Journal
BRAIN AND BEHAVIOR
Volume 7, Issue 9, Pages -Publisher
WILEY
DOI: 10.1002/brb3.791
Keywords
apolipoprotein E; genetic factors; human studies; outcome measures; traumatic brain injury; verbal memory
Categories
Funding
- NINDS [1RC2NS069409-01, 3RC2NS069409-02S1, 5RC2NS069409-02, 1U01NS086090-01, 3U01NS086090-02S1, 3U01NS086090-02S2, 3U01NS086090-03S1, 5U01NS086090-02, 5U01NS086090-03]
- US DOD [W81XWH-13-1-0441, W81XWH-14-2-0176]
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Introduction: The apolipoprotein E (APOE) epsilon 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-epsilon 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-epsilon 4(-) = 79; APOE-epsilon 4(+)=35), ApoE-epsilon 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-epsilon 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.
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