Association between Apolipoprotein 4 and long-term outcome after traumatic brain injury

A H P Willemse-van Son ^1*, G M Ribbers ², W C J Hop ¹, C M van Duijn ¹ and H J Stam ¹

¹ Erasmus Medical Centre, Netherlands
² Rijndam Rehabilitation Centre, Netherlands

^* To whom correspondence should be addressed. E-mail: a.vanson-willemse{at}erasmusmc.nl.

Accepted 17 October 2007

Abstract

BackgroundTo investigate the effect of carrying the APOE-4 allele on global functional outcome, on activity limitations and participation restrictions, and on community integration at 3, 6, 12, 18, 24, and 36 months after traumatic brain injury.

Method: The Glasgow Outcome Scale (GOS), the Sickness Impact Profile-68 (SIP-68), and the Community Integration Questionnaire (CIQ) were assessed in 79 moderate and severe traumatic brain injury patients at 3, 6, 12, 18, 24, and 36 months post-injury. Repeated measures analyses of variance were performed with APOE-4 status and time of measurement as independent variables and the GOS, SIP-68, and CIQ as dependent variables. Analyses were adjusted for baseline age, gender, and the Glasgow Coma Score.

Results: Patients with the APOE-4 allele had a significantly better global functional outcome on the GOS than patients without the APOE-4 allele. No significant associations were found between APOE-4 status and the SIP-68 and CIQ.

Discussion: In contrast to other studies, we found that carrying the APOE-4 allele had a protective influence on outcome. Multiple mechanisms, and in some cases competitive mechanisms, may explain the variable relation between the APOE-4 allele and outcome after traumatic brain injury.

Keywords: Apolipoprotein E4, craniocerebral trauma, prognosis, traumatic brain injury

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