Brain Advance Access originally published online on October 20, 2004
Brain 2004 127(12):2621-2628; doi:10.1093/brain/awh296
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Brain Vol. 127 No. 12 © Guarantors of Brain 2004; all rights reserved
Six-month recovery from mild to moderate Traumatic Brain Injury: the role of APOE-
4 allele
1 University of Toronto, 2 Department of Psychiatry, Traumatic Brain Injury Clinic, Sunnybrook and Women's College Health Sciences Centre and 3 Department of Clinical Pathology, Sunnybrook and Women's College Health Sciences Centre, Toronto, ON, Canada
Correspondence to: Dr Anthony Feinstein, Department of Psychiatry, FG08, Sunnybrook and Women's College Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada E-mail: loricham{at}yahoo.com, antfeinstein{at}aol.com
The possession of at least one APOE-
4 allele may be linked to poor outcome in patients with predominantly severe traumatic brain injury (TBI). In mild TBI, which accounts for approximately 85% of all cases, the role of the APOE-4 allele is less clear. Studies completed to date have relied on brief cognitive assessments or coarse measures of global functioning, thereby limiting their conclusions. Our study investigated the influence of the APOE-4 allele in a prospective sample of 90 adults with mild to moderate TBI in whom neuropsychiatric outcome 6 months after injury was assessed as follows: (i) a detailed neuropsychological battery; (ii) an index of emotional distress (General Health Questionnaire); (iii) a diagnosis of major depression (Structured Clinical Interview for DSM-IV); (iv) a measure of global functioning (Glasgow Outcome Scale); (v) an index of psychosocial outcome (Rivermead Head Injury Follow-up Questionnaire); and (vi) symptoms of persistent post-concussion disorder (Rivermead Post-Concussion Symptoms Questionnaire). No association was found between the presence of the APOE-4 allele and poor outcome across all measures. Given the homogeneous nature of our sample (mild to moderate injury severity), the uniform follow-up period (6 months) and the comprehensive markers of recovery used, our data suggest that the APOE-4 allele does not adversely impact outcome in this group of TBI patients.
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