Apolipoprotein E genotype and concussion in college athletes

Clin J Sport Med. 2010 Nov;20(6):464-8. doi: 10.1097/JSM.0b013e3181fc0a81.


Objective: To evaluate the association between apolipoprotein E (APOE) polymorphisms (E2, C/T Arg158Cys; E4, T/C Cys112Arg; and promoter, g-219t) and the history of concussion in college athletes. We hypothesized that carrying 1 or more APOE rare (or minor) allele assessed in this study would be associated with having a history of 1 or more concussions.

Design: Multicenter cross-sectional study.

Setting: University athletic facilities.

Participants: One hundred ninety-six male football (n = 163) and female soccer (n = 33) college athletes volunteered.

Interventions: Written concussion history questionnaire and saliva samples for genotyping.

Main outcome measures: Self-reported history of a documented concussion and rare APOE genotype (E2, E4, promoter).

Results: There was a significant association (Wald χ² = 3.82; P = 0.05; odds ratio = 9.8) between carrying all APOE rare alleles and the history of a previous concussion. There was also a significant association (Wald χ² = 3.96, P = 0.04, odds ratio = 8.4) between carrying the APOE promoter minor allele and experiencing 2 or more concussions.

Conclusions: Carriers of all 3 APOE rare (or minor) alleles assessed in this study were nearly 10 times more likely to report a previous concussion and may be at a greater risk of concussion versus noncarriers. Promoter minor allele carriers were 8.4 times more likely to report multiple concussions and may be at a greater risk of multiple concussions versus noncarriers. Research involving larger samples of individuals with multiple concussions and carriers of multiple APOE rare alleles is warranted.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Apolipoprotein E2 / genetics*
  • Apolipoprotein E4 / genetics*
  • Athletes / statistics & numerical data
  • Athletic Injuries / genetics*
  • Brain Concussion / epidemiology*
  • Brain Concussion / genetics*
  • Cross-Sectional Studies
  • Female
  • Football / injuries*
  • Humans
  • Male
  • Polymorphism, Genetic
  • Promoter Regions, Genetic
  • Risk Factors
  • Saliva / chemistry
  • Soccer / injuries*
  • Young Adult


  • Apolipoprotein E2
  • Apolipoprotein E4