PDF(Pubmed)
Abstract：
There are no validated diagnostic criteria for traumatic encephalopathy syndrome (TES). During the early and middle 20th century, TES was described as a clinical condition that was experienced by some high-exposure boxers-and it was believed to reflect chronic traumatic brain injury. Consensus criteria for the diagnosis of TES were published in 2021. We applied the consensus criteria for TES retrospectively to cases of chronic brain damage in boxers described in articles published in the 20th century that were obtained from narrative and systematic reviews. The sample included 157 boxers identified in 21 articles published between 1929 and 1999. Two authors reviewed each case description and coded the criteria for TES. For the core clinical features, cognitive impairment was noted in 63.1%, and in 28.7% of cases the person\'s cognitive functioning appeared to be broadly normal. Neurobehavioral dysregulation was present in 25.5%. One third (34.4%) were identified as progressive, 30.6% were not progressive, and the course could not be clearly determined in 35.0%. In total, 29.9% met the TES consensus criteria, 28.0% did not, and 42.0% had insufficient information to make a diagnostic determination. TES, in the 20th century, was described as a neurological condition, not a psychiatric disorder-and this supports the decision of the 2021 consensus group to remove primary and secondary psychiatric diagnoses from being a core diagnostic feature. Future research is needed to determine whether, or the extent to which, cognitive impairment or neurobehavioral dysregulation described as characterizing TES are associated with chronic traumatic encephalopathy neuropathological change.
摘要：
没有有效的创伤性脑病综合征（TES）的诊断标准。在20世纪早期和中期，TES被描述为一些高暴露拳击手所经历的临床状况，并且被认为反映了慢性创伤性脑损伤。TES诊断的共识标准于2021年公布。我们将TES的共识标准回顾性地应用于20世纪发表的文章中描述的拳击手慢性脑损伤的病例，这些文章是从叙事和系统评价中获得的。样本包括1929年至1999年间发表的21篇文章中确定的157名拳击手。两位作者回顾了每个病例描述，并编码了TES的标准。对于核心临床特征，认知障碍占63.1%，在28.7%的病例中，这个人的认知功能似乎大致正常。25.5%存在神经行为失调。三分之一(34.4%)被确定为进步的，30.6%不是进步的，35.0%的病程无法明确确定。总的来说,29.9%符合TES共识标准,28.0%没有，42.0%的人没有足够的信息来做出诊断决定。TES,在20世纪,被描述为神经系统疾病，不是精神疾病-这支持了2021年共识小组的决定，即从核心诊断特征中删除原发性和继发性精神病诊断。需要未来的研究来确定是否，或者在多大程度上，以TES为特征的认知障碍或神经行为失调与慢性创伤性脑病神经病理学改变有关。
