Prediction of time trends in recovery of cognitive function after mild head injury.
OBJECTIVE
To investigate relations between predictors and outcomes, and especially to identify predictors influencing the time trend in recovery after mild traumatic brain injury.


METHODS
We included 59 patients with mild head injury in a prospective study. They underwent comprehensive assessment with neurological and neuroradiological examinations, serum S-100B analysis, and apolipoprotein E (APOE) genotyping. Neuropsychological testing was performed before and 6 months after discharge. Linear mixed models were used to assess associations between baseline predictors and neurocognitive performance and its change.


RESULTS
A Glasgow Coma Scale score of less than 15, traumatic brain injury demonstrated with computed tomography, magnetic resonance imaging, and serum S-100B greater than 0.14 microg/L predicted impaired cognitive performance both at baseline and after 6 months; APOE genotype did not. There was significant improvement of performance after 6 months. APOE-epsilon4 genotype was the only independent factor significantly predicting less improvement.


CONCLUSIONS
The presence of the APOE-epsilon4 allele predicts less recovery of cognitive function after mild head injury.
Department of Neurosurgery, University Hospital of North Norway, Tromsø, Norway. kay.muller@unn.no
Kay
K
Müller
Tor
T
Ingebrigtsen
Tom
T
Wilsgaard
Gry
G
Wikran
Toril
T
Fagerheim
Bertil
B
Romner
Knut
K
Waterloo
D000293:Adolescent; D000328:Adult; D000368:Aged; D001057:Apolipoproteins E / Q000235:genetics; D003072:Cognition Disorders / Q000097:blood / Q000209:etiology* / Q000235:genetics / Q000473:pathology; D006259:Craniocerebral Trauma / Q000097:blood / Q000150:complications* / Q000235:genetics; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D016014:Linear Models; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009414:Nerve Growth Factors / Q000097:blood; D009460:Neurologic Examination / Q000379:methods; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D020127:Recovery of Function / Q000502:physiology*; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins / Q000097:blood; D014057:Tomography, X-Ray Computed / Q000379:methods; D055815:Young Adult
D001057:Apolipoproteins E; D009414:Nerve Growth Factors; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins