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Apolipoprotein E (APOE) ϵ4 Allele Is Associated with Increased Symptom Reporting Following Sports Concussion

Published online by Cambridge University Press:  20 October 2015

Victoria C. Merritt*
Affiliation:
Penn State University, University Park, Pennsylvania
Peter A. Arnett
Affiliation:
Penn State University, University Park, Pennsylvania
*
Correspondence and reprint requests to: Victoria C. Merritt; 372 Moore Building, Department of Psychology, Penn State University, University Park, PA 16802. E-mail: vca106@psu.edu

Abstract

Exploring the relationship between genetic factors and outcome following brain injury has received increased attention in recent years. However, few studies have evaluated the influence of genes on specific sequelae of concussion. The purpose of this study was to determine how the ϵ4 allele of the apolipoprotein E (APOE) gene influences symptom expression following sports-related concussion. Participants included 42 collegiate athletes who underwent neuropsychological testing, including completion of the Post-Concussion Symptom Scale (PCSS), within 3 months after sustaining a concussion (73.8% were evaluated within 1 week). Athletes provided buccal samples that were analyzed to determine the make-up of their APOE genotype. Dependent variables included a total symptom score and four symptom clusters derived from the PCSS. Mann-Whitney U tests showed higher scores reported by athletes with the ϵ4 allele compared to those without it on the total symptom score and the physical and cognitive symptom clusters. Furthermore, logistic regression showed that the ϵ4 allele independently predicted those athletes who reported physical and cognitive symptoms following concussion. These findings illustrate that ϵ4+ athletes report greater symptomatology post-concussion than ϵ4- athletes, suggesting that the ϵ4 genotype may confer risk for poorer post-concussion outcome. (JINS, 2016, 22, 89–94)

Type
Brief Communication
Copyright
Copyright © The International Neuropsychological Society 2015 

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References

Ariza, M., Pueyo, R., del M Matarín, M., Junqué, C., Mataró, M., Clemente, I., & Sahuquillo, J. (2006). Influence of APOE polymorphism on cognitive and behavioral outcome in moderate and severe traumatic brain injury. Journal of Neurology, Neurosurgery, & Psychiatry, 77(10), 11911193.CrossRefGoogle ScholarPubMed
Bazarian, J.J., Zemlan, F.P., Mookerjee, S., & Stigbrand, T. (2006). Serum S-100B and cleaved-tau are poor predictors of long-term outcome after mild traumatic brain injury. Brain Injury, 20(7), 759765.CrossRefGoogle ScholarPubMed
Blennow, K., Hardy, J., & Zetterberg, H. (2012). The neuropathology and neurobiology of traumatic brain injury. Neuron, 76(5), 886899.CrossRefGoogle ScholarPubMed
Chamelian, L., Reis, M., & Feinstein, A. (2004). Six-month recovery from mild to moderate traumatic brain injury: The role of APOE-epsilon4 allele. Brain, 127(12), 26212628.CrossRefGoogle ScholarPubMed
Chiang, M.-F., Chang, J.-G., & Hu, C.-J. (2003). Association between apolipoprotein E genotype and outcome of traumatic brain injury. Acta Neurochirurgica, 145(8), 649654.CrossRefGoogle ScholarPubMed
Christensen, H., Batterham, P.J., Mackinnon, A.J., Jorm, A.F., Mack, H.A., Mather, K.A., & Easteal, S. (2008). The association of APOE genotype and cognitive decline in interaction with risk factors in a 65–69 year old community sample. BMC Geriatrics, 8(1), 1424.CrossRefGoogle Scholar
Dardiotis, E., Fountas, K.N., Dardioti, M., Xiromerisiou, G., Kapsalaki, E., Tasiou, A. &Hadjigeorgiou, G.M. (2010). Genetic association studies in patients with traumatic brain injury. Neurosurgical Focus, 28(1), E9:112.CrossRefGoogle ScholarPubMed
Eisenberg, D.T.A., Kuzawa, C.W., & Hayes, M.G. (2010). Worldwide allele frequencies of the human apolipoprotein E gene: Climate, local adaptations, and evolutionary history. American Journal of Physical Anthropology, 143(1), 100111.CrossRefGoogle ScholarPubMed
Freeman, B., Smith, N., Curtis, C., Huckett, L., Mill, J., & Craig, I.W. (2003). DNA from buccal swabs recruited by mail: Evaluation of storage effects on long-term stability and suitability for multiplex polymerase chain reaction genotyping. Behavior Genetics, 33(1), 6772.CrossRefGoogle ScholarPubMed
Ingelsson, M., Shin, Y., Irizarry, M.C., Hyman, B.T., Lilius, L., Forsell, C. & Graff, C. (2003). Genotyping of apolipoprotein E: Comparative evaluation of different protocols. Current Protocols in Human Genetics, Chapter 9, Unit 9.14.CrossRefGoogle Scholar
Jordan, B.D. (2007). Genetic influences on outcome following traumatic brain injury. Neurochemical Research, 32(4-5), 905915.CrossRefGoogle ScholarPubMed
Lange, R.T., Brickell, T., French, L.M., Ivins, B., Bhagwat, A., Pancholi, S. & Iverson, G.L. (2013). Risk factors for postconcussion symptom reporting after traumatic brain injury in U.S. military service members. Journal of Neurotrauma, 30(4), 237246.CrossRefGoogle ScholarPubMed
Liaquat, I., Dunn, L.T., Nicoll, J.A.R., Teasdale, G.M., & Norrie, J.D. (2002). Effect of apolipoprotein E genotype on hematoma volume after trauma. Journal of Neurosurgery, 96(1), 9096.CrossRefGoogle ScholarPubMed
Lovell, M.R., Iverson, G.L., Collins, M.W., Podell, K., Johnston, K.M., Pardini, D., & Maroon, J.C. (2006). Measurement of symptoms following sports-related concussion: Reliability and normative data for the post-concussion scale. Applied Neuropsychology, 13(3), 166174.CrossRefGoogle ScholarPubMed
Merritt, V.C., & Arnett, P.A. (2014). Premorbid predictors of postconcussion symptoms in collegiate athletes. Journal of Clinical and Experimental Neuropsychology, 36(10), 10981111.CrossRefGoogle ScholarPubMed
Moran, L.M., Taylor, H.G., Ganesalingam, K., Gastier-Foster, J.M., Frick, J., Bangert, B., & Wright, M. (2009). Apolipoprotein E4 as a predictor of outcomes in pediatric mild traumatic brain injury. Journal of Neurotrauma, 26(9), 14891495.CrossRefGoogle ScholarPubMed
Ruff, R.M., Iverson, G.L., Barth, J.T., Bush, S.S., & Broshek, D.K. (2009). Recommendations for diagnosing a mild traumatic brain injury: A National Academy of Neuropsychology education paper. Archives of Clinical Neuropsychology, 24(1), 310.CrossRefGoogle ScholarPubMed
Silver, J.M., McAllister, T.W., & Arciniegas, D. (2009). Depression and cognitive complaints following mild traumatic brain injury. American Journal of Psychiatry, 166(6), 653661.CrossRefGoogle ScholarPubMed
Sundström, A., Marklund, P., Nilsson, L.G., Cruts, M., Adolfsson, R., Van Broeckhoven, C. & Nyberg, L. (2004). APOE influences on neuropsychological function after mild head injury: Within-person comparisons. Neurology, 62(11), 19631966.CrossRefGoogle ScholarPubMed
Teasdale, G.M., Murray, G.D., & Nicoll, J.A.R. (2005). The association between APOE ε4, age and outcome after head injury: A prospective cohort study. Brain, 128(11), 25562561.CrossRefGoogle ScholarPubMed