HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS REGISTER		Author Keyword(s) Vol Page [Advanced]

This Article Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this link to a friend Similar articles in this journal Similar articles in PubMed Add article to my folders Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Smith, C Articles by Nicoll, J A R Search for Related Content PubMed PubMed Citation Articles by Smith, C Articles by Nicoll, J A R Related Collections Other Neurology Dementia Related Articles

Association of APOE e4 and cerebrovascular pathology in traumatic brain injury

¹ Department of Neuropathology, University of Glasgow, Institute of Neurological Sciences, Southern General Hospital, Glasgow UK
² Neuropathology Laboratory, Department of Pathology, University of Edinburgh, Western General Hospital, Edinburgh, UK
³ Department of Medicine and Therapeutics, University of Glasgow, Western Infirmary, Glasgow, UK
⁴ Division of Clinical Neurosciences, University of Southampton, Southampton General Hospital, Southampton, UK

Correspondence to:
Correspondence to:
Dr C Smith
Neuropathology Laboratory, Department of Pathology, University of Edinburgh, Western General Hospital, Edinburgh EH4 2XU, UK; col.smith{at}ed.ac.uk

Background: Previous studies have found the e4 allele of the apolipoprotein E gene (APOE e4) is associated with an unfavourable outcome after head injury, but this has not been related to specific pathological features.

Objectives: This study tested the postulate that head injured patients with APOE e4, amounting to approximately a third of the population, are selectively predisposed to one or more of the different pathological features that constitute the response to traumatic brain injury (TBI), and that this underlies the association of APOE e4 with poor clinical outcome.

Methods: Included in the study were 239 fatal cases of TBI (1987–1999) for which APOE genotypes were determined from archival tissue. For each case, specific pathological features of trauma were recorded by researchers blinded to the APOE e4 status. Of the 239 cases examined, 83 (35%) were APOE e4 carriers and 156 (65%) were non-carriers.

Results: Possession of APOE e4 was associated with a greater incidence of moderate or severe contusions (42% v 30% for carriers versus e4 non-carriers; p = 0.05) and there was a trend towards a greater incidence of severe ischaemic brain damage (54% v 42%; p = 0.08). Significant differences were not noted between the other pathological features examined.

Conclusions: Possession of APOE e4 is associated with a greater incidence of moderate/severe contusional injury and severe ischaemic brain damage in fatal cases of TBI. This may be relevant to the relatively poor outcome from traumatic brain injury in patients with APOE e4 identified in clinical studies.

Keywords: APOE; polymorphisms; head injury; contusions; ischaemic damage

Related Articles

Influence of APOE polymorphism on cognitive and behavioural outcome in moderate and severe traumatic brain injury

M Ariza, R Pueyo, M del M Matarín, C Junqué, M Mataró, I Clemente, P Moral, M A Poca, Á Garnacho, and J Sahuquillo
J. Neurol. Neurosurg. Psychiatry 2006 77: 1191-1193. [Abstract] [Full Text] [PDF]

This article has been cited by other articles:

				M. Wilson and H. Montgomery Impact of genetic factors on outcome from brain injury Br. J. Anaesth., July 1, 2007; 99(1): 43 - 48. [Abstract] [Full Text] [PDF]

				H Houlden and R Greenwood Apolipoprotein E4 and traumatic brain injury J. Neurol. Neurosurg. Psychiatry, October 1, 2006; 77(10): 1106 - 1107. [Full Text] [PDF]