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脑震荡后综合征诊断的进展:对流行病学、病理生理学、神经病理学、神经影像学和唾液生物标志物的见解

Advancements in diagnosing Post-concussion Syndrome: insights into epidemiology, pathophysiology, neuropathology, neuroimaging, and salivary biomarkers.

作者信息

Mavroudis Ioannis, Petridis Foivos, Ciobica Alin, Kamal Fatima Zahra, Padurariu Manuela, Kazis Dimitrios

机构信息

Department of Neuroscience, Leeds Teaching Hospitals, NHS Trust, Leeds, UK.

Leeds University, Leeds, UK.

出版信息

Acta Neurol Belg. 2025 Jan 8. doi: 10.1007/s13760-024-02695-7.

Abstract

Post-Concussion Syndrome (PCS) represents a complex constellation of symptoms that persist following a concussion or mild traumatic brain injury (mTBI), with significant implications for patient care and outcomes. Despite its prevalence, diagnosing PCS presents considerable challenges due to the subjective nature of symptoms, the absence of specific diagnostic tests, and the overlap with other neurological and psychiatric conditions. This review explores the multifaceted diagnostic challenges associated with PCS, including the heterogeneity of symptom presentation, the limitations of current neuroimaging techniques, and the overlap of PCS symptoms with other disorders. We also discuss the potential of emerging biomarkers and advanced imaging modalities to enhance diagnostic accuracy and provide a more objective basis for PCS identification. Additionally, the review highlights the importance of a multidisciplinary approach in the diagnosis and management of PCS, integrating clinical evaluation with innovative diagnostic tools to improve patient outcomes. Through a comprehensive analysis of current practices and future directions, this review aims to shed light on the complexities of PCS diagnosis and pave the way for improved strategies in the identification and treatment of this condition.

摘要

脑震荡后综合征(PCS)表现为脑震荡或轻度创伤性脑损伤(mTBI)后持续存在的一系列复杂症状,对患者的护理和预后具有重大影响。尽管其发病率很高,但由于症状的主观性、缺乏特定的诊断测试以及与其他神经和精神疾病的重叠,诊断PCS面临着相当大的挑战。本综述探讨了与PCS相关的多方面诊断挑战,包括症状表现的异质性、当前神经影像学技术的局限性以及PCS症状与其他疾病的重叠。我们还讨论了新兴生物标志物和先进成像模式在提高诊断准确性以及为PCS识别提供更客观依据方面的潜力。此外,该综述强调了多学科方法在PCS诊断和管理中的重要性,将临床评估与创新诊断工具相结合以改善患者预后。通过对当前实践和未来方向的全面分析,本综述旨在阐明PCS诊断的复杂性,并为改善该疾病的识别和治疗策略铺平道路。

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