The Association between Apolipoprotein E and Traumatic Brain Injury Severity and Functional Outcome in a Rehabilitation Sample
Abstract
Traumatic brain injury (TBI) can result in significant disability, but outcome is variable. The impact of known predictors accounts for a limited proportion of the variance in outcomes. Apolipoprotein E (ApoE) genotype has been investigated as an additional source of variability in injury severity and outcome, with mixed findings reflecting variable methodology and generally limited sample sizes. This study aimed to examine whether possession of the ApoE ɛ4 allele was associated with greater acute injury severity and poorer long-term outcome in patients referred for rehabilitation following TBI. ApoE genotype was determined for 648 patients with TBI, who were prospectively followed up a mean of 1.9 years post-injury. Hypotheses that ɛ4 carriers would have lower Glasgow Coma Scale (GCS) scores and longer post-traumatic amnesia (PTA) duration were not supported. Prediction of worse Glasgow Outcome Scale-Extended (GOSE) scores for ɛ4 carriers was supported with greater susceptibility seen in females. These results indicate the ApoE ɛ4 allele may be associated with poorer long-term outcome, but not acute injury severity. Possible mechanisms include differential effects of the ɛ4 allele on inflammatory and cellular repair processes, and/or amyloid deposition.
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Women carrying the APOE4 allele had worse GOS-E scores than men carriers in a study of 651 patients with mild to severe TBI.
“For example, women carrying the APOE4 allele had worse Glasgow Outcome Scale-Extended (GOS-E) scores than men carriers in a study of 651 patients with mild to severe TBI. 28”
From Sex Differences in Traumatic Brain Injury: What We Know and What We Should Know (2019) · cites this paper as [28]
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- Authors
- Ponsford, J., McLaren, A., Schönberger, M., Burke, R., Rudzki, D., Olver, J., & Ponsford, M.
- Affiliations
- Epworth Hospital (AU)
- Monash University (AU)
- University of Freiburg (DE)
- Corresponding author
- Ponsford, Jennie
- Venue
- Journal of Neurotrauma
- Publisher
- SAGE Publications
- Published
- 2011-09
- Volume
- 28
- Issue
- 9
- Pages
- 1683-1692
- ISSN
- 0897-7151 (ISSN-L)
- 1557-9042
- OpenAlex
- W2010169691
- Cited by
- 103
- References
- 79
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 5 · 2023: 2 · 2022: 8 · 2021: 9 · 2020: 5 · 2019: 11 · 2018: 4 · 2017: 9 · 2016: 10 · 2015: 13 · 2014: 9 · 2013: 5 · 2012: 5
- FWCI
- 4.79
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Neurotrauma (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Transport Accident Commission
- Topics
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Health Sciences › Medicine › Neurology › Traumatic Brain Injury and Neurovascular Disturbances
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Automotive and Human Injury Biomechanics
- Keywords
- traumatic brain injury, apolipoprotein E, APOE ε4, genetic susceptibility, injury severity, functional outcome, Glasgow Outcome Scale-Extended, post-traumatic amnesia, sex differences, rehabilitation, amyloid deposition, neuroinflammation
- MeSH terms
- Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Alleles, Apolipoproteins E, Brain Injuries, Female, Follow-Up Studies, Gene Frequency, Genotype, Humans, Male, Middle Aged, Prognosis, Severity of Illness Index, Sex Factors, Glasgow Coma Scale, Treatment Outcome, Recovery of Function
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