executive dysfunction and suicide. CET is definitely diagnosed only at autopsy, there is no specific treatment for it, but support and safety measures can help the patient. Advances to definitively diagnose CTE in living people and specific treatment for this disease are needed.

摘要

该研究的目的是证明运动员、球员、拳击手和军事人员是否真的会成为慢性创伤性脑病(CTE)的受害者,并阐明这种病理状况。在53篇文章中,有14篇被选入结果表进行定性综合分析,该表涉及足球、英式足球和橄榄球运动员、拳击手以及军事人员中的CTE。在神经病理学上,CTE表现为脑萎缩、有小孔的盆腔隔膜腔、密集的弥漫性免疫反应性包涵体以及TDP - 43蛋白病。在显微镜下,整个大脑存在广泛的神经原纤维缠结和梭形神经突。因此,CTE的特征是一种独特的tau蛋白病且具有明确的环境病因。美式橄榄球运动员、拳击手和军事人员由于头部不断受到机械冲击,更有可能引发CTE。最常见的临床表现为:头痛、攻击性、痴呆、执行功能障碍和自杀。CTE只有在尸检时才能明确诊断,目前尚无针对它的特效治疗方法,但支持和安全措施有助于患者。需要在活人身上明确诊断CTE的进展以及针对这种疾病的特效治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c96/11623818/197ace0818fb/ms9-86-7238-g001.jpg

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