脑震荡与沉睡的大脑

IF 4.1 2区 医学 Q1 SPORT SCIENCES
Catherine C Donahue, Jacob E Resch
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引用次数: 0

摘要

背景:新近的研究表明,睡眠是青少年和成年人脑震荡恢复轨迹的一个调节因素。尽管人们越来越认识到睡眠与脑震荡之间的关系,但这种关系的机制和生理过程仍有待确定:主要内容:脑震荡发生后,会出现一系列病理生理事件,其特点是包括小胶质细胞激活、离子失衡和兴奋性神经递质释放在内的众多因素。重要的是,这些因素中的每一个都在睡眠-觉醒周期的调节中发挥作用。因此,损伤后的睡眠失调可能是轴突损伤和继发性生理事件后大脑功能弥漫性紊乱的一种表现。由于脑震荡后睡眠相关症状的出现极不稳定,临床医生应了解这些症状出现的时间和方式。据报道,在急性、亚急性和慢性恢复阶段,伤后睡眠的变化会延长症状缓解的时间,影响神经认知能力,并影响情绪状态。尽管这些变化支持睡眠作为康复的调节因素,但在脑震荡后的睡眠管理方面,对临床医生或患者的指导却很有限。这可能是由于研究将睡眠与脑震荡的恢复联系起来,但却未能解释为什么会存在这种联系。睡眠是一个复杂的、多因素的过程,脑震荡后出现的睡眠变化是调节睡眠-觉醒周期的众多过程相互作用的结果:简短结论:通过识别和考虑这一多因素过程中的生物、社会学和心理学相互作用,对睡眠进行评估和管理,将使临床医生能够应对脑震荡后睡眠变化的动态性质。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Concussion and the Sleeping Brain.

Background: Emerging research has suggested sleep to be a modifier of the trajectory of concussion recovery in adolescent and adult populations. Despite the growing recognition of the relationship between sleep and concussion, the mechanisms and physiological processes governing this association have yet to be established.

Main body: Following a concussion, a pathophysiologic cascade of events occurs, characterized by numerous factors including microglia activation, ionic imbalance, and release of excitatory neurotransmitters. Importantly, each of these factors plays a role in the regulation of the sleep-wake cycle. Therefore, dysregulation of sleep following injury may be a function of the diffuse disruption of cerebral functioning in the wake of both axonal damage and secondary physiological events. As the onset of sleep-related symptoms is highly variable following a concussion, clinicians should be aware of when and how these symptoms present. Post-injury changes in sleep have been reported in the acute, sub-acute, and chronic phases of recovery and can prolong symptom resolution, affect neurocognitive performance, and influence mood state. Though these changes support sleep as a modifier of recovery, limited guidance exists for clinicians or their patients in the management of sleep after concussion. This may be attributed to the fact that research has correlated sleep with concussion recovery but has failed to explain why the correlation exists. Sleep is a complex, multifactorial process and the changes seen in sleep that are seen following concussion are the result of interactions amongst numerous processes that regulate the sleep-wake cycle.

Short conclusion: The assessment and management of sleep by identifying and considering the biological, sociological, and psychological interactions of this multifactorial process will allow for clinicians to address the dynamic nature of changes in sleep following concussion.

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来源期刊
Sports Medicine - Open
Sports Medicine - Open SPORT SCIENCES-
CiteScore
7.00
自引率
4.30%
发文量
142
审稿时长
13 weeks
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