Open AccessApolipoprotein E epsilon 4 ( APOE ‐ ε 4) genotype is associated with decreased 6‐month verbal memory performance after mild traumatic brain injury
Author(s) -
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.,
Mukherjee Pratik,
DiazArrastia Ramon,
Valadka Alex B.,
Okonkwo David O.,
Manley Geoffrey T.
Publication year - 2017
Publication title -
brain and behavior
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.915
H-Index - 41
ISSN - 2162-3279
DOI - 10.1002/brb3.791
Subject(s) - california verbal learning test , glasgow coma scale , verbal memory , apolipoprotein e , traumatic brain injury , medicine , psychology , memory impairment , neuropsychology , verbal learning , recall , audiology , psychiatry , cognition , disease , cognitive psychology
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 .