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Genetic polymorphisms, concussion risk, and post concussion neurocognitive deficits in college and high school athletes
  1. Thomas R Terrell1,2,*,
  2. Roberd M Bostick3,
  3. Jeffery Barth4,
  4. Douglas McKeag5,
  5. Robert C Cantu6,
  6. Rick Sloane7,
  7. Leslie Galloway8,9,
  8. David Erlanger10,
  9. Verle Valentine11,
  10. K Bielak12
  1. 1University of Tennessee Graduate School of Medicine, Department of Family Medicine, Sports Medicine Fellowship, Knoxville, Tennessee, USA
  2. 2University of Tennessee, Memphis School of Medicine
  3. 3Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
  4. 4University of Virginia School of Medicine, Department of Psychiatry and Neurobehavioral Sciences, Division of Neuropsychology, Charlottesville, Virginia, USA
  5. 5University of Indiana School of Medicine, Department of Family Medicine, Indianapolis, Indiana, USA
  6. 6Boston University School of Medicine, Department of Neurosurgery, Center for Study of Chronic Traumatic Encephalopathy; Emerson Hospital, Boston, Massachusetts, USA
  7. 7Duke University School of Medicine, Durham, North Carolina, USA
  8. 8University of Tennessee, Knoxville, Tennessee, USA
  9. 9Oak Ridge National Lab, Oak Ridge, Tennessee, USA
  10. 10Columbia University, New York, New York, USA
  11. 11Sanford Orthopaedics and Sports Medicine, Sioux Falls, South Dakota, USA
  12. 12University of Tennessee Graduate School of Medicine, Department of Family Medicine, Knoxville, Tennessee, USA

    Abstract

    Objective To investigate associations of APOE and Tau gene polymorphisms with sports-related acute concussions and baseline to post-concussion neuropsychological test score changes.

    Design Multi-center prospective cohort study.

    Setting Scholarship athletes at 21 universities and 4 high schools Participants: 3218 athletes playing football (70%) or soccer (23%).

    Assessment of Risk Factors APOE, APOE G-219T promoter (APOEProm), Tau exon 6 Ser53Pro (TauSer), and Tau exon 6 Hist47Tyr (TauHis) genetic polymorphisms.

    Main Outcome Measurements (1) Acute concussions and (2) differences between baseline and 24–72 h post-concussion Headminder Neuropsychological Test Scores of Simple and Complex Reaction Time (SRT and CRT, respectively) and Processing Speed.

    Results There were a total of 131 athletes with incident concussions and genetic data and neuropsychological test scores. There were no statistically significant differences in frequencies of acute concussions according to genotypes by χ2 test. By t-test, the mean baseline to post-concussion neuropsychological changes were statistically significantly greater for CRT and SRT in those with the TauSer ‘TT’ genotype and for CRT in those with the APOEProm ‘TT’ genotype, and borderline significantly greater in those with the TauSer ‘TT’ genotype (p=0.09).

    Conclusions The statistically significantly worse mean baseline to post-concussion neuropsychological test scores in those with the APOEProm and TauSer polymorphisms suggests a possible genetic influence on post-concussion neurocognitive recovery. These preliminary findings provide no evidence for associations of the four APOE and Tau gene polymorphisms investigated with acute concussions, although the small sample size and lack of control for confounders are limitations.

    Acknowledgements Grant funding was provided through the NOCSAE (National Operating Committee for Safety Athletic Equipment) and the American Medical Society for Sports Medicine (AMSSM) Foundations. The opinions expressed in this abstract are not those of NOCSAE or AMSSM.

    Competing interests None.

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