原文题目：

Shorter Recovery Time in Concussed Elite Ice Hockey Players by Early Head-and-Neck Cooling: A Clinical Trial

原文链接：

https://www.liebertpub.com/doi/10.1089/neu.2022.0248

[REF: Al-Husseini A, Fazel Bakhsheshi M, Gard A, Tegner Y, Marklund N. Shorter Recovery Time in Concussed Elite Ice Hockey Players by Early Head-and-Neck Cooling: A Clinical Trial. J Neurotrauma. 2023;40(11-12):1075-1085. doi:10.1089/neu.2022.0248 PMID: 36222612]

A sports-related concussion (SRC) is most commonly sustained in contact sports, and is defined as a mild traumatic brain injury. An exercise-induced elevation of core body temperature is associated with increased brain temperature that may accelerate secondary injury processes following SRC, and exacerbate the brain injury. In a recent pilot study, acute head-neck cooling of 29 concussed ice hockey players resulted in shorter time to return-to-play.

运动相关脑震荡(SRC)是接触性运动中最常见的，被定义为轻微的创伤性脑损伤。运动引起的核心体温升高与脑温度升高有关，这可能会加速SRC后的继发性损伤过程，并加剧脑损伤。在最近的一项初步研究中，29名脑震荡的冰球运动员的头颈部急性降温导致重返赛场的时间缩短。

原文题目：

Tau, β-Amyloid, and Glucose Metabolism Following Service-Related Traumatic Brain Injury in Vietnam War Veterans: The Australian Imaging Biomarkers and Lifestyle Study of Aging-Veterans Study (AIBL-VETS)

原文链接：

https://www.liebertpub.com/doi/10.1089/neu.2022.0172

Traumatic brain injury (TBI) is common among military veterans and has been associated with an increased risk of dementia. It is unclear if this is due to increased risk for Alzheimer's disease (AD) or other mechanisms. This case control study sought evidence for AD, as defined by the 2018 National Institute on Aging - Alzheimer's Association (NIA-AA) research framework, by measuring tau, β-amyloid, and glucose metabolism using positron emission tomography (PET) in veterans with service-related TBI. Seventy male Vietnam war veterans-40 with TBI (age 68.0 ± 2.5 years) and 30 controls (age 70.1 ± 5.3 years)-with no prior diagnosis of dementia or mild cognitive impairment underwent β-amyloid (18F-Florbetaben), tau (18F-Flortaucipir), and fluorodeoxyglucose (18F-FDG) PET. In conclusion, no increase in the later life accumulation of the neuropathological markers of AD in veterans with a remote history of TBI was identified.

创伤性脑损伤在退伍军人中很常见，并与痴呆症风险增加有关。目前尚不清楚这是由于阿尔茨海默病(AD)风险增加还是其他机制造成的。这项病例对照研究通过使用正电子发射断层扫描测量退伍军人中的tau、β-淀粉样蛋白和糖代谢，寻找2018年国家老龄-阿尔茨海默氏症协会研究框架定义的AD的证据。对70名越战退伍军人进行了β-淀粉样蛋白(18F-Florbetaben)、tau(18F-Flortaucipir)和氟代脱氧葡萄糖(18F-FDG)的正电子发射计算机断层扫描。总而言之，在有远期脑外伤病史的退伍军人中，AD的神经病理标记物的晚年积聚没有增加。

原文题目：

Impact of Chronological Age and Biological Sex on Cerebrovascular Reactivity in Moderate/Severe Traumatic Brain Injury: A CAnadian High-Resolution Traumatic Brain Injury (CAHR-TBI) Study

原文链接：

https://www.liebertpub.com/doi/10.1089/neu.2022.0293

Impaired cerebrovascular reactivity has emerged as an important associate with poor long-term outcome after moderate/severe traumatic brain injury (TBI). However, our understanding of what drives or modulates the degree of impaired cerebrovascular function remains poor. Age and biological sex remain important modifiers of cerebrovascular function in health and disease, yet their impact on cerebrovascular reactivity after TBI remains unclear. The aim of this study was to explore subgroup responses based on age and biological sex on cerebral physiology.  In corollary, a statistically significant relationship was found between increasing age on trichotomized and decades of age analysis with PAx and RAC measures. PRx failed to demonstrate such relationships to advancing age. There was no clear difference in cerebrovascular reactivity profiles between biological sex categories. These findings suggest that AMP-based cerebrovascular reactivity indices may be better positioned to detect impairment in TBI patients with advancing age. Further investigation into the utility of PAx and RAC is required, as they may prove useful for certain subgroups of patients.

脑血管反应性受损已成为中、重型颅脑损伤后远期预后不良的重要原因之一。然而，我们对是什么驱动或调节脑血管功能受损程度的了解仍然很差。在健康和疾病中，年龄和生物性别仍然是脑血管功能的重要调节因素，但它们对脑创伤后脑血管反应性的影响尚不清楚。本研究的目的是探索基于年龄和生物性别的亚组反应对脑生理学的影响。在推论中，在PAx和RAC测量中，发现了在将年龄进行三分组和按十年为单位进行分析时，年龄增长与统计学显著相关的关系。PRX未能证明这种与年龄增长的关系。不同生物性别之间的脑血管反应性分布无明显差异。这些发现表明，基于AMP的脑血管反应性指数可能更适合于检测年龄越大的脑外伤患者的损害。需要进一步研究PAX和RAC的效用，因为它们可能被证明对某些亚群的患者有用。

The objectives of this machine-learning (ML) resting-state magnetoencephalography (rs-MEG) study involving children with mild traumatic brain injury (mTBI) and orthopedic injury (OI) controls were to define a neural injury signature of mTBI and to delineate the pattern(s) of neural injury that determine behavioral recovery. The ML algorithm accounted for 84.5% of the variance in predicting recovery measured by PCS changes between 3 weeks and 3 months post-injury in the mTBI group, and this was significantly lower (p < 10-4) in the OI group (65.6%). Frontal lobe pole (higher) gamma activity was significantly (p < 0.001) associated with (worse) PCS recovery exclusively in the mTBI group. These findings demonstrate a neural injury signature of pediatric mTBI and patterns of mTBI-induced neural injury related to behavioral recovery.

这项机器学习(ML)静息状态脑磁图(RS-MEG)研究的目的是确定轻度创伤性脑损伤(MTBI)儿童和骨科损伤(OI)对照组儿童的神经损伤特征，并描绘决定行为恢复的神经损伤模式。在mTBI组，ML算法可以解释损伤后3周至3个月PCS变化预测恢复的84.5%，而OI组(65.6%)显著低于OI组(p<10-4)。在脑外伤组中，额叶(较高)伽马活动与(较差)PCS恢复显著相关(p<0.001)。这些发现显示了儿童mTBI的神经损伤特征，以及与行为恢复相关的mTBI所致神经损伤的模式。

原文题目：

Association Between Serum Neurofilament Light and Glial Fibrillary Acidic Protein Levels and Head Impact Burden in Women's Collegiate Water Polo

原文链接：

https://www.liebertpub.com/doi/10.1089/neu.2022.0300

Recent investigations have identified water polo athletes as at risk for concussions and repetitive subconcussive head impacts. Head impact exposure in collegiate varsity women's water polo, however, has not yet been longitudinally quantified. We aimed to determine the relationship between cumulative and acute head impact exposure across pre-season training and changes in serum biomarkers of brain injury.  Hormonal contraceptive use was associated with lower serum NfL and GFAP levels over time, and elevated salivary levels of progesterone were also associated with lower serum NfL levels. These results suggest that detecting increases in serum NfL may be a useful way to monitor cumulative head impact burden in women's contact sports and that female-specific factors, such as hormonal contraceptive use and circulating progesterone levels, may be neuroprotective, warranting further investigations.

最近的调查发现，水球运动员有脑震荡和反复亚脑震荡头部撞击的风险。然而，在大学校队女子水球比赛中，头部撞击暴露还没有得到纵向量化。我们的目标是确定在季前训练期间累积和急性头部撞击暴露与脑损伤血清生物标记物变化之间的关系。随着时间的推移，激素避孕药的使用与血清NFL和GFAP水平的降低有关，唾液中孕酮水平的升高也与血清NFL水平的降低有关。这些结果表明，检测血清NFL的增加可能是监测女性接触性运动中累积头部撞击负荷的有用方法，女性特有的因素，如激素避孕药的使用和循环孕酮水平，可能具有神经保护作用，值得进一步研究。

原文题目：

Acute Blood Levels of Neurofilament Light Indicate One-Year White Matter Pathology and Functional Impairment in Repetitive Mild Traumatic Brain Injured Mice

原文链接：

https://www.liebertpub.com/doi/10.1089/neu.2022.0252

Mild traumatic brain injury (mTBI) mostly causes transient symptoms, but repeated (r)mTBI can lead to neurodegenerative processes. Diagnostic tools to evaluate the presence of ongoing occult neuropathology are lacking. These findings show that rmTBI causes white matter pathology detectable by MRI before chronic functional impairment. Early quantification of plasma NfL correlates with the degree of white matter atrophy one year after rmTBI and can serve to monitor the brain's susceptibility to a second mTBI, supporting its potential clinical application to guide the return to practice in sport-related TBI.

轻度创伤性脑损伤(MTBI)主要引起一过性症状，但反复(R)mTBI可导致神经变性过程。缺乏诊断工具来评估正在进行的隐匿性神经病理的存在。这些结果表明，rmTBI导致脑白质病变，在慢性功能损害之前，MRI可以检测到。血浆NFL的早期定量与rmTBI后一年脑白质萎缩的程度相关，并可用于监测大脑对第二次mTBI的易感性，支持其潜在的临床应用，以指导运动相关TBI的回归实践。

原文题目：

Blunt Cerebrovascular Injury in the Elderly With Traumatic Cervical Spine Injuries: Results of a Retrospective Multi-Center Study of 1512 Cases in Japan

原文链接：

https://www.liebertpub.com/doi/10.1089/neu.2022.0180

This study is nationwide retrospective multi-center study to investigate the incidence and characteristics of blunt cerebrovascular injury (BCVI) in elderly Japanese patients with traumatic cervical spine injuries (CSI) including spinal cord injury (SCI) without major bone injury. In conclusion, 53 (3.5%) elderly patients were complicated with BCVI. BCVI more frequently complicated head injury, severe neurological deficit (ASIA A or tetraplegia), AO type F, and/or C fractures and cervical dislocation in these patients. Six patients (11%) suffered brain infarction and two patients died from BCVI.

本研究是一项全国性的多中心回顾性研究，旨在调查日本老年创伤性颈椎损伤(CSI)患者闭合性脑血管损伤(BCVI)的发生率和特点。53例(3.5%)老年患者合并BCVI。BCVI更常合并颅脑损伤、严重神经功能障碍(ASIA A或四肢瘫痪)、AO型F和/或C型骨折和颈椎脱位。6例(11%)患者发生脑梗塞，2例死于BCVI。

For many years, experts have recognized the importance of studying traumatic brain injury (TBI) among active-duty service members and veterans. A majority of this research has been conducted in Veterans Administration (VA) or Department of Defense settings. However, far less is known about military personnel who seek their medical care outside these settings. Studies that have been conducted in civilian settings have either not enrolled active duty or veteran participants, or failed to measure military history, precluding study of TBI outcomes by military history. Individuals with military history without combat deployment had modestly more favorable cognition and psychological health in the first 5 years post-injury relative to those without military history. Our data suggest that individuals with TBI with military history are heterogeneous, with some favorable and other deleterious health outcomes, relative to their non-military counterparts, which may be driven by characteristics of service, including combat exposure and era of service.

多年来，专家们已经认识到在现役军人和退伍军人中研究创伤性脑损伤(TBI)的重要性。这项研究的大部分是在退伍军人管理局(VA)或国防部进行的。然而，人们对在这些环境之外寻求医疗服务的军事人员知之甚少。在平民环境中进行的研究要么没有招募现役或退伍军人参与者，要么未能衡量军事历史，从而排除了通过军事历史来研究脑外伤结果的可能性。在创伤后的头5年里，与没有军事历史的个体相比，有军事历史的个体在受伤后的头5年中有更好的认知和心理健康。我们的数据表明，与非军人相比，有军事病史的脑外伤患者具有异质性，有一些有利的和其他有害的健康后果，这可能是由服役特征所驱动的，包括战斗暴露和服役时间。

Concussions can impact cognitive processes necessary for driving. Young adults, a group who are more likely to engage in risky behaviors, have limited driving experience and a higher rate of motor vehicle collisions; they may be at higher risk for driving impairment after concussion. There are no clear guidelines for return-to-driving following a concussion. We sought to examine the simulated driving performance of young drivers after receiving medical care following a concussion, compared with a similar control population, to examine the association of driving performance with performance on neuropsychological tests. Results suggest that neurocognitive screening may be a useful tool for predicting capacity to return to drive. However, further research is needed to determine guidelines for how neuropsychological tests can be used to make return to driving recommendations and to evaluate effects of concussion on real world driving.

脑震荡会影响驾驶所必需的认知过程。年轻人是一个更有可能从事危险行为的群体，他们的驾驶经验有限，机动车相撞的几率更高；他们可能在脑震荡后出现驾驶损伤的风险更高。对于脑震荡后恢复驾驶，目前还没有明确的指导方针。我们试图检查年轻司机在脑震荡后接受医疗护理后的模拟驾驶表现，并与类似的对照组人群进行比较，以检验驾驶表现与神经心理测试中表现的相关性。结果表明，神经认知筛查可能是预测恢复驾驶能力的有用工具。然而，还需要进一步的研究来确定如何使用神经心理测试来做出回归驾驶建议的指导方针，以及评估脑震荡对现实世界驾驶的影响。

Therapies are limited for pediatric traumatic brain injury (TBI), especially for the very young who can experience long-term consequences to learning, memory, and social behavior. Animal models of pediatric TBI have yielded mechanistic insights, but demonstration of clinically relevant long-term behavioral and/or cognitive deficits has been challenging. We characterized short- and long-term outcomes in a controlled cortical impact (CCI) model of pediatric TBI using a panel of tests between 2 weeks and ∼4 months after injury. The study demonstrates the high sensitivity of comprehensive cognitive testing to detect long-term effects of early-age craniotomy and TBI and provides a template for future testing of experimental therapies.

儿童创伤性脑损伤(TBI)的治疗方法有限，特别是对可能会对学习、记忆和社会行为产生长期影响的非常年轻的人。儿童颅脑损伤的动物模型已经产生了机械性的见解，但证明临床上相关的长期行为和/或认知缺陷一直是具有挑战性的。我们通过一组在受伤后2周至4个月∼之间的测试，对儿童脑外伤的受控皮质撞击模型的短期和长期结果进行了表征。这项研究证明了综合认知测试在检测早期开颅手术和脑外伤的长期影响方面的高度敏感性，并为未来实验疗法的测试提供了一个模板。

The goal of the current study was to identify a potential relationship between high-fat diet (HFD) consumption and TBI on HPA axis function in juvenile rats. In the present study, male juvenile Long-Evans rats were fed either a combination of an HFD with a high-fructose corn syrup solution or a standard chow diet.mmediately following TBI, injured juveniles had increased time to righting and walking, with HFD-fed TBI rats having increased time to walking over Chow-fed TBI rats. HFD-fed TBI rats had a reduced number of entries to the center of the OFT, in addition to reduced time spent in the center compared with HFD Sham controls and Chow TBI rats. During the acute restraint stress test, HFD-fed TBI rats had elevated pre-stress ACTH and corticosterone and post-stress ACTH levels. Pre-stress ACTH levels were significantly elevated in HFD TBI compared with Chow TBI. Further, pre-stress ACTH:corticosterone ratios were elevated in HFD TBI compared with Chow TBI. cFos immunoreactivity in the paraventricular nucleus (PVN) of the hypothalamus following the acute restraint stress test was elevated in HFD-fed TBI rats. HFD TBI rats had greater activation of cFos in the PVN compared with Chow TBI. In addition, RT-PCR showed significantly reduced expression of relevant HPA axis genes, NR3C1, NR3C2, and CRHR2, in the hypothalamus of TBI subjects compared with Sham subjects. Further, AVP and CRHR2 in the hypothalamus were significantly reduced in HFD TBI compared with Chow TBI. These results offer evidence that TBI paired with high-fat diet consumption can cause HPA axis dysfunction, resulting in more anxiety-like behaviors.

本研究的目的是确定高脂饮食(HFD)摄入和脑外伤对幼年大鼠HPA轴功能的潜在关系。在本研究中，雄性幼年Long-Evans大鼠被喂以HFD和高果糖玉米糖浆溶液或标准饮食的组合。在颅脑损伤后的即刻，受伤幼鼠的站立和行走时间增加，喂HFD的TBI大鼠行走的时间比喂食Chow的TBI大鼠增加。与HFD Sham对照组和Chow TBI大鼠相比，HFD喂养的TBI大鼠进入OFT中心的次数减少，在中心停留的时间也减少。在急性束缚应激试验中，给予HFD的TBI大鼠的应激前ACTH、皮质酮和应激后ACTH水平均升高。HFD组与CHW组相比，应激前ACTH水平显著升高。此外，与CHOW TBI相比，HFD TBI组的预应激ACTH：皮质酮比率升高。急性束缚应激大鼠急性束缚应激后下丘脑室旁核(PVN)CFos免疫反应增强。与CHOW-TBI相比，HFD-TBI大鼠PVN中CFO的活化程度更高。此外，RT-PCR显示，与假手术组相比，脑外伤组下丘脑中HPA轴相关基因NR3C1、NR3C2和CRHR2的表达显著降低。此外，与CHOW-TBI相比，HFD-TBI组大鼠下丘脑中AVP和CRHR2的表达显著降低。这些结果提供了证据，即脑外伤和高脂饮食摄入可以导致HPA轴功能障碍，从而导致更多的焦虑症行为。

Blast-induced shock waves (BSWs) are responsible for several aspects of psychiatric disorders that are collectively termed mild traumatic brain injury (mTBI). The pathophysiology of mTBI includes vascular leakage resulting from blood-brain barrier (BBB) disruption. In this study, the precise sequence of BBB breakdown was examined using an Evans blue and fluorescein isothiocyanate (FITC)-dextran double labeling technique. Our findings provide important insights into the pathogenesis underlying mTBI and indicate that even mild BSW exposure affects the whole brain.

冲击波(BSWs)导致精神障碍的几个方面，统称为轻度创伤性脑损伤(MTBI)。MTBI的病理生理学包括血脑屏障(BBB)破坏引起的血管渗漏。在这项研究中，使用伊文思蓝和异硫氰酸荧光素(FITC)-葡聚糖双标记技术检测了血脑屏障破裂的精确序列。我们的发现为mTBI潜在的发病机制提供了重要的见解，并表明即使是轻微的BSW暴露也会影响整个大脑。

Mild traumatic brain injury (mTBI) can be accompanied by structural damage to the brain. Here, we investigated how the presence of intracranial traumatic computed tomography (CT) pathologies relates to the global functional outcome in young patients one year after mTBI. All patients with mTBI (Glasgow Coma Scale: 13-15) ≤24 years in the multi-center, prospective, observational Collaborative European NeuroTrauma Effectiveness Research in TBI (CENTER-TBI) study were included. Patient demographics and CT findings were assessed at admission, and the Glasgow Outcome Scale Extended (GOSE) was evaluated at 12 months follow-up.Patients with a positive CT scan were less likely to achieve a complete recovery 12 months post-injury. The presence of any CT abnormality was associated with both lower GOSE scores (odds ratio [OR]: 0.39 [0.24-0.63]) and incomplete recovery (GOSE <8; OR: 0.41 [0.25-0.68]), also when adjusted for demographical and clinical baseline factors. The presence of intracranial traumatic CT pathologies was predictive of outcome 12 months after mTBI in young patients, which might help to identify candidates for early follow-up and additional care.

轻度创伤性脑损伤(MTBI)可伴有脑部结构性损伤。在这里，我们调查了在mTBI后一年的年轻患者中，颅内创伤性计算机断层扫描(CT)病理的存在与整体功能结果之间的关系。纳入在多中心、前瞻性、观察性欧洲神经创伤有效性研究(中心-≤)研究中有24年脑损伤(格拉斯哥昏迷分级评分：13-15)的所有患者。入院时评估患者的人口统计学和CT表现，12个月后评估扩展格拉斯哥预后量表(GOSE)。CT扫描阳性的患者在伤后12个月实现完全恢复的可能性较小。在调整人口学和临床基线因素后，任何CT异常的存在都与较低的Gose评分(优势比[OR]：0.39[0.24-0.63])和不完全恢复(Gose<8；OR：0.41[0.25-0.68])相关。年轻患者mTBI后12个月，颅内创伤性CT病理改变可以预测预后，这可能有助于确定早期随访和额外护理的候选对象。

The objectives of this systematic review were to examine the current literature on neuroimaging in TBI-related PTSD, summarize key findings, and highlight strengths and limitations to guide future research. There was no consensus regarding neuroimaging correlates of TBI-related PTSD among the included articles. A small number of studies suggest that TBI-related PTSD is associated with white matter tract changes, particularly in frontotemporal regions, as well as changes in whole-brain networks of resting-state connectivity.

这项系统性综述的目的是审查目前有关脑外伤相关创伤后应激障碍的神经成像的文献，总结关键的发现，并强调优势和局限性，以指导未来的研究。在纳入的文章中，没有关于脑外伤相关创伤后应激障碍的神经影像相关性的共识。少数研究表明，与脑外伤相关的创伤后应激障碍与白质束改变有关，尤其是额颞区，以及静息状态连接的全脑网络的改变。

Studies investigating long-term symptoms and disability after mild traumatic brain injury (mTBI) have yielded mixed results. This systematic review and meta-analysis aimed to determine the prevalence of self-reported post-concussion symptoms (PCS) and disability following mTBI. We conclude that nearly one in three adults who present to an emergency department or trauma center with mTBI report at least mild severity PCS 3-6 months later, but controlling for attrition bias, the true prevalence may be one in six. Studies with representative samples and high retention rates are needed.

对轻度创伤性脑损伤(MTBI)后长期症状和残疾的研究结果喜忧参半。这项系统性综述和荟萃分析旨在确定mTBI后自我报告的脑震荡后症状(PCS)和残疾的患病率。我们得出结论，到急诊科或创伤中心就诊的患有mTBI的成年人中，近三分之一的人在3-6个月后报告至少轻度严重的PCS，但控制偏差，真正的患病率可能是六分之一。需要对具有代表性的样本和高保留率进行研究。

Traumatic brain injury (TBI) is known to be a signature wound of the post-9/11 conflicts. In response, the U.S. Department of Defense (DOD) and other federal organizations have directed significant investments toward TBI research on characterizing injury populations and understanding long-term outcomes. To address legislative requirements and research gaps, several observational, longitudinal TBI studies were initiated as an effective means of investigating TBI clinical management, outcomes, and recovery. This review synthesizes the landscape (i.e., requirements and gaps, infrastructure, geography, timelines, TBI severity definitions, military and injury populations of interest, and measures) of DOD-funded longitudinal TBI studies being conducted in service member and veteran (SMV) populations. Based on the landscape described here, we present recommended actions and solutions that would allow a consolidated and cooperative future state of longitudinal TBI research, optimized continued investments, and advances in the state of the science without redundancy.

创伤性脑损伤(TBI)被认为是9/11冲突后的标志性创伤。作为回应，美国国防部(DOD)和其他联邦组织已将大量资金投入到TBI研究上，以确定受伤人群的特征并了解长期结果。为了解决立法要求和研究空白，启动了几项观察性的、纵向的脑损伤研究，作为研究脑损伤临床管理、结果和恢复的有效手段。这篇综述综合了国防部资助的在服役人员和退伍军人(SMV)人群中进行的纵向脑损伤研究的概况(即，要求和差距、基础设施、地理、时间表、脑损伤严重程度定义、感兴趣的军事和受伤人口以及措施)。根据这里描述的情况，我们提出了建议的行动和解决方案，以实现纵向TBI研究的巩固和合作的未来状态，优化持续投资，并在没有冗余的情况下推进科学状态。

首都医科大学附属北京天坛医院神经外科博士研究生

主要研究方向为糖皮质激素在创伤性脑损伤后继发性损伤和修复的机制