Prediction of time trends in recovery of cognitive function after mild head injury

Neurosurgery. 2009 Apr;64(4):698-704; discussion 704. doi: 10.1227/01.NEU.0000340978.42892.78.

Abstract

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.

Conclusion: The presence of the APOE-epsilon4 allele predicts less recovery of cognitive function after mild head injury.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Apolipoproteins E / genetics
  • Cognition Disorders / blood
  • Cognition Disorders / etiology*
  • Cognition Disorders / genetics
  • Cognition Disorders / pathology
  • Craniocerebral Trauma / blood
  • Craniocerebral Trauma / complications*
  • Craniocerebral Trauma / genetics
  • Female
  • Glasgow Coma Scale
  • Humans
  • Linear Models
  • Magnetic Resonance Imaging / methods
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Nerve Growth Factors / blood
  • Neurologic Examination / methods
  • Neuropsychological Tests
  • Predictive Value of Tests
  • Recovery of Function / physiology*
  • S100 Calcium Binding Protein beta Subunit
  • S100 Proteins / blood
  • Tomography, X-Ray Computed / methods
  • Young Adult

Substances

  • Apolipoproteins E
  • Nerve Growth Factors
  • S100 Calcium Binding Protein beta Subunit
  • S100 Proteins