smjournalСпортивная медицина: наука и практикаSports medicine: research and practice2223-25242587-9014NEICON10.47529/2223-2524.2022.1.3smjournal-381Research ArticleСПОРТИВНАЯ ТРАВМАТОЛОГИЯSPORTS TRAUMATOLOGYПрофилактика осложнений спортивной черепно-мозговой травмыPrevention of traumatic brain injury complications in sportsСмоленскийА. В.SmolenskiyA. V.

Смоленский Андрей Вадимович, д.м.н., профессор, заведующий кафедрой спортивной медицины

105122,  Москва, Сиреневый б-р, 4

+7 (916) 681-29-93

Andrey V. Smolenskiy, M.D., D.Sc. (Medicine), Professor, Head of the Department of Sports Medicine

4, Sirenevy blvd, Moscow, 105122+7 (916) 681-29-93

smolensky52@mail.ruШевелевО. А.ShevelevO. A.

Шевелев Олег Алексеевич, д.м.н., профессор, главный научный сотрудник НИИ реабилитологии; профессор кафедры общей патологии и патологической физиологии им. В.А. Фролова Медицинского института

127051, Москва, ул. Петровка, д. 24/2117198, Москва, ул. Миклухо-Маклая, д. 6

Oleg A. Shevelev, M.D., D.Sc. (Medicine), Professor, Chief Researcher; Professor of the Department of General Pathology and Pathological Physiology named after V.A. Frolov of the Medical Institute

6, Miklukho-Maclay str., Moscow, 11719824/2, Petrovka str., Moscow, 127051

ПетроваМ. В.PetrovaM. V.

Петрова Марина Владимировна, д.м.н., профессор, заместитель директора по научно-клинической работе; заведующая кафедрой анестезиологии и реаниматологии с курсом медицинской реабилитации Медицинского института

127051, Москва, ул. Петровка, д. 24/2117198, Москва, ул. Миклухо-Маклая, д. 6

Marina V. Petrova, M.D., D.Sc. (Medicine), Professor, Deputy Director for Scientific and Clinical work; Head of the Department of Anesthesiology and Resuscitation with the course of medical rehabilitation of the Medical Institute

6, Miklukho-Maclay str., Moscow, 11719824/2, Petrovka str., Moscow, 127051

ЮрьевМ. Ю.YuryevM. Yu.

Юрьев Михаил Юрьевич, к.м.н., старший научный сотрудник лаборатории клинической нейрофизиологии

127051, Москва, ул. Петровка, д. 24/2

Mikhail Y. Yuryev, M.D., Ph.D. (Medicine), Senior Researcher at the Laboratory of Clinical Neurophysiology

24/2, Petrovka str., Moscow, 127051

ШевелеваЕ. О.ShevelevaE. O.

Шевелева Екатерина Олеговна, к.м.н., ассистент кафедры общей патологии и патологической физиологии им. В.А. Фролова Медицинского института

117198, Москва, ул. Миклухо-Маклая, д. 6

Ekaterina O. Sheveleva, M.D., Ph.D. (Medicine), Assistant of the Department of General Pathology and Pathological Physiology named after V.A. Frolov of the Medical Institute

6, Miklukho-Maclay str., Moscow, 117198

ТарасовА. В.TarasovA. V.

Тарасов Александр Викторович, к.м.н., доцент, доцент кафедры спортивной медицины

105122, Россия, Москва, Сиреневый б-р, 4

Alexandr V. Tarasov, M.D., Ph.D. (Medicine), Associate Professor, Associate Professor of the Department of Sports Medicine

4, Sirenevy blvd, Moscow, 105122

МирошниковА. Б.MiroshnikovA. B.

Мирошников Александр Борисович, к.б.н., доцент кафедры спортивной медицины

105122, Россия, Москва, Сиреневый бульвар, 4

Alexandr B. Miroshnikov, Ph.D. (Biology), Associate Professor of the Department of Sports Medicine

4, Sirenevy blvd, Moscow, 105122

ГБОУ ВО «Российский государственный университет физической культуры, спорта, молодежи и туризма (ГЦОЛИФК)» Министерства спорта Российской ФедерацииРоссияRussian State University of Physical Culture, Sports, Youth and TourismRussian FederationФГБНУ «Федеральный научно-клинический центр реаниматологии и реабилитологии» (ФНКЦ РР) Министерства науки и образования Российской Федерации; ФГАОУ ВО «Российский университет дружбы нардов» (РУДН)РоссияResearch Institute of Rehabilitation of the Federal Research and Clinical Centre of Resuscitation and Rehabilitation of the Ministry of Science and Higher Education of the Russian Federation; Medical Institute of the Federal State Educational Institution «Peoples' Friendship University of Russia» (RUDN University)Russian FederationФГБНУ «Федеральный научно-клинический центр реаниматологии и реабилитологии» (ФНКЦ РР) Министерства науки и образования Российской ФедерацииРоссияResearch Institute of Rehabilitation of the Federal Research and Clinical Centre of Resuscitation and Rehabilitation of the Ministry of Science and Higher Education of the Russian FederationRussian FederationФГАОУ ВО «Российский университет дружбы нардов» (РУДН)РоссияMedical Institute of the Federal State Educational Institution «Peoples' Friendship University of Russia» (RUDN University)Russian Federation2022300420221216472Copyright © Смоленский А.В., Шевелев О.А., Петрова М.В., Юрьев М.Ю., Шевелева Е.О., Тарасов А.В., Мирошников А.Б., 20222022Смоленский А.В., Шевелев О.А., Петрова М.В., Юрьев М.Ю., Шевелева Е.О., Тарасов А.В., Мирошников А.Б.Smolenskiy A.V., Shevelev O.A., Petrova M.V., Yuryev M.Y., Sheveleva E.O., Tarasov A.V., Miroshnikov A.B.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.smjournal.ru/jour/article/view/381

Цель обзора — информирование врачей и тренеров команд различных видов спорта о технологиях предупреждения осложнений спортивных черепно-мозговых травм (ЧМТ). Мягкая выраженность клинических проявлений, особенности индивидуальной реакции на травму, антиагравационное поведение спортсменов и отсутствие объективных инструментальных методов диагностики являются частой причиной недооценки тяжести полученной травмы. В практике оказания помощи и проведения реабилитационных мероприятий при легкой спортивной ЧМТ недостаточно учтены ее особенности, обусловленные повышенной температурой тела и головного мозга, а также сниженной церебральной перфузией во время травмирующего воздействия. Травма мозга является причиной повышения церебральной температуры, что способно ухудшить последствия травматизации. Контроль температуры мозга возможен с использованием неинвазивной методики микроволновой радиотермометрии, а для предупреждения осложнений спортивных ЧМТ правомочно использование краниоцеребральной гипотермии (КЦГ), которая обладает выраженными нейропротекторными эффектами.

The aim of the review is to inform doctors and trainers of sports teams about technologies that prevent complications of sport brain injuries (SBI). Low levels of visibility of clinical manifestations, specific characteristics of individual reactions to injury, anti-aggravation behavior among sportsmen, absence of unbiased methods of diagnostics of SBI are the main reasons behind underestimation of the severity of trauma. Treatment and rehabilitation procedures of mild SBI do not currently consider specific characteristics of trauma, associated with the increase in body and brain temperature and reduced cerebral perfusion during the traumatizing intervention. Injury of the brain causes an increase in cerebral temperature, which, in turn, can aggravate the consequences of traumatization. The control of the temperature of the brain can be achieved with non-invasive method of microwave radiometry, while the technology of craniocerebral hypothermia (CCH), which has evident neuroprotective properties, can aid in the prevention of complications of SBI.

краниоцеребральная гипотермияспортивная черепно-мозговая травмагипертермиятемпература мозгарадиотермометрияcraniocerebral hypothermiasport brain injuryhypothermiatemperature of the brainmicrowave radiometryReferencesПотапов А.А., Лихтерман Л.Б., Кравчук А.Д., Охлопков В.А., Александрова Е.В., Филатова М.М., и др. Легкая черепно-мозговая травма: клинические рекомендации. Москва: Ассоциации нейрохирургов России; 2016.Potapov A.A., Lihterman L.B., Kravchuk A.D., Ohlopkov V.A., Aleksandrova E.V., Filatova M.M., et al. Mild traumatic brain injury: clinical guidelines. Moscow: Association of Neurosurgeons of Russia; 2016 (In Russ.).Ассоциация нейрохирургов России. Сотрясение головного мозга. Клинические рекомендации [интернет]. 2022. Режим доступа: https://cr.minzdrav.gov.ru/recomend/734_1.Association of Neurosurgeons of Russia. Brain concussion. Clinical guidelines [internet]. 2022 g. Available at: https://cr.minzdrav.gov.ru/recomend/734_1 (In Russ.).Theadom A., Mahon S., Hume P., Starkey N., BarkerCollo S., Jones K., Majdan M., Feigin V.L. Incidence of SportsRelated Traumatic Brain Injury of All Severities: A Systematic Review. Neuroepidemiology. 2020;54(2):192–199. https://doi.org/10.1159/000505424Theadom A., Mahon S., Hume P., Starkey N., BarkerCollo S., Jones K., Majdan M., Feigin V.L. Incidence of SportsRelated Traumatic Brain Injury of All Severities: A Systematic Review. Neuroepidemiology. 2020;54(2):192–199. https://doi.org/10.1159/000505424Brazinova A., Rehorcikova V., Taylor M.S., Buckova V., Majdan M., Psota M., et al. Epidemiology of traumatic brain injury in Europe: a living systematic review. J. Neurotrauma. 2021;38(10):1411–1440. https://doi.org/10.1089/neu.2015.4126Brazinova A., Rehorcikova V., Taylor M.S., Buckova V., Majdan M., Psota M., et al. Epidemiology of traumatic brain injury in Europe: a living systematic review. J. Neurotrauma. 2021;38(10):1411–1440. https://doi.org/10.1089/neu.2015.4126Sun Y.-J., Zhang Z.-Y., Fan B., Li G.-Y. Neuroprotection by Therapeutic Hypothermia. Front. Neurosci. 2019;13:586. https://doi.org/10.3389/fnins.2019.00586Sun Y.-J., Zhang Z.-Y., Fan B., Li G.-Y. Neuroprotection by Therapeutic Hypothermia. Front. Neurosci. 2019;13:586. https://doi.org/10.3389/fnins.2019.00586Dietrich W.D., Bramlett H.M. Therapeutic hypothermia and targeted temperature management for traumatic brain injury: Experimental and clinical experience. Brain Circ. 2017;3(4):186– 198. https://doi.org/10.4103/bc.bc_28_17Dietrich W.D., Bramlett H.M. Therapeutic hypothermia and targeted temperature management for traumatic brain injury: Experimental and clinical experience. Brain Circ. 2017;3(4):186– 198. https://doi.org/10.4103/bc.bc_28_17Lee J.H., Zhang J., Yu Sh.P. Neuroprotective mechanisms and translational potential of therapeutic hypothermia in the treatment of ischemic stroke. Neural Regen. Res. 2017;12(3):341–350. https://doi.org/10.4103/1673-5374.202915Lee J.H., Zhang J., Yu Sh.P. Neuroprotective mechanisms and translational potential of therapeutic hypothermia in the treatment of ischemic stroke. Neural Regen. Res. 2017;12(3):341–350. https://doi.org/10.4103/1673-5374.202915Gard A., Tegner Ye., Bakhsheshi M.F., Marklund N. Selective head–neck cooling after concussion shortens return-to-play in ice hockey players. Concussion. 2021;6(2):CNC90. https://doi.org/10.2217/cnc-2021-0002Gard A., Tegner Ye., Bakhsheshi M.F., Marklund N. Selective head–neck cooling after concussion shortens return-to-play in ice hockey players. Concussion. 2021;6(2):CNC90. https://doi.org/10.2217/cnc-2021-0002Shevelev O., Petrova M., Smolensky A., Osmonov B., Toimatov S., Kharybina T., et al. Using medical microwave radiometry for brain temperature measurements. Drug Discov. Today. 2021;27(3):881–889. https://doi.org/10.1016/j.drudis.2021.11.004Shevelev O., Petrova M., Smolensky A., Osmonov B., Toimatov S., Kharybina T., et al. Using medical microwave radiometry for brain temperature measurements. Drug Discov. Today. 2021;27(3):881–889. https://doi.org/10.1016/j.drudis.2021.11.004Mrozek S., Bounes F.V., Geeraerts T. Brain Temperature: Physiology and Pathophysiology after Brain Injury. Anesthesiol. Res. Pract. 2012;2012(1):989487. https://doi.org/10.1155/2012/989487Mrozek S., Bounes F.V., Geeraerts T. Brain Temperature: Physiology and Pathophysiology after Brain Injury. Anesthesiol. Res. Pract. 2012;2012(1):989487. https://doi.org/10.1155/2012/989487Klein S.P., Depreitere B., Meyfroidt G. How I monitor cerebral autoregulation. Crit. Care. 2019;23(1):160. https://doi.org/10.1186/s13054-019-2454-1Klein S.P., Depreitere B., Meyfroidt G. How I monitor cerebral autoregulation. Crit. Care. 2019;23(1):160. https://doi.org/10.1186/s13054-019-2454-1Fantini S., Sassaroli А., Tgavalekos K.T., Joshua K.J. Cerebral blood flow and autoregulation: current measurement techniques and prospects for noninvasive optical methods. Neurophotonics. 2016;3(3):031411. https://doi.org/10.1117/1.NPh.3.3.031411Fantini S., Sassaroli А., Tgavalekos K.T., Joshua K.J. Cerebral blood flow and autoregulation: current measurement techniques and prospects for noninvasive optical methods. Neurophotonics. 2016;3(3):031411. https://doi.org/10.1117/1.NPh.3.3.031411Hayward J.N., Baker M.A. Role of cerebral arterial blood in the regulation of brain temperature in the monkey. Am. J. Physiol. 1968;215(2):389–403. https://doi.org/10.1152/ajplegacy.1968.215.2.389Hayward J.N., Baker M.A. Role of cerebral arterial blood in the regulation of brain temperature in the monkey. Am. J. Physiol. 1968;215(2):389–403. https://doi.org/10.1152/ajplegacy.1968.215.2.389Cabanac М., Brinnel Н. Blood flow in the emissary veins of the human head during hyperthermia. Eur. J. Appl. Physiol. Occup. Physiol. 1985;54(2):172–176. https://doi.org/10.1007/BF02335925Cabanac М., Brinnel Н. Blood flow in the emissary veins of the human head during hyperthermia. Eur. J. Appl. Physiol. Occup. Physiol. 1985;54(2):172–176. https://doi.org/10.1007/BF02335925Gaillard F., Sharma R. Cerebral blood flow (CBF). Reference article. Radiopaedia.org [internet]. Available at: https://radiopaedia.org/articles/43779. https://doi.org/10.53347/rID-43779Gaillard F., Sharma R. Cerebral blood flow (CBF). Reference article. Radiopaedia.org [internet]. Available at: https://radiopaedia.org/articles/43779. https://doi.org/10.53347/rID-43779Kiyatkin E.A. Brain temperature and its role in physiology and pathophysiology: Lessons from 20 years of thermorecording. Temperature. 2019;6(4):271–333. https://doi.org/10.1080/23328940.2019.1691896Kiyatkin E.A. Brain temperature and its role in physiology and pathophysiology: Lessons from 20 years of thermorecording. Temperature. 2019;6(4):271–333. https://doi.org/10.1080/23328940.2019.1691896Guatteo E., Chung K.K., Bowala T.K., Bernardi G., Mercuri N.B., Lipski J. Temperature sensitivity of dopaminergic neurons of the substantia nigra pars compacta: involvement of transient receptor potential channels. J. Neurophysiol. 2005;94(5):3069–3080. https://doi.org/10.1152/jn.00066.2005Guatteo E., Chung K.K., Bowala T.K., Bernardi G., Mercuri N.B., Lipski J. Temperature sensitivity of dopaminergic neurons of the substantia nigra pars compacta: involvement of transient receptor potential channels. J. Neurophysiol. 2005;94(5):3069–3080. https://doi.org/10.1152/jn.00066.2005Fohlmeister J.F., Cohen E.D., Newman E.A. Mechanisms and distribution of ion channels in retinal ganglion cells: using temperature as an independent variable. J. Neurophysiol. 2010;103(3):1357–1374. https://doi.org/10.1152/jn.00123.2009Fohlmeister J.F., Cohen E.D., Newman E.A. Mechanisms and distribution of ion channels in retinal ganglion cells: using temperature as an independent variable. J. Neurophysiol. 2010;103(3):1357–1374. https://doi.org/10.1152/jn.00123.2009Yu Y., Hill A.P., Mccormick D.A. Warm body temperature facilitates energy efficient cortical action potentials. PLoS Comput. Biol. 2012;8(4):e1002456. https://doi.org/10.1371/journal.pcbi.1002456Yu Y., Hill A.P., Mccormick D.A. Warm body temperature facilitates energy efficient cortical action potentials. PLoS Comput. Biol. 2012;8(4):e1002456. https://doi.org/10.1371/journal.pcbi.1002456Kiyatkin E.A. Brain temperature homeostasis: physiological fluctuations and pathological shifts. Front. Biosci. (Landmark Ed). 2010;15(1):73–92. https://doi.org/10.2741/3608Kiyatkin E.A. Brain temperature homeostasis: physiological fluctuations and pathological shifts. Front. Biosci. (Landmark Ed). 2010;15(1):73–92. https://doi.org/10.2741/3608Nybo L., Nielsen B. Middle cerebral artery blood flow velocity is reduced with hyperthermia during prolonged exercise in humans. J. Physiol. 2001;534(Pt 1):279–286. https://doi.org/10.1111/j.1469-7793.2001.t01-1-00279.xNybo L., Nielsen B. Middle cerebral artery blood flow velocity is reduced with hyperthermia during prolonged exercise in humans. J. Physiol. 2001;534(Pt 1):279–286. https://doi.org/10.1111/j.1469-7793.2001.t01-1-00279.xMa W., Liu W., Li M. Analytical heat transfer model for targeted brain hypothermia. Int. J. Therm. Sci. 2016;100:66–74. https://doi.org/10.1016/j.ijthermalsci.2015.09.014Ma W., Liu W., Li M. Analytical heat transfer model for targeted brain hypothermia. Int. J. Therm. Sci. 2016;100:66–74. https://doi.org/10.1016/j.ijthermalsci.2015.09.014Uygun M., Kucuka S., Colpan C.O. 3B modeling and temperature distribution of human brain. In: 20th National Biomedical Engineering Meeting (BIYOMUT). IEEE; 2016. https://doi.org/10.1109/BIYOMUT.2016.7849378Uygun M., Kucuka S., Colpan C.O. 3B modeling and temperature distribution of human brain. In: 20th National Biomedical Engineering Meeting (BIYOMUT). IEEE; 2016. https://doi.org/10.1109/BIYOMUT.2016.7849378Веснин С.Г., Седанкин М.К. Разработка серии антеннаппликаторов для неинвазивного измерения температуры тканей организма человека при различных патологиях. Вестник МГТУ им. Н.Э. Баумана, Сер. Естественные науки. 2012;(11):43–61.Vesnin S.G., Sedankin M.K. Development of an antenna-applicator series for tissue temperature non-invasive measurement of a human body at different pathologies. Vestnik MGTU im. N.E. Baumana, Ser. Estestvennye nauki = Herald of the Bauman Moscow State Technical University, Series Natural Sciences. 2012;(11):43–61 (In Russ.).Поляков М.В., Хоперсков А.В. Математическое моделирование пространственного распределения радиационного поля в биоткани: определение яркостной температуры для диагностики. Вестник Волгоградского гос. университета. Серия 1. Мат. Физ. 2016;(5):73–84. https://doi.org/10.15688/jvolsu1.2016.5.7Polyakov M.V., Khoperskov A.V. Mathematical modeling of radiation fields in biological tissues: the definition of the brightness temperature for the diagnosis. Bulletin of the Volgograd State University. Series 1. Mathematics. Physics. 2016;(5):73–84 (In Russ.). https://doi.org/10.15688/jvolsu1.2016.5.7Maloney S.K., Mitchell D., Mitchell G., Fuller A. Absence of selective brain cooling in unrestrained baboons exposed to heat. Am. J. Phisiol. Regul. Integr. Comp. Physiol. 2007;292(5):R2059– 2067. https://doi.org/10.1152/ajpregu.00809.2006Maloney S.K., Mitchell D., Mitchell G., Fuller A. Absence of selective brain cooling in unrestrained baboons exposed to heat. Am. J. Phisiol. Regul. Integr. Comp. Physiol. 2007;292(5):R2059– 2067. https://doi.org/10.1152/ajpregu.00809.2006Шевелев О.А., Бутров А.В., Чебоксаров Д.В., Ходорович Н.А., Лапаев Н.Н., Покатилова Н.С. Патогенетическая роль церебральной гипертермии при поражениях головного мозга. Клиническая медицина. 2017;95(4):302–309. https://doi.org/10.18821/0023-2149-2017-95-4-302-309Shevelev O.A., Butrov A.V., Cheboksarov D.V., Hodorovich N.A., Lapaev N.N., Pokatilova N.S. The pathogenetic role of cerebral hyperthermia in brain lesion. Klinicheskaya medicina = Clinical Medicine. 2017;95(4):302–309 (In Russ.). https://doi.org/10.18821/0023-2149-2017-95-4-302-309Sharma H.S. Hyperthermia induced brain oedema: current status and future perspectives. Indian J. Med. Res. 2006;123(5):629–652Sharma H.S. Hyperthermia induced brain oedema: current status and future perspectives. Indian J. Med. Res. 2006;123(5):629–652Bain A.R., Morrison S.A., Ainslie P.N. Cerebral oxygenation and hyperthermia. Front. Physiol. 2014;5:92. https://doi.org/10.3389/fphys.2014.00092Bain A.R., Morrison S.A., Ainslie P.N. Cerebral oxygenation and hyperthermia. Front. Physiol. 2014;5:92. https://doi.org/10.3389/fphys.2014.00092Nybo L., Nielsen B. Middle cerebral artery blood flow velocity is reduced with hyperthermia during prolonged exercise in humans. J. Physiol. 2001;534(Pt 1):279–286. https://doi.org/10.1111/j.1469-7793.2001.t01-1-00279.xNybo L., Nielsen B. Middle cerebral artery blood flow velocity is reduced with hyperthermia during prolonged exercise in humans. J. Physiol. 2001;534(Pt 1):279–286. https://doi.org/10.1111/j.1469-7793.2001.t01-1-00279.xCampos F., Perez-Mato M., Agulla J., Blanco M., Barral D., Almeida A., et al. Glutamate Excitoxicity Is the Key Molecular Mechanism Which Is Influenced by Body Temperature during the Acute Phase of Brain Stroke. PLoS One. 2012;7(8):e44191. https://doi.org/10.1371/journal.pone.0044191Campos F., Perez-Mato M., Agulla J., Blanco M., Barral D., Almeida A., et al. Glutamate Excitoxicity Is the Key Molecular Mechanism Which Is Influenced by Body Temperature during the Acute Phase of Brain Stroke. PLoS One. 2012;7(8):e44191. https:// doi.org/10.1371/journal.pone.0044191Шевелев О.А., Гречко А.В., Петрова М.В. Терапевтическая гипотермия: монография. Москва: РУДН; 2019.Shevelev O.A., Grechko A.V., Petrova M.V. Therapeutic hypothermia. Moscow: RUDN; 2019 (In Russ.).Шевелев О.А., Смоленский А.В., Мирошников А.Б., Тарасов А.В., Хусяйнов З.М., Гаракян А.И. Температурный баланс коры головного мозга у спортсменов боксеров во время тренировок и соревнований. Спортивно-педагогическое образование. 2020;(4):59–63.Shevelev O.A., Smolenskij A.V., Miroshnikov A.B., Tarasov A.V., Husyajnov Z.M., Garakyan A.I. Temperature balance of the cerebral cortex in athletes boxers during training and competitions. Sportivno-pedagogicheskoe obrazovanie = Sport and pedagogical education. 2020;(4):59–63 (In Russ.).

The authors declare that there are no conflicts of interest present.