학술논문
Apolipoprotein E epsilon 4 ( APOE-ε 4) genotype is associated with decreased 6-month verbal memory performance after mild traumatic brain injury.
Document Type
Article
Author
Yue, John K.; Robinson, Caitlin K.; Burke, John F.; Winkler, Ethan A.; Deng, Hansen; Cnossen, Maryse C.; Lingsma, Hester F.; Ferguson, Adam R.; McAllister, Thomas W.; Rosand, Jonathan; Burchard, Esteban G.; Sorani, Marco D.; Sharma, Sourabh; Nielson, Jessica L.; Satris, Gabriela G.; Talbott, Jason F.; Tarapore, Phiroz E.; Korley, Frederick K.; Wang, Kevin K.W.; Yuh, Esther L.
Source
Subject
*BRAIN injuries
*APOLIPOPROTEIN E
*VERBAL memory
*NEURODEGENERATION
*NEUROSURGERY
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Language
ISSN
2162-3279
Abstract
Introduction The apolipoprotein E ( APOE) ε 4 allele associates with memory impairment in neurodegenerative diseases. Its association with memory after mild traumatic brain injury ( mTBI) is unclear. Methods mTBI patients (Glasgow Coma Scale score 13-15, no neurosurgical intervention, extracranial Abbreviated Injury Scale score ≤1) aged ≥18 years with APOE genotyping results were extracted from the Transforming Research and Clinical Knowledge in Traumatic Brain Injury Pilot ( TRACK- TBI Pilot) study. Cohorts determined by APOE-ε 4(+/−) were assessed for associations with 6-month verbal memory, measured by California Verbal Learning Test, Second Edition ( CVLT- II) subscales: Immediate Recall Trials 1-5 ( IRT), Short-Delay Free Recall ( SDFR), Short-Delay Cued Recall ( SDCR), Long-Delay Free Recall ( LDFR), and Long-Delay Cued Recall ( LDCR). Multivariable regression controlled for demographic factors, seizure history, loss of consciousness, posttraumatic amnesia, and acute intracranial pathology on computed tomography ( CT). Results In 114 mTBI patients ( APOE-ε 4(−)=79; APOE-ε 4(+)=35), ApoE-ε 4(+) was associated with long-delay verbal memory deficits ( LDFR: B = −1.17 points, 95% CI [−2.33, −0.01], p = .049; LDCR: B = −1.58 [−2.63, −0.52], p = .004), and a marginal decrease on SDCR ( B = −1.02 [−2.05, 0.00], p = .050). CT pathology was the strongest predictor of decreased verbal memory ( IRT: B = −8.49, SDFR: B = −2.50, SDCR: B = −1.85, LDFR: B = −2.61, LDCR: B = −2.60; p < .001). Seizure history was associated with decreased short-term memory ( SDFR: B = −1.32, p = .037; SDCR: B = −1.44, p = .038). Conclusion The APOE-ε 4 allele may confer an increased risk of impairment of 6-month verbal memory for patients suffering mTBI, with implications for heightened surveillance and targeted therapies. Acute intracranial pathology remains the driver of decreased verbal memory performance at 6 months after mTBI. [ABSTRACT FROM AUTHOR]