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Updated: Jul 3, 2026
A Neuroscientific Approach to the Examination of Concussions in Student-Athletes
Published on: December 8, 2014
Does the apolipoprotein epsilon 4 allele predispose varsity athletes to concussion? A prospective cohort study
Vicki L Kristman1, Charles H Tator, Nancy Kreiger
1Department of Public Health Sciences, University of Toronto, Toronto, Ontario, Canada. vicki.kristman@uhnresearch.ca
Objective:
To determine the association between the apolipoprotein epsilon 4 allele and concussion. We hypothesized that apolipoprotein epsilon 4 carriers may be more likely to sustain a concussion.
Design:
Prospective cohort study.
Setting:
University of Toronto varsity athletics.
Participants:
Included 318 of 822 collegiate student athletes who participated in University of Toronto varsity sports from September 2002 to April 2006.
Assessment Of Risk Factors:
The presence of apolipoprotein epsilon 4 was described dichotomously after genotyping blood samples collected from participants.
Main Outcome Measurements:
Concussions were identified by sport-medicine professionals present on the sidelines using on-field assessment forms. All concussion diagnoses were verified by a sports medicine physician. Survival analysis was used to determine the association between apolipoprotein epsilon 4 and first concussion.
Results:
The unadjusted hazard ratio for concussion in the apolipoprotein epsilon 4 carriers was 1.18 (95% CI: 0.52, 2.69) compared to noncarriers. Adjustment for sex, weight, height, and team type resulted in a hazard ratio of 1.06 (95% CI: 0.41, 2.72), indicating little effect from confounding factors.
Conclusions:
There is no important association between carrying the apolipoprotein epsilon 4 allele and sustaining a concussion. At this time, we do not recommend preseason genetic testing for varsity athletes as a mechanism for targeting prevention strategies.
