一名 19 岁虐待儿童患者的创伤性脑病综合征和 Tauopathy。

IF 1.8 Q3 CLINICAL NEUROLOGY
Neurotrauma reports Pub Date : 2023-12-26 eCollection Date: 2023-01-01 DOI:10.1089/neur.2023.0078
Mike Rueb, Katrin Rauen, Inga Katharina Koerte, Alexandra Gersing, Henrik Zetterberg, Joel Simrén, Matthias Brendel, Kristina Adorjan
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引用次数: 0

摘要

据报道,大多数创伤性脑病综合征(TES)病例都发生在曾经参加过接触性运动的运动员身上。这是首例创伤性脑病综合征病例,患者是一名19岁的男性,15年来每天都会遭受家庭暴力,头部被反复击打,认知能力逐渐下降。患者表现为中度抑郁发作和进行性认知功能衰退。使用 220 MBq [18F]PI-2620 进行的 Tau 正电子发射断层扫描(PET)显示,额叶和顶叶白质/灰质边界的灶性信号增加。脑磁共振成像(MRI)显示有一个透明隔腔,左侧海马体积缩小,左侧中脑病变。脑脊液结果显示总tau和p-tau升高。入院时进行的神经认知测试显示,患者的记忆力明显低于平均水平,功能障碍表现为处理速度缓慢,错误率较低,这表明患者存在后天注意力障碍,因此是继发性的。我们诊断该患者患有 TES,提示其患有慢性创伤性脑病,并将其归类为轻微/轻度功能障碍,极有可能在 TES 标准内过渡到轻度痴呆。本报告强调,虐待儿童是诊断头部反复受到撞击的 TES 的相关标准。除临床标记物外,我们还展示了液体tau生物标记物和tau-PET的相关性,以支持根据最近公布的TES诊断标准对TES进行诊断。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Traumatic Encephalopathy Syndrome and Tauopathy in a 19-Year-Old With Child Abuse.

The majority of traumatic encephalopathy syndrome (TES) cases have been reported in former contact sport athletes. This is the first case with TES in a 19-year-old male patient with progressive cognitive decline after daily domestic physical violence through repeated hits to the head for 15 years. The patient presented with a moderate depressive episode and progressive cognitive decline. Tau positron emission tomography (PET) with 220 MBq of [18F]PI-2620 revealed increased focal signal at the frontal and parietal white/gray matter border. Brain magnetic resonance imaging (MRI) showed a cavum septum pellucidum, reduced left-sided hippocampal volume, and a left midbrain lesion. Cerebrospinal fluid results showed elevated total and p-tau. Neurocognitive testing at admission showed memory deficits clearly below average, and hampered dysfunctions according to the slow processing speed with a low mistake rate, indicating the acquired, thus secondary, attentional deficits. We diagnosed the patient with a TES suggestive of chronic traumatic encephalopathy and classified him as having subtle/mild functional limitation with a most likely transition to mild dementia within the TES criteria. This report underlines child abuse as a relevant criterion in diagnosing TES in cases with repetitive hits to the head. In addition to clinical markers, we show the relevance of fluid tau biomarkers and tau-PET to support the diagnosis of TES according to the recently published diagnosis criteria for TES.

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CiteScore
2.40
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