Background/aim To evaluate the association of genetic polymorphisms APOE, APOE G-219T promoter, microtubule associated protein(MAPT)/tau exon 6 Ser53Pro, MAPT/tau Hist47Tyr, IL-6572 G/C and IL-6R Asp358Ala with the risk of concussion in college athletes.
Methods A 23-centre prospective cohort study of 1056 college athletes with genotyping was completed between August 2003 and December 2012. All athletes completed baseline medical and concussion questionnaires, and post-concussion data were collected for athletes with a documented concussion.
Results The study cohort consisted of 1056 athletes of mean±SD age 19.7±1.5 years, 89.3% male, 59.4% Caucasian, 35.0% African-American, 5.6% other race. The athletes participated in American football, soccer, basketball, softball, men’s wrestling and club rugby. A total of 133 (12.1% prevalence) concussions occurred during an average surveillance of 3 years per athlete. We observed a significant positive association between IL-6R CC (p=0.001) and a negative association between APOE4 (p=0.03) and the risk of concussion. Unadjusted and adjusted logistic regression analysis showed a significant association between IL-6R CC and concussion (OR 3.48; 95% CI 1.58 to 7.65; p=0.002) and between the APOE4 allele and concussion (OR 0.61; 95% CI 0.38 to 0.96; p=0.04), which persisted after adjustment for confounders.
Conclusions IL-6R CC was associated with a three times greater concussion risk and APOE4 with a 40% lower risk.
- IL-6 gene
- traumatic brain injury
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Contributors Each of the authors in this study contributed appropriately to the research study described in the manuscript and have each reviewed the manuscript and had an opportunity to make editorial changes.
Funding Grant funding was provided by the National Operating Committee on Standards for Athletic Equipment (NOCSAE), American Medical Society of Sports Medicine (AMSSM), and Physicians Medical Education and Research Foundation of the University of Tennessee Medical Center (PMERF). The opinions expressed by the authors are not those of these organizations, but are rather our own.
Competing interests RCC is a paid consultant to the NFL Head Neck and Spine Committee, NOCSAE, Concussion Legacy Foundation, receives royalties from book publications and compensation for expert legal opinion.
Ethics approval University of Tennessee Graduate School of Medicine IRB.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement Any unpublished data are available from the primary author.