Factors influencing recovery from mild traumatic brain injury

ABSTRACT

Primary Objective

This study determined whether initial GCS score, head CT results, cognitive performance on IMPACT testing, or APOE genotype most effectively predicted 1-month functional outcome after mild traumatic brain injury (mTBI). This study tested the hypotheses that participants with poor performance on initial cognitive testing and those with an APOEe4 genotype would exhibit a poorer 1-month recovery after mTBI.

Research Design

Regression analysis determined which independent variables were most effective in predicting 1-month GOS-E or DRS score. Independent t-test procedures determined whether cognitive recovery varied across APOEe4 carriers.

Methods and Procedures

49 participants admitted to the hospital with mTBI received cognitive evaluation within 48 hours after injury and again one month later. DNA analysis provided participant APOE genotype.

Main Outcomes and Results

Results showed that no study variables significantly predicted GOS-E or DRS scores, however, differences were identified when APOE groups were compared. Participants who were noncarriers of APOEe4 had significantly slower reaction times compared to APOEe4 carriers. Participants who were homozygous APOEe4 carriers had significantly lower instances of impulsivity than noncarriers.

Conclusions

Further research is needed to understand how APOE allele status and performance on initial cognitive testing may influence short-term recovery after mTBI.

KEYWORDS:

• Traumatic brain injury
• APOE
• cognitive impairment
• recovery
• prognosis

Acknowledgments

The authors thank both UNCH and UNCG for their ongoing collaborative relationship to facilitate research related to traumatic brain injury.

Disclosure of interest

No competing financial interests exist for any author of this paper. The authors report no conflict of interest.

Data Availability Statement

The data set associated with this paper can be found at: http://dx.doi.org/10.17632/wpcc72nz53.1#folder-fd3e2cd8-a379-4c8f-8f5d-8d6889a8a89c