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Apolipoprotein E4 as a predictor of outcomes in pediatric mild traumatic brain injury
Lisa M Moran1, H Gerry Taylor, Kalaichelvi Ganesalingam
1Department of Psychology, The Ohio State University, Columbus, Ohio, USA.
Insights
The apolipoprotein E (APOE) epsilon4 allele did not consistently impact outcomes in children with mild traumatic brain injury (TBI). Further research is needed to understand genetic influences on pediatric TBI recovery.
Area of Science:
- Neuroscience
- Genetics
- Pediatric Traumatology
Background:
- The apolipoprotein E (APOE) epsilon4 allele is associated with adverse outcomes in adult traumatic brain injury (TBI).
- Preliminary evidence suggests a similar pattern in pediatric TBI, necessitating further investigation.
Purpose of the Study:
- To investigate the relationship between the APOE epsilon4 allele and outcomes in children with mild TBI.
- To assess the impact of the APOE epsilon4 allele on acute injury severity, neuropsychological performance, and post-concussive symptoms in pediatric mild TBI.
Main Methods:
- Prospective, longitudinal study of 99 children (ages 8-15) with mild TBI.
- Outcomes assessed acutely and at 2 weeks, 3 months, and 12 months post-injury.
- Comparison of children with and without the APOE epsilon4 allele on injury severity, neuropsychological tests, and symptom scales.
Main Results:
- Children with the APOE epsilon4 allele were more likely to have a Glasgow Coma Scale score < 15, but no differences in other injury severity measures.
- APOE epsilon4 carriers showed better constructional skill performance but no differences in other neuropsychological tests or post-concussive symptoms.
- No significant demographic differences were observed between children with and without the APOE epsilon4 allele.
Conclusions:
- The APOE epsilon4 allele does not appear to be consistently related to outcomes in children with mild TBI.
- Findings suggest the APOE epsilon4 allele's role in pediatric mild TBI may differ from its role in adults or severe TBI.
Abstract:
The epsilon4 allele of the apolipoprotein E (APOE) gene has been linked to negative outcomes among adults with traumatic brain injury (TBI) across the spectrum of severity, with preliminary evidence suggesting a similar pattern among children. This study investigated the relationship of the APOE epsilon4 allele to outcomes in children with mild TBI. Participants in this prospective, longitudinal study included 99 children with mild TBI between the ages of 8 and 15 recruited from consecutive admissions to Emergency Departments at two large children's hospitals. Outcomes were assessed acutely in the Emergency Department and at follow-ups at 2 weeks, 3 months, and 12 months post-injury. Among the 99 participants, 28 had at least one epsilon4 allele. Children with and without an epsilon4 allele did not differ demographically. Children with an epsilon4 allele were significantly more likely than those without an epsilon4 allele to have a Glasgow Coma Scale score of less than 15, but the groups did not differ on any other measures of injury severity. Those with an epsilon4 allele exhibited better performance than children without an epsilon4 allele on a test of constructional skill, but the groups did not differ on any other neuropsychological tests. Children with and without an epsilon4 allele also did not differ on measures of post-concussive symptoms. Overall, the findings suggest that the APOE epsilon4 allele is not consistently related to the outcomes of mild TBI in children.
