Apolipoprotein E and functional recovery from brain injury following postacute rehabilitation

Objective: APOE epsilon4 has been associated with late-onset familial and sporadic AD and delayed recovery from head injury. The authors examined the relationship between functional recovery of patients with head injury and the APOE alleles. Methods: Thirty-one patients with head injury who had completed the Acute Neurorehabilitation Program at Helen Hayes Hospital were evaluated for presence of APOE epsilon4 and assessed for recovery based on Functional Independence Measures (FIM). Results: Analysis of covariance (using coma days as the covariate to control for differences in initial severity of injury between subjects with and without APOE epsilon4) revealed a significant difference for both total FIM and motor FIM scores between the subjects with and without APOE epsilon4. Specifically, there were lower scores for total FIM (df = 30; F = 3.341; p = 0.05) and motor FIM (df = 30; F = 4.189; p = 0.026) in APOE epsilon4 carriers, No difference was found for the cognitive portion of the FIM. Conclusions: The data suggest that the presence of the lipoprotein APOE epsilon4 adversely affects rehabilitation outcome for traumatic brain injury survivors.