慢性创伤性脑病(CTE)与病理改变有关,然而,在生活中发现这些变化已被证明是难以捉摸的。正电子发射断层扫描(PET)提供了识别这种病理的潜力。迄今为止,很少有研究完成,其方法和结果多种多样。这篇综述的目的是系统地检查使用PET配体的相关研究,这些配体与CTE中确定的病理学结合。我们专注于识别结合模式和解决CTEPET成像知识中的空白。进行了全面的文献检索。使用的数据于2017年5月22日或之前发布。由于现有文献有限,任何同行评审的评估军事的文章,联系体育运动员,或专业战士被考虑包括在内。主要结果是通过对照比较或临床指标确定的与大脑区域的区域结合(例如,标准化摄取体积比)。共确定了1207篇论文供审查,其中六项符合纳入标准。荟萃分析是有计划的,但由于确定的研究数量很少,因此被认为是不合适的。这些初始论文中的方法论问题包括小样本量,缺乏对照比较,使用非标准统计程序来量化数据,以及潜在脱靶结合区域的解释。在整个研究中,海马,杏仁核,和中脑有相当一致的摄取增加。皮质区域摄取增加的证据不太一致。证据表明,在有CTE风险的人群中,PET成像领域仍处于起步阶段。随着该领域的发展,包括更严格的研究,PET的配体可能被证明是体内识别CTE的重要工具。
Chronic traumatic encephalopathy (CTE) is associated with pathological changes, yet detecting these changes during life has proven elusive. Positron emission tomography (PET) offers the potential for identifying such pathology. Few studies have been completed to date and their approaches and results have been diverse. It was the objective of this
review to systematically examine relevant research using ligands for PET that bind to identified pathology in CTE. We focused on identification of patterns of binding and addressing gaps in knowledge of PET imaging for CTE. A comprehensive literature search was conducted. Data used were published on or before May 22, 2017. As the extant literature is limited, any peer-reviewed article assessing military, contact sports athletes, or professional fighters was considered for inclusion. The main outcomes were regional binding to brain regions identified through control comparisons or through clinical metrics (e.g., standardized uptake volume ratios). A total of 1207 papers were identified for
review, of which six met inclusion criteria. Meta-analyses were planned but were deemed inappropriate given the small number of studies identified. Methodological concerns in these initial papers included small sample sizes, lack of a control comparison, use of nonstandard statistical procedures to quantify data, and interpretation of potentially off-target binding areas. Across studies, the hippocampi, amygdalae, and midbrain had reasonably consistent increased uptake. Evidence for increased uptake in cortical regions was less consistent. The evidence suggests that the field of PET imaging in those at risk for CTE remains nascent. As the field evolves to include more stringent studies, ligands for PET may prove an important tool in identifying CTE in vivo.