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Feigen CM, Charney MF, Glajchen S, Myers C, Cherny S, Lipnitsky R, Yang WW, Glassman NR, Lipton ML. Genetic Variants and Persistent Impairment Following Mild Traumatic Brain Injury: A Systematic Review. J Head Trauma Rehabil 2024:00001199-990000000-00148. [PMID: 38668678 DOI: 10.1097/htr.0000000000000907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2024]
Abstract
OBJECTIVE The purpose of this review is to systematically assess primary research publications on known genetic variants, which modify the risk for symptoms or dysfunction persisting 30 days or more following mild traumatic brain injury (mTBI). SUMMARY OF REVIEW A search of PubMed and Embase from inception through June 2022 identified 42 studies that associated genetic variants with the presence of symptoms or cognitive dysfunction 30 days or more following mTBI. Risk of bias was assessed for each publication using the Newcastle Ottawa Scale (NOS). Fifteen of the 22 studies evaluating apolipoprotein E ( APOE ) ɛ4 concluded that it was associated with worse outcomes and 4 of the 8 studies investigating the brain-derived neurotrophic factor ( BDNF ) reported the Val66Met allele was associated with poorer outcomes. The review also identified 12 studies associating 28 additional variants with mTBI outcomes. Of these, 8 references associated specific variants with poorer outcomes. Aside from analyses comparing carriers and noncarriers of APOE ɛ4 and BDNF Val66Met, most of the reviewed studies were too dissimilar, particularly in terms of specific outcome measures but also in genes examined, to allow for direct comparisons of their findings. Moreover, these investigations were observational and subject to varying degrees of bias. CONCLUSIONS The most consistent finding across articles was that APOE ɛ4 is associated with persistent post-mTBI impairment (symptoms or cognitive dysfunction) more than 30 days after mTBI. The sparsity of other well-established and consistent findings in the mTBI literature should motivate larger, prospective studies, which characterize the risk for persistent impairment with standardized outcomes in mTBI posed by other genetic variants influencing mTBI recovery.
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Affiliation(s)
- Chaim M Feigen
- Author Affiliations: Department of Neurological Surgery, Montefiore Medical Center, Bronx, New York (Mr Feigen); Gruss Magnetic Resonance Research Center, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York (Drs Charney and Lipton and Ms Glajchen); D. Samuel Gottesman Library, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York (Ms Glassman); Departments of Radiology, Psychiatry and Behavioral Sciences, and Neurology (Dr Lipton) and Dominick P. Purpura Department of Neuroscience (Mr Feigen and Dr Lipton), Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York; Tulane University, New Orleans, Louisiana (Ms Myers); New York Medical College, Valhalla, New York (Mr Cherny); New York University College of Dentistry, New York, New York (Ms Lipnitsky); and University of South Florida Health Morsani College of Medicine, Tampa, Florida (Ms Yang)
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Merritt VC, Maihofer AX, Gasperi M, Chanfreau-Coffinier C, Stein MB, Panizzon MS, Hauger RL, Logue MW, Delano-Wood L, Nievergelt CM. Genome-wide association study of traumatic brain injury in U.S. military veterans enrolled in the VA million veteran program. Mol Psychiatry 2023:10.1038/s41380-023-02304-8. [PMID: 37875548 DOI: 10.1038/s41380-023-02304-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 09/21/2023] [Accepted: 10/11/2023] [Indexed: 10/26/2023]
Abstract
Large-scale genetic studies of traumatic brain injury (TBI) are lacking; thus, our understanding of the influence of genetic factors on TBI risk and recovery is incomplete. This study aimed to conduct a genome-wide association study (GWAS) of TBI in VA Million Veteran Program (MVP) enrollees. Participants included a multi-ancestry cohort (European, African, and Hispanic ancestries; N = 304,485; 111,494 TBI cases, 192,991 controls). TBI was assessed using MVP survey data and International Classification of Diseases (ICD) codes from the Veterans Health Administration's electronic health record. GWAS was performed using logistic regression in PLINK, and meta-analyzed in METAL. FUMA was used for post-GWAS analysis. Genomic structural equation modeling (gSEM) was conducted to investigate underlying genetic associations with TBI, and bivariate MiXeR was used to estimate phenotype specific and shared polygenicity. SNP-based heritability was 0.060 (SE = 0.004, p = 7.83×10-66). GWAS analysis identified 15 genome-wide significant (GWS) loci at p < 5×10-8. Gene-based analyses revealed 14 gene-wide significant genes; top genes included NCAM1, APOE, FTO, and FOXP2. Gene tissue expression analysis identified the brain as significantly enriched, particularly in the frontal cortex, anterior cingulate cortex, and nucleus accumbens. Genetic correlations with TBI were significant for risk-taking behaviors and psychiatric disorders, but generally not significant for the neurocognitive variables investigated. gSEM analysis revealed stronger associations with risk-taking traits than with psychiatric traits. Finally, the genetic architecture of TBI was similar to polygenic psychiatric disorders. Neurodegenerative disorders including Alzheimer's and Parkinson's disease showed much less polygenicity, however, the proportion of shared variance with TBI was high. This first well-powered GWAS of TBI identified 15 loci including genes relevant to TBI biology, and showed that TBI is a heritable trait with comparable genetic architecture and high genetic correlation with psychiatric traits. Our findings set the stage for future TBI GWASs that focus on injury severity and diversity and chronicity of symptom sequelae.
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Affiliation(s)
- Victoria C Merritt
- VA San Diego Healthcare System (VASDHS), San Diego, CA, USA.
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA.
- Center of Excellence for Stress and Mental Health, VASDHS, San Diego, CA, USA.
| | - Adam X Maihofer
- VA San Diego Healthcare System (VASDHS), San Diego, CA, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Marianna Gasperi
- VA San Diego Healthcare System (VASDHS), San Diego, CA, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Center of Excellence for Stress and Mental Health, VASDHS, San Diego, CA, USA
| | | | - Murray B Stein
- VA San Diego Healthcare System (VASDHS), San Diego, CA, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- School of Public Health, University of California San Diego, La Jolla, CA, USA
| | - Matthew S Panizzon
- VA San Diego Healthcare System (VASDHS), San Diego, CA, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA
| | - Richard L Hauger
- VA San Diego Healthcare System (VASDHS), San Diego, CA, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Center of Excellence for Stress and Mental Health, VASDHS, San Diego, CA, USA
- Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA
| | - Mark W Logue
- National Center for PTSD, Behavioral Sciences Division, VA Boston Healthcare System, Boston, MA, USA
- Boston University Chobanian & Avedisian School of Medicine, Department of Psychiatry, Boston, MA, USA
- Boston University Chobanian & Avedisian School of Medicine, Biomedical Genetics, Boston, MA, USA
- Boston University School of Public Health, Department of Biostatistics, Boston, MA, USA
| | - Lisa Delano-Wood
- VA San Diego Healthcare System (VASDHS), San Diego, CA, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Center of Excellence for Stress and Mental Health, VASDHS, San Diego, CA, USA
| | - Caroline M Nievergelt
- VA San Diego Healthcare System (VASDHS), San Diego, CA, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Center of Excellence for Stress and Mental Health, VASDHS, San Diego, CA, USA
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Antrobus MR, Brazier J, Callus P, Herbert AJ, Stebbings GK, Day SH, Kilduff LP, Bennett MA, Erskine RM, Raleigh SM, Collins M, Pitsiladis YP, Heffernan SM, Williams AG. Concussion-Associated Gene Variant COMT rs4680 Is Associated With Elite Rugby Athlete Status. Clin J Sport Med 2023; 33:e145-e151. [PMID: 35350037 DOI: 10.1097/jsm.0000000000001030] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 02/22/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Concussions are common match injuries in elite rugby, and reports exist of reduced cognitive function and long-term health consequences that can interrupt or end a playing career and produce continued ill health. The aim of this study was to investigate the association between elite rugby status and 8 concussion-associated risk polymorphisms. We hypothesized that concussion-associated risk genotypes and alleles would be underrepresented in elite rugby athletes compared with nonathletes. DESIGN A case-control genetic association study. SETTING Institutional (university). PARTICIPANTS Elite White male rugby athletes [n = 668, mean (SD) height 1.85 (0.07) m, mass 102 (12) kg, and age 29 (7) years] and 1015 nonathlete White men and women (48% men). INTERVENTIONS Genotype was the independent variable, obtained by PCR of genomic DNA using TaqMan probes. MAIN OUTCOME MEASURE Elite athlete status with groups compared using χ 2 and odds ratio (OR). RESULTS The COMT rs4680 Met/Met (AA) genotype, Met allele possession, and Met allele frequency were lower in rugby athletes (24.8%, 74.6%, and 49.7%, respectively) than nonathletes (30.2%, 77.6%, and 54.0%; P < 0.05). The Val/Val (GG) genotype was more common in elite rugby athletes than nonathletes (OR 1.39, 95% confidence interval 1.04-1.86). No other polymorphism was associated with elite athlete status. CONCLUSIONS Elite rugby athlete status is associated with COMT rs4680 genotype that, acting pleiotropically, could affect stress resilience and behavioral traits during competition, concussion risk, and/or recovery from concussion. Consequently, assessing COMT rs4680 genotype might aid future individualized management of concussion risk among athletes.
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Affiliation(s)
- Mark R Antrobus
- Sports Genomics Laboratory, Department of Sport and Exercise Sciences, Manchester Metropolitan University, Manchester, United Kingdom
- Sport and Exercise Science, University of Northampton, Northampton, United Kingdom
| | - Jon Brazier
- Sports Genomics Laboratory, Department of Sport and Exercise Sciences, Manchester Metropolitan University, Manchester, United Kingdom
- Department of Psychology and Sports Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Peter Callus
- Sports Genomics Laboratory, Department of Sport and Exercise Sciences, Manchester Metropolitan University, Manchester, United Kingdom
| | - Adam J Herbert
- School of Health Sciences, Birmingham City University, Birmingham, United Kingdom
| | - Georgina K Stebbings
- Sports Genomics Laboratory, Department of Sport and Exercise Sciences, Manchester Metropolitan University, Manchester, United Kingdom
| | - Stephen H Day
- Faculty of Science and Engineering, University of Wolverhampton, Wolverhampton, United Kingdom
| | - Liam P Kilduff
- Applied Sports Science Technology and Medicine Research Centre (A-STEM), Faculty of Science and Engineering, Swansea University, Swansea, United Kingdom
| | - Mark A Bennett
- Applied Sports Science Technology and Medicine Research Centre (A-STEM), Faculty of Science and Engineering, Swansea University, Swansea, United Kingdom
| | - Robert M Erskine
- Research Institute for Sport & Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
- Institute of Sport, Exercise and Health, University College London, London, United Kingdom
| | - Stuart M Raleigh
- School of Health Sciences, Coventry University, Coventry, United Kingdom
| | - Malcolm Collins
- Division of Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town, South Africa ; and
| | - Yannis P Pitsiladis
- FIMS Reference Collaborating Centre of Sports Medicine for Anti-Doping Research, University of Brighton, Brighton, United Kingdom
| | - Shane M Heffernan
- Applied Sports Science Technology and Medicine Research Centre (A-STEM), Faculty of Science and Engineering, Swansea University, Swansea, United Kingdom
| | - Alun G Williams
- Sports Genomics Laboratory, Department of Sport and Exercise Sciences, Manchester Metropolitan University, Manchester, United Kingdom
- Institute of Sport, Exercise and Health, University College London, London, United Kingdom
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Lippa SM, Lange RT, Dalgard CL, Soltis AR, Guedes VA, Brickell TA, French LM, Gill J. APOE Is Associated With Serum Tau Following Uncomplicated Mild Traumatic Brain Injury. Front Neurol 2022; 13:816625. [PMID: 35911887 PMCID: PMC9329522 DOI: 10.3389/fneur.2022.816625] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 05/23/2022] [Indexed: 11/13/2022] Open
Abstract
Background and Objectives APOE e4 has been linked to poor outcome following traumatic brain injury (TBI); however, the mechanisms behind this relationship are unclear. Few studies have investigated the relationship between the APOE genotype and established brain related protein biomarkers following TBI. The purpose of this study was to examine this relationship in service members and veterans (SMVs) following TBI. Methods Participants were 209 SMVs [124 uncomplicated mild TBI (mTBI); 85 complicated mild, moderate, severe, or penetrating TBI (mod-sev TBI)] prospectively enrolled in the DVBIC-TBICoE 15-Year Longitudinal TBI Study. APOE genotyping was undertaken using non-fasting blood serum samples. Participants were divided into three groups: APOE e2+, APOE e3/e3, and APOE e4+. Results In participants with mTBI, those with the APOE e2 allele had significantly lower levels of tau than those with APOE e4 (p = 0.005, r = 0.43, medium-large effect size). Those with APOE e3/e3 trended toward having higher tau than those APOE e2+ (p = 0.076, r = 0.20, small-medium effect size) and lower tau than those with APOE e4+ (p = 0.062, r = 0.21, small-medium effect size). There were no significant differences in biomarkers based on APOE in the mod-sev TBI group. Discussion This study is the first to demonstrate APOE genotype is related to serum tau levels following a mTBI, extending prior findings to human serum following mTBI. In addition to higher serum tau levels in APOE e4 carriers, lower tau levels were observed in APOE e2 carriers, suggesting a possible protective effect.
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Affiliation(s)
- Sara M. Lippa
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, United States
| | - Rael T. Lange
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, United States
- Department of Research, Tramatic Brain Injury Center of Excellence, Silver Spring, MD, United States
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
- Centre of Excellence on Post-traumatic Stress Disorder, Ottawa, ON, Canada
- General Dynamics Information Technology, Falls Church, VA, United States
| | - Clifton L. Dalgard
- Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
- The American Genome Center, Bethesda, MD, United States
| | - Anthony R. Soltis
- Henry M. Jackson Foundation, Bethesda, MD, United States
- PRIMER, Bethesda, MD, United States
| | | | - Tracey A. Brickell
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, United States
- Department of Research, Tramatic Brain Injury Center of Excellence, Silver Spring, MD, United States
- Centre of Excellence on Post-traumatic Stress Disorder, Ottawa, ON, Canada
- General Dynamics Information Technology, Falls Church, VA, United States
- Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - Louis M. French
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, United States
- Department of Research, Tramatic Brain Injury Center of Excellence, Silver Spring, MD, United States
- Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - Jessica Gill
- Division of Intramural Research, National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, United States
- School of Nursing, Johns Hopkins University, Baltimore, MD, United States
- Department of Neurology, School of Medicine, Johns Hopkins University, Baltimore, MD, United States
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Mahmoudi A, Heydari S, Markina YV, Barreto GE, Sahebkar A. Role of statins in regulating molecular pathways following traumatic brain injury: A system pharmacology study. Biomed Pharmacother 2022; 153:113304. [PMID: 35724514 DOI: 10.1016/j.biopha.2022.113304] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 06/10/2022] [Accepted: 06/13/2022] [Indexed: 11/28/2022] Open
Abstract
Traumatic brain injury (TBI) is a serious disorder with debilitating physical and psychological complications. Previous studies have indicated that genetic factors have a critical role in modulating the secondary phase of injury in TBI. Statins have interesting pleiotropic properties such as antiapoptotic, antioxidative, and anti-inflammatory effects, which make them a suitable class of drugs for repurposing in TBI. In this study, we aimed to explore how statins modulate proteins and pathways involved in TBI using system pharmacology. We first explored the target associations with statins in two databases to discover critical clustering groups, candidate hub and critical hub genes in the network of TBI, and the possible connections of statins with TBI-related genes. Our results showed 1763 genes associated with TBI. Subsequently, the analysis of centralities in the PPI network displayed 55 candidate hub genes and 15 hub genes. Besides, MCODE analysis based on threshold score:10 determined four modular clusters. Intersection analysis of genes related to TBI and statins demonstrated 204 shared proteins, which suggested that statins influence 31 candidate hub and 9 hub genes. Moreover, statins had the highest interaction with MCODE1. The biological processes of the 31 shared proteins are related to gene expression, inflammation, antioxidant activity, and cell proliferation. Biological enriched pathways showed Programmed Cell Death proteins, AGE-RAGE signaling pathway, C-type lectin receptor signalling pathway, and MAPK signaling pathway as top clusters. In conclusion, statins could target several critical post-TBI genes mainly involved in inflammation and apoptosis, supporting the previous research results as a potential therapeutic agent.
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Affiliation(s)
- Ali Mahmoudi
- Department of Medical Biotechnology and Nanotechnology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad 9177899191, the Islamic Republic of Iran; Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, the Islamic Republic of Iran
| | - Sahar Heydari
- Department of Physiology and Pharmacology, Faculty of Medicine, Sabzevar University of Medical Sciences, the Islamic Republic of Iran; Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, the Islamic Republic of Iran
| | - Yuliya V Markina
- Laboratory of Cellular and Molecular Pathology of Cardiovascular System, Avtsyn Research Institute of Human Morphology of FSBI "Petrovsky National Research Center of Surgery", 3 Tsyurupy Str., 117418, Moscow, the Russian Federation
| | - George E Barreto
- Department of Biological Sciences, University of Limerick, Limerick, Ireland.
| | - Amirhossein Sahebkar
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, the Islamic Republic of Iran; Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, the Islamic Republic of Iran; Department of Biotechnology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, the Islamic Republic of Iran.
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Antrobus MR, Brazier J, Callus PC, Herbert AJ, Stebbings GK, Khanal P, Day SH, Kilduff LP, Bennett MA, Erskine RM, Raleigh SM, Collins M, Pitsiladis YP, Heffernan SM, Williams AG. Concussion-Associated Polygenic Profiles of Elite Male Rugby Athletes. Genes (Basel) 2022; 13:820. [PMID: 35627205 PMCID: PMC9141383 DOI: 10.3390/genes13050820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 04/27/2022] [Accepted: 04/28/2022] [Indexed: 12/04/2022] Open
Abstract
Due to the high-velocity collision-based nature of elite rugby league and union, the risk of sustaining a concussion is high. Occurrence of and outcomes following a concussion are probably affected by the interaction of multiple genes in a polygenic manner. This study investigated whether suspected concussion-associated polygenic profiles of elite rugby athletes differed from non-athletes and between rugby union forwards and backs. We hypothesised that a total genotype score (TGS) using eight concussion-associated polymorphisms would be higher in elite rugby athletes than non-athletes, indicating selection for protection against incurring or suffering prolonged effects of, concussion in the relatively high-risk environment of competitive rugby. In addition, multifactor dimensionality reduction was used to identify genetic interactions. Contrary to our hypothesis, TGS did not differ between elite rugby athletes and non-athletes (p ≥ 0.065), nor between rugby union forwards and backs (p = 0.668). Accordingly, the TGS could not discriminate between elite rugby athletes and non-athletes (AUC ~0.5), suggesting that, for the eight polymorphisms investigated, elite rugby athletes do not have a more ‘preferable’ concussion-associated polygenic profile than non-athletes. However, the COMT (rs4680) and MAPT (rs10445337) GC allele combination was more common in rugby athletes (31.7%; p < 0.001) and rugby union athletes (31.8%; p < 0.001) than non-athletes (24.5%). Our results thus suggest a genetic interaction between COMT (rs4680) and MAPT (rs10445337) assists rugby athletes in achieving elite status. These findings need exploration vis-à-vis sport-related concussion injury data and could have implications for the management of inter-individual differences in concussion risk.
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Affiliation(s)
- Mark R. Antrobus
- Department of Sport and Exercise Sciences, Manchester Metropolitan University Institute of Sport, Manchester Metropolitan University, Manchester M1 7EL, UK; (J.B.); (P.C.C.); (G.K.S.); (P.K.); (A.G.W.)
- Sport and Exercise Science, University of Northampton, Northampton NN1 5PH, UK
| | - Jon Brazier
- Department of Sport and Exercise Sciences, Manchester Metropolitan University Institute of Sport, Manchester Metropolitan University, Manchester M1 7EL, UK; (J.B.); (P.C.C.); (G.K.S.); (P.K.); (A.G.W.)
- Department of Psychology and Sports Sciences, University of Hertfordshire, Hatfield AL10 9AB, UK
| | - Peter C. Callus
- Department of Sport and Exercise Sciences, Manchester Metropolitan University Institute of Sport, Manchester Metropolitan University, Manchester M1 7EL, UK; (J.B.); (P.C.C.); (G.K.S.); (P.K.); (A.G.W.)
| | - Adam J. Herbert
- Research Centre for Life and Sport Sciences (C-LaSS), School of Health Sciences, Birmingham City University, Birmingham B15 3TN, UK;
| | - Georgina K. Stebbings
- Department of Sport and Exercise Sciences, Manchester Metropolitan University Institute of Sport, Manchester Metropolitan University, Manchester M1 7EL, UK; (J.B.); (P.C.C.); (G.K.S.); (P.K.); (A.G.W.)
| | - Praval Khanal
- Department of Sport and Exercise Sciences, Manchester Metropolitan University Institute of Sport, Manchester Metropolitan University, Manchester M1 7EL, UK; (J.B.); (P.C.C.); (G.K.S.); (P.K.); (A.G.W.)
| | - Stephen H. Day
- School of Medicine and Clinical Practice, University of Wolverhampton, Wolverhampton WV1 1LY, UK;
| | - Liam P. Kilduff
- Applied Sports Science Technology and Medicine Research Centre (A-STEM), College of Engineering, Swansea University, Swansea SA1 8EN, UK; (L.P.K.); (M.A.B.); (S.M.H.)
| | - Mark A. Bennett
- Applied Sports Science Technology and Medicine Research Centre (A-STEM), College of Engineering, Swansea University, Swansea SA1 8EN, UK; (L.P.K.); (M.A.B.); (S.M.H.)
| | - Robert M. Erskine
- Research Institute for Sport & Exercise Sciences, Liverpool John Moores University, Liverpool L3 3AF, UK;
- Institute of Sport, Exercise and Health, University College London, London WC1E 6BT, UK
| | - Stuart M. Raleigh
- Cardiovascular and Lifestyle Medicine Research Group, CSELS, Coventry University, Coventry CV1 5FB, UK;
| | - Malcolm Collins
- Health through Physical Activity, Lifestyle and Sport Research Centre (HPALS), Department of Human Biology, and the International Federation of Sports Medicine (FIMS) Collaborative Centre of Sports Medicine, University of Cape Town, Rondebosch, Cape Town 7701, South Africa;
| | - Yannis P. Pitsiladis
- FIMS Reference Collaborating Centre of Sports Medicine for Anti-Doping Research, University of Brighton, Brighton BN20 7SP, UK;
- Centre for Exercise Sciences and Sports Medicine, FIMS Collaborating Centre of Sports Medicine, Piazza L. de Bosis 6, 00135 Rome, Italy
| | - Shane M. Heffernan
- Applied Sports Science Technology and Medicine Research Centre (A-STEM), College of Engineering, Swansea University, Swansea SA1 8EN, UK; (L.P.K.); (M.A.B.); (S.M.H.)
| | - Alun G. Williams
- Department of Sport and Exercise Sciences, Manchester Metropolitan University Institute of Sport, Manchester Metropolitan University, Manchester M1 7EL, UK; (J.B.); (P.C.C.); (G.K.S.); (P.K.); (A.G.W.)
- Applied Sports Science Technology and Medicine Research Centre (A-STEM), College of Engineering, Swansea University, Swansea SA1 8EN, UK; (L.P.K.); (M.A.B.); (S.M.H.)
- Institute of Sport, Exercise and Health, University College London, London WC1E 6BT, UK
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Inampudi C, Ciccotosto GD, Cappai R, Crack PJ. Genetic Modulators of Traumatic Brain Injury in Animal Models and the Impact of Sex-Dependent Effects. J Neurotrauma 2021; 37:706-723. [PMID: 32027210 DOI: 10.1089/neu.2019.6955] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Traumatic brain injury (TBI) is a major health problem causing disability and death worldwide. There is no effective treatment, due in part to the complexity of the injury pathology and factors affecting its outcome. The extent of brain injury depends on the type of insult, age, sex, lifestyle, genetic risk factors, socioeconomic status, other co-injuries, and underlying health problems. This review discusses the genes that have been directly tested in TBI models, and whether their effects are known to be sex-dependent. Sex differences can affect the incidence, symptom onset, pathology, and clinical outcomes following injury. Adult males are more susceptible at the acute phase and females show greater injury in the chronic phase. TBI is not restricted to a single sex; despite variations in the degree of symptom onset and severity, it is important to consider both female and male animals in TBI pre-clinical research studies.
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Affiliation(s)
- Chaitanya Inampudi
- Department of Pharmacology and Therapeutics, University of Melbourne, Parkville, Victoria, Australia
| | - Giuseppe D Ciccotosto
- Department of Pharmacology and Therapeutics, University of Melbourne, Parkville, Victoria, Australia
| | - Roberto Cappai
- Department of Pharmacology and Therapeutics, University of Melbourne, Parkville, Victoria, Australia
| | - Peter J Crack
- Department of Pharmacology and Therapeutics, University of Melbourne, Parkville, Victoria, Australia
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Kim SK, Roche MD, Fredericson M, Dragoo JL, Horton BH, Avins AL, Belanger HG, Ioannidis JPA, Abrams GD. A Genome-wide Association Study for Concussion Risk. Med Sci Sports Exerc 2021; 53:704-711. [PMID: 33017352 DOI: 10.1249/mss.0000000000002529] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE This study aimed to screen the entire genome for genetic markers associated with risk for concussion. METHODS A genome-wide association analyses was performed using data from the Kaiser Permanente Research Bank and the UK Biobank. Concussion cases were identified based on electronic health records from the Kaiser Permanente Research Bank and the UK Biobank from individuals of European ancestry. Genome-wide association analyses from both cohorts were tested for concussion using a logistic regression model adjusting for sex, height, weight, and race/ethnicity using allele counts for single nucleotide polymorphisms. Previously identified genes within the literature were also tested for association with concussion. RESULTS There were a total of 4064 cases of concussion and 291,472 controls within the databases, with two single nucleotide polymorphisms demonstrating a genome-wide significant association with concussion. The first polymorphism, rs144663795 (P = 9.7 × 10-11; OR = 2.91 per allele copy), is located within the intron of SPATA5. Strong, deleterious mutations in SPATA5 cause intellectual disability, hearing loss, and vision loss. The second polymorphism, rs117985931 (P = 3.97 × 10-9; OR = 3.59 per allele copy), is located within PLXNA4. PLXNA4 plays a key role is axon outgrowth during neural development, and DNA variants in PLXNA4 are associated with risk for Alzheimer's disease. Previous investigations have identified five candidate genes that may be associated with concussion, but none showed a significant association in the current model (P < 0.05). CONCLUSION Two genetic markers were identified as potential risk factors for concussion and deserve further validation and investigation of molecular mechanisms.
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Affiliation(s)
- Stuart K Kim
- Department of Developmental Biology, Stanford University Medical School, Stanford, CA
| | - Megan D Roche
- Department Orthopaedic Surgery, Stanford University Medical Center, Stanford, CA
| | - Michael Fredericson
- Department Orthopaedic Surgery, Stanford University Medical Center, Stanford, CA
| | - Jason L Dragoo
- UCHealth Steadman Hawkins Clinic Denver-Surgery Center, Englewood, CO
| | - Brandon H Horton
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
| | - Andy L Avins
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
| | | | | | - Geoffrey D Abrams
- Department Orthopaedic Surgery, Stanford University Medical Center, Stanford, CA
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9
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Abstract
PURPOSE OF REVIEW Sport-related concussion (SRC) is a significant public health problem. Understanding the behavioral and personal factors that influence risk and incidence of SRC is critically important for appropriate care and management. Sensation-seeking and impulsivity have been posited to be two such factors that may be significantly associated with SRC. We performed a focused review of recent evidence of the relationships between sensation-seeking and impulsivity in athletes with SRC. RECENT FINDINGS While the research is relatively limited, extant findings demonstrate a significant relationship between sensation-seeking and contact sport participation and risk of prior and future SRC. Impulsivity appears to be common among athletes competing in high contact sports and may contribute to neural and functional brain changes following SRC; however, causal relationships between impulsivity, contact sport participation, and SRC have not been demonstrated. Both sensation-seeking and impulsivity are significantly associated with SRC in collegiate athletes. Interventions designed to ameliorate high levels of these constructs may prove to be beneficial avenues to reducing SRC risk and improving patient care and outcomes.
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Affiliation(s)
- Spencer W Liebel
- Neuropsychology Section, Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA.
- Michigan Concussion Center, University of Michigan, Ann Arbor, MI, USA.
| | - Katherine A M Edwards
- Neuropsychology Section, Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Steven P Broglio
- Michigan Concussion Center, University of Michigan, Ann Arbor, MI, USA
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10
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Chen Y, Herrold AA, Walter AE, Reilly JL, Seidenberg PH, Nauman EA, Talavage T, Vandenbergh DJ, Slobounov SM, Breiter HC. Brain Perfusion Bridges Virtual-Reality Spatial Behavior to TPH2 Genotype for Head Acceleration Events. J Neurotrauma 2021; 38:1368-1376. [PMID: 33413020 DOI: 10.1089/neu.2020.7016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Neuroimaging demonstrates that athletes of collision sports can suffer significant changes to their brain in the absence of concussion, attributable to head acceleration event (HAE) exposure. In a sample of 24 male Division I collegiate football players, we examine the relationships between tryptophan hydroxylase 2 (TPH2), a gene involved in neurovascular function, regional cerebral blood flow (rCBF) measured by arterial spin labeling, and virtual reality (VR) motor performance, both pre-season and across a single football season. For the pre-season, TPH2 T-carriers showed lower rCBF in two left hemisphere foci (fusiform gyrus/thalamus/hippocampus and cerebellum) in association with higher (better performance) VR Reaction Time, a dynamic measure of sensory-motor reactivity and efficiency of visual-spatial processing. For TPH2 CC homozygotes, higher pre-season rCBF in these foci was associated with better performance on VR Reaction Time. A similar relationship was observed across the season, where TPH2 T-carriers showed improved VR Reaction Time associated with decreases in rCBF in the right hippocampus/amygdala, left middle temporal lobe, and left insula/putamen/pallidum. In contrast, TPH2 CC homozygotes showed improved VR Reaction Time associated with increases in rCBF in the same three clusters. These findings show that TPH2 T-carriers have an abnormal relationship between rCBF and the efficiency of visual-spatial processing that is exacerbated after a season of high-impact sports in the absence of diagnosable concussion. Such gene-environment interactions associated with behavioral changes after exposure to repetitive HAEs have been unrecognized with current clinical analytical tools and warrant further investigation. Our results demonstrate the importance of considering neurovascular factors along with traumatic axonal injury to study long-term effects of repetitive HAEs.
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Affiliation(s)
- Yufen Chen
- Center for Translational Imaging, Department of Radiology, Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Amy A Herrold
- Edward Hines Jr., VA Hospital, Research Service, Hines, Illinois, USA.,Warren Wright Adolescent Center, Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Alexa E Walter
- Department of Kinesiology, Pennsylvania State University, University Park, Pennsylvania, USA
| | - James L Reilly
- Warren Wright Adolescent Center, Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Peter H Seidenberg
- Departments of Orthopedics and Rehabilitation and Family and Community Medicine, College of Medicine, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Eric A Nauman
- School of Electrical and Computer Engineering, Purdue University, West Lafayette, Indiana, USA.,Department of Basic Medical Sciences, Purdue University, West Lafayette, Indiana, USA.,Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana, USA
| | - Thomas Talavage
- School of Electrical and Computer Engineering, Purdue University, West Lafayette, Indiana, USA.,Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana, USA
| | - David J Vandenbergh
- Department of Biobehavioral Health, Pennsylvania State University, University Park, Pennsylvania, USA.,Penn State Neuroscience Institute, Pennsylvania State University, University Park, Pennsylvania, USA.,Molecular, Cellular, and Integrative Biosciences Program, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Semyon M Slobounov
- Department of Kinesiology, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Hans C Breiter
- Warren Wright Adolescent Center, Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.,Laboratory of Neuroimaging and Genetics, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
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11
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Xie X, Li L, Wu H, Hou F, Chen Y, Xue Q, Zhou Y, Zhang J, Gong J, Song R. Comprehensive Integrative Analyses Identify TIGD5 rs75547282 as a Risk Variant for Autism Spectrum Disorder. Autism Res 2021; 14:631-644. [PMID: 33393181 DOI: 10.1002/aur.2466] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 12/16/2020] [Accepted: 12/21/2020] [Indexed: 12/12/2022]
Abstract
Although recent genome-wide association studies have identified risk loci that strongly associates with autism spectrum disorder (ASD), how to pinpoint the causal genes remains a challenge. We aimed to pinpoint the potential causal genes and explore the possible susceptibility and mechanism. A convergent functional genomics (CFG) method was used to prioritize the candidate genes by combining lines of evidence, including Sherlock analysis, spatio-temporal expression patterns, expression analysis, protein-protein interactions, co-expression and association with brain structure. A higher score in the CFG approach suggested that more evidence supported this gene as an ASD risk gene. We screened genes with higher CFG scores for candidate functional single nucleotide polymorphisms (SNPs). A genotyping experiment (602 ASD children and 604 healthy sex-matched children) and the dual-luciferase reporter gene assay were followed to validate the effects of SNPs. We identified three genes (MAPT, ZNF285, and TIGD5) as candidate causal genes using the CFG approach. The genotyping experiment showed that TIGD5 rs75547282 was associated with an increased risk of ASD under the dominant model (OR = 1.37, 95% CI = 1.09-1.72, P = 0.006) though the statistical power was limited (5.2%). The T allele of rs75547282 activated the expression of TIGD5 compared with the C allele in the dual-luciferase reporter assay. Our study indicates that such comprehensive integrative analyses may be an effective way to explore promising ASD susceptibility variants and needs to be further investigated in future research. Genotyping experiments should, however, be based on a larger population sample to increase statistical power. LAY SUMMARY: We set out to pinpoint the potential causal genes of ASD and explore the possible susceptibility and mechanism by combining lines of evidence from different analyses. Our results show that TIGD5 rs75547282 is associated with the risk of ASD in the Han Chinese population. In addition, a similar framework to seek promising ASD risk variants could be further investigated in future research Autism Res 2021, 14: 631-644. © 2021 International Society for Autism Research and Wiley Periodicals LLC.
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Affiliation(s)
- Xinyan Xie
- Department of Maternal and Child Health and MOE (Ministry of Education) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Li Li
- Maternity and Children Health Care Hospital of Luohu District, Shenzhen, China
| | - Hao Wu
- Department of Maternal and Child Health and MOE (Ministry of Education) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fang Hou
- Maternity and Children Health Care Hospital of Luohu District, Shenzhen, China
| | - Yanlin Chen
- Maternity and Children Health Care Hospital of Luohu District, Shenzhen, China
| | - Qi Xue
- Department of Maternal and Child Health and MOE (Ministry of Education) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yu Zhou
- Department of Maternal and Child Health and MOE (Ministry of Education) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jiajia Zhang
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
| | - Jianhua Gong
- Maternity and Children Health Care Hospital of Luohu District, Shenzhen, China
| | - Ranran Song
- Department of Maternal and Child Health and MOE (Ministry of Education) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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12
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Pender SC, Smith AM, Finnoff JT, Huston J, Stuart MJ. Concussions in Ice Hockey - Moving Toward Objective Diagnoses and Point-of-care Treatment: A Review. Curr Sports Med Rep 2020; 19:380-386. [PMID: 32925378 DOI: 10.1249/jsr.0000000000000752] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The incidence of sport-related concussion coupled with a doubling of the participation rate in youth hockey over the past two decades provides impetus for the review of the most promising concussion treatment options. This narrative review summarizes the future treatment options for sport-related concussions in ice hockey, while acknowledging their generalizability to concussion in all sports. Symptom assessment, sign observation, as well as cognitive and balance testing, have historically been used to diagnose a concussion. These methods continue to improve, but the need for effective treatments is clear. Pharmacologic, transcranial light, and nutritional supplement treatment options for concussion warranting further investigation have been identified. Dimethyl fumarate is an immunomodulatory compound thought to trigger antioxidant gene expression. Memantine reduces apoptosis and astrogliosis by inhibiting the calcium influx into cells normally caused by glutamate's activation of N-methyl-D-aspartate receptors. Thioredoxin-mimetic peptides and transcranial photobiomodulation temper the effects of the energy crisis by acting as free radical scavengers. In addition, seven neuroprotective nutritional supplements have been identified: berberine, creatine, curcumin, melatonin, omega-3 fatty acids, resveratrol, and vitamins. An estimated US $1.1 billion has been spent on unsuccessful traumatic brain injury clinical trials. As our ability to accurately diagnose concussion improves, dimethyl fumarate, memantine, thioredoxin-mimetic peptides, transcranial photobiomodulation, and nutritional supplements (berberine, creatine, curcumin, melatonin, omega-3 fatty acids, resveratrol, and vitamins) warrant further preclinical and clinical examination in advancing the treatment of sport-related concussions.
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Affiliation(s)
- Sara C Pender
- School of Medicine, University College Dublin, Dublin, IRELAND
| | | | - Jonathan T Finnoff
- Department of Physical Medicine and Rehabilitation, Mayo Clinic College of Medicine and Science, Rochester, MN
| | - John Huston
- Department of Radiology, Mayo Clinic College of Medicine and Science, Rochester, MN
| | - Michael J Stuart
- Department of Orthopedic Surgery, Mayo Clinic College of Medicine and Science, Rochester, MN
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13
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Terry DP, Wojtowicz M, Cook NE, Maxwell BA, Zafonte R, Seifert T, Silverberg ND, Berkner PD, Iverson GL. Factors Associated With Self-Reported Concussion History in Middle School Athletes. Clin J Sport Med 2020; 30 Suppl 1:S69-S74. [PMID: 32132480 DOI: 10.1097/jsm.0000000000000594] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Identifying personal characteristics associated with sustaining a concussion is of great interest, yet only a few have examined this in children. The purpose of this study was to examine the association between sex, neurodevelopmental disorders, health history, and lifetime history of self-reported concussion in 12- and 13-year-old athletes. DESIGN Cross-sectional study. SETTING Middle schools. PARTICIPANTS Participants were 1744 twelve- and thirteen-year-old student athletes who completed preseason Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) testing, including a self-report questionnaire about previous concussions, developmental diagnoses, and previous medical treatment. INDEPENDENT VARIABLES Age, sex, attention-deficit/hyperactivity disorder (ADHD), learning disabilities (LDs), and previous treatment for migraine. MAIN OUTCOME MEASURES Self-reported history of concussion. RESULTS A minority of athletes (13.7%) reported previous concussions (1 concussion, n = 181; 2 concussions, n = 41; and 3+ concussions, n = 17). A small proportion reported a history of ADHD (4.4%), LD (2.8%) or migraine treatment (4.0%). Higher rates of self-reported previous concussions were associated with male sex [16.9% vs 9.1%; χ(1) = 21.47, P < 0.001] and previous migraine treatment [31.9% vs 13.0%; χ(1) = 20.08, P < 0.001]. There were no differences in self-reported concussion history between 12- and 13-year olds (P = 0.18) and those with/without ADHD (P = 0.41) or LDs (P = 0.06). The overall logistic regression model was statistically significant [χ(5) = 42.01, P < 0.001] but explained only 4.3% of the variance. Previous treatment for migraine [P < 0.001, Exp(B) = 3.30] and male sex [P < 0.001, Exp(B) = 2.06] were independently associated with a self-reported concussion history, whereas age, LD, and ADHD were not (P's > 0.05). CONCLUSIONS Male sex and previous migraine treatment were associated with higher rates of self-reported previous concussions in both independent and multivariate models in middle school athletes, whereas age, ADHD, and LDs were not.
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Affiliation(s)
- Douglas P Terry
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts
- Spaulding Rehabilitation Hospital, Boston, Massachusetts
- Home Base, A Red Sox Foundation and Massachusetts General Hospital Program, Boston, Massachusetts
- MassGeneral Hospital for Children Sport Concussion Program, Boston, Massachusetts
| | | | - Nathan E Cook
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts
- Spaulding Rehabilitation Hospital, Boston, Massachusetts
- MassGeneral Hospital for Children Sport Concussion Program, Boston, Massachusetts
| | - Bruce A Maxwell
- Department of Computer Science, Colby College, Waterville, Maine
| | - Ross Zafonte
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts
- Spaulding Rehabilitation Hospital, Boston, Massachusetts
- Home Base, A Red Sox Foundation and Massachusetts General Hospital Program, Boston, Massachusetts
- MassGeneral Hospital for Children Sport Concussion Program, Boston, Massachusetts
| | - Tad Seifert
- Departments of Neurology and Sports Health, Norton Healthcare, Louisville, Kentucky
- Kentucky Boxing and Wrestling Commission, Frankfort, Kentucky
| | - Noah D Silverberg
- Division of Physical Medicine & Rehabilitation, University of British Columbia, Vancouver, BC, Canada
- Vancouver Coastal Health Research Institute Rehabilitation Research Program, Vancouver, BC, Canada; and
| | - Paul D Berkner
- Department of Biology and Health Services, Colby College, Waterville, Maine
| | - Grant L Iverson
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts
- Spaulding Rehabilitation Hospital, Boston, Massachusetts
- Home Base, A Red Sox Foundation and Massachusetts General Hospital Program, Boston, Massachusetts
- MassGeneral Hospital for Children Sport Concussion Program, Boston, Massachusetts
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14
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Giarratana AO, Teng S, Reddi S, Zheng C, Adler D, Thakker-Varia S, Alder J. BDNF Val66Met Genetic Polymorphism Results in Poor Recovery Following Repeated Mild Traumatic Brain Injury in a Mouse Model and Treatment With AAV-BDNF Improves Outcomes. Front Neurol 2019; 10:1175. [PMID: 31787925 PMCID: PMC6854037 DOI: 10.3389/fneur.2019.01175] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 10/21/2019] [Indexed: 01/23/2023] Open
Abstract
Clinicians have long noticed that some Traumatic Brain Injury (TBI) patients have worse symptoms and take a longer time to recover than others, for reasons unexplained by known factors. Identifying what makes some individuals more susceptible is critical to understanding the underlying mechanisms through which TBI causes deleterious effects. We have sought to determine the effect of a single nucleotide polymorphism (SNP) in Brain-derived neurotrophic factor (BDNF) at amino acid 66 (rs6265) on recovery after TBI. There is controversy from human studies as to whether the BDNF Val66Val or Val66Met allele is the risk factor for worse outcomes after brain trauma. We therefore investigated cellular and behavioral outcomes in genetically engineered mice following repeated mild TBI (rmTBI) using a lateral fluid percussion (LFP) injury model. We found that relative to injured Val66Val carriers, injured Val66Met carriers had a larger inflammation volume and increased levels of neurodegeneration, apoptosis, p-tau, activated microglia, and gliosis in the cortex and/or hippocampus at 1 and/or 21 days post-injury (DPI). We therefore concluded that the Val66Met genetic polymorphism is a risk factor for poor outcomes after rmTBI. In order to determine the mechanism for these differences, we investigated levels of the apoptotic-inducing pro BDNF and survival-inducing mature BDNF isoforms and found that Met carriers had less total BDNF in the cortex and a higher pro/mature ratio of BDNF in the hippocampus. We then developed a personalized approach to treating genetically susceptible individuals by overexpressing wildtype BDNF in injured Val66Met mice using an AAV-BDNF virus. This intervention improved cellular, motor, and cognitive behavior outcomes at 21 DPI and increased levels of mature BDNF and phosphorylation of mature BDNF's receptor trkB. This study lays the groundwork for further investigation into the genetics that play a role in the extent of injury after rmTBI and highlights how personalized therapeutics may be targeted for recovery in susceptible individuals.
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Affiliation(s)
- Anna O Giarratana
- Department of Neuroscience and Cell Biology, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ, United States
| | - Shavonne Teng
- Department of Neuroscience and Cell Biology, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ, United States
| | - Sahithi Reddi
- Department of Neuroscience and Cell Biology, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ, United States
| | - Cynthia Zheng
- Department of Neuroscience and Cell Biology, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ, United States
| | - Derek Adler
- Department of Neuroscience and Cell Biology, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ, United States
| | - Smita Thakker-Varia
- Department of Neuroscience and Cell Biology, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ, United States
| | - Janet Alder
- Department of Neuroscience and Cell Biology, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ, United States
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15
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Cutting to the Pathophysiology Chase: Translating Cutting-Edge Neuroscience to Rehabilitation Practice in Sports-Related Concussion Management. J Orthop Sports Phys Ther 2019; 49:811-818. [PMID: 31154951 DOI: 10.2519/jospt.2019.8884] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Mild traumatic brain injury, or concussion, is a common sports injury. Concussion involves physical injury to brain tissue and vascular and axonal damage that manifests as transient and often nonspecific clinical symptoms. Concussion diagnosis is challenging, and the relationship between brain injury and clinical symptoms is unclear. The purpose of this commentary was to translate cutting-edge neuroscience to rehabilitation practice. We (1) highlight potential biomarkers that may improve our understanding of concussion and its recovery, (2) explain why researchers must address the paucity of concussion research in female athletes, and (3) present female-specific factors that should be accounted for in future studies. Integrating objective, quantitative measures of concussion pathophysiology with concussion history, genetics, and genomics will help caregivers identify concussed athletes, tailor recovery protocols, and protect athletes from potential long-term effects of cumulative head impact. J Orthop Sports Phys Ther 2019;49(11):811-818. Epub 1 Jun 2019. doi:10.2519/jospt.2019.8884.
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16
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Finan JD, Udani SV, Patel V, Bailes JE. The Influence of the Val66Met Polymorphism of Brain-Derived Neurotrophic Factor on Neurological Function after Traumatic Brain Injury. J Alzheimers Dis 2019; 65:1055-1064. [PMID: 30149456 DOI: 10.3233/jad-180585] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Functional outcomes after traumatic brain injury (TBI) vary widely across patients with apparently similar injuries. This variability hinders prognosis, therapy, and clinical innovation. Recently, single nucleotide polymorphism (SNPs) that influence outcome after TBI have been identified. These discoveries create opportunities to personalize therapy and stratify clinical trials. Both of these changes would propel clinical innovation in the field. This review focuses on one of most well-characterized of these SNPs, the Val66Met SNP in the brain-derived neurotrophic factor (BDNF) gene. This SNP influences neurological function in healthy subjects as well as TBI patients and patients with similar acute insults to the central nervous system. A host of other patient-specific factors including ethnicity, age, gender, injury severity, and post-injury time point modulate this influence. These interactions confound efforts to define a simple relationship between this SNP and TBI outcomes. The opportunities and challenges associated with personalizing TBI therapy around this SNP and other similar SNPs are discussed in light of these results.
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Affiliation(s)
- John D Finan
- Department of Neurosurgery, NorthShore University Health System, Evanston, IL, USA
| | - Shreya V Udani
- Department of Neurosurgery, NorthShore University Health System, Evanston, IL, USA
| | - Vimal Patel
- Department of Neurosurgery, NorthShore University Health System, Evanston, IL, USA
| | - Julian E Bailes
- Department of Neurosurgery, NorthShore University Health System, Evanston, IL, USA
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17
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Wan X, Gan C, You C, Fan T, Zhang S, Zhang H, Wang S, Shu K, Wang X, Lei T. Association of APOE ε4 with progressive hemorrhagic injury in patients with traumatic intracerebral hemorrhage. J Neurosurg 2019; 133:496-503. [PMID: 31323634 DOI: 10.3171/2019.4.jns183472] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 04/18/2019] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The intracranial hematoma volume in patients with traumatic brain injury is a key parameter for the determination of the management approach and outcome. Apolipoprotein E (APOE) ε4 is reported to be a risk factor for larger hematoma volume, which might contribute to a poor outcome. However, whether APOE ε4 is related to progressive hemorrhagic injury (PHI), a common occurrence in the clinical setting, remains unclear. In this study, the authors aimed to investigate the association between the APOE genotype and occurrence of PHI. METHODS This prospective study included a cohort of 123 patients with traumatic intracerebral hemorrhage who initially underwent conservative treatment. These patients were assigned to the PHI or non-PHI group according to the follow-up CT scan. A polymerase chain reaction and sequencing method were carried out to determine the APOE genotype. Multivariate logistic regression analysis was applied to identify predictors of PHI. RESULTS The overall frequency of the alleles was as follows: E2/2, 0%; E2/3, 14.6%; E3/3, 57.8%; E2/4, 2.4%; E3/4, 22.8%; and E4/4, 2.4%. Thirty-four patients carried at least one allele of ε4. In this study 60 patients (48.8%) experienced PHI, and the distribution of the alleles was as follows: E2/2, 0%; E2/3, 5.7%; E3/3, 22.8%; E2/4, 2.4%; E3/4, 16.3%; and E4/4, 1.6%, which was significantly different from that in the non-PHI group (p = 0.008). Additionally, the late operation rate in the PHI group was significantly higher than that in the non-PHI group (24.4% vs 11.4%, p = 0.002). Multivariate logistic regression identified APOE ε4 (OR 5.14, 95% CI 2.40-11.62), an elevated international normalized ratio (OR 3.57, 95% CI 1.61-8.26), and higher glucose level (≥ 10 mmol/L) (OR 3.88, 95% CI 1.54-10.77) as independent risk factors for PHI. Moreover, APOE ε4 was not a risk factor for the coagulopathy and outcome of the patients with traumatic intracerebral hemorrhage. CONCLUSIONS The presence of APOE ε4, an elevated international normalized ratio, and a higher glucose level (≥ 10 mmol/L) are predictors of PHI. Additionally, APOE ε4 is not associated with traumatic coagulopathy and patient outcome.
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Affiliation(s)
| | | | | | | | | | | | | | - Kai Shu
- 1Department of Neurosurgery and
| | - Xiong Wang
- 2Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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18
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Abstract
Over the past 2 decades, concussion care is increasingly in demand as research and media attention shed light on the importance of proper diagnosis and medical management to prevent complex, potentially disabling sequelae. The purpose of this review is to discuss the future of clinical concussion care across selected topics under the broad themes of diagnosis/assessment, intervention/treatment, and patient characteristics/presentations with the intent to direct clinicians' attention to important anticipated developments in the field. The current status of biomarkers, clinical settings, models of clinical concussion, return-to-activity, clinical subpopulations, treatment approaches, patient perceptions of injury, and social media are reviewed along with predictions for future developments.
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Affiliation(s)
- Aliyah R Snyder
- David Geffen School of Medicine, University of California, Los Angeles, CA.
| | - Christopher C Giza
- David Geffen School of Medicine, University of California, Los Angeles, CA; Department of Pediatrics, David Geffen School of Medicine and UCLA Mattel Children's Hospital, University of California, Los Angeles, CA
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19
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Walter A, Herrold AA, Gallagher VT, Lee R, Scaramuzzo M, Bream T, Seidenberg PH, Vandenbergh D, O'Connor K, Talavage TM, Nauman EA, Slobounov SM, Breiter HC. KIAA0319 Genotype Predicts the Number of Past Concussions in a Division I Football Team: A Pilot Study. J Neurotrauma 2019; 36:1115-1124. [DOI: 10.1089/neu.2017.5622] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Affiliation(s)
- Alexa Walter
- Department of Kinesiology, The Pennsylvania State University, University Park, Pennsylvania
- Concussion Neuroimaging Consortium, Florida State University, Florida; Harvard University, Massachusetts; Michigan State University, Michigan; Northwestern University, Illinois; Ohio State University, Ohio; Purdue University, Indiana; The Pennsylvania State University, Pennsylvania; University of Central Florida, Florida; University of Nebraska, Nebraska
| | - Amy A. Herrold
- Warren Wright Adolescent Center, Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- Edward Hines Jr., VA Hospital, Hines, Illinois
- Concussion Neuroimaging Consortium, Florida State University, Florida; Harvard University, Massachusetts; Michigan State University, Michigan; Northwestern University, Illinois; Ohio State University, Ohio; Purdue University, Indiana; The Pennsylvania State University, Pennsylvania; University of Central Florida, Florida; University of Nebraska, Nebraska
| | - Virginia T. Gallagher
- Warren Wright Adolescent Center, Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- Concussion Neuroimaging Consortium, Florida State University, Florida; Harvard University, Massachusetts; Michigan State University, Michigan; Northwestern University, Illinois; Ohio State University, Ohio; Purdue University, Indiana; The Pennsylvania State University, Pennsylvania; University of Central Florida, Florida; University of Nebraska, Nebraska
| | - Rosa Lee
- Warren Wright Adolescent Center, Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- Concussion Neuroimaging Consortium, Florida State University, Florida; Harvard University, Massachusetts; Michigan State University, Michigan; Northwestern University, Illinois; Ohio State University, Ohio; Purdue University, Indiana; The Pennsylvania State University, Pennsylvania; University of Central Florida, Florida; University of Nebraska, Nebraska
| | - Madeleine Scaramuzzo
- Athletic Department, The Pennsylvania State University, University Park, Pennsylvania
| | - Tim Bream
- Athletic Department, The Pennsylvania State University, University Park, Pennsylvania
| | - Peter H. Seidenberg
- Athletic Department, The Pennsylvania State University, University Park, Pennsylvania
| | - David Vandenbergh
- Department of Biobehavioral Health, Molecular and Cellular Biosciences Program and Institute for the Neurosciences, The Pennsylvania State University, University Park, Pennsylvania
| | - Kailyn O'Connor
- Warren Wright Adolescent Center, Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Thomas M. Talavage
- School of Electrical and Computer Engineering, Purdue University, West Lafayette, Indiana
- Concussion Neuroimaging Consortium, Florida State University, Florida; Harvard University, Massachusetts; Michigan State University, Michigan; Northwestern University, Illinois; Ohio State University, Ohio; Purdue University, Indiana; The Pennsylvania State University, Pennsylvania; University of Central Florida, Florida; University of Nebraska, Nebraska
| | - Eric A. Nauman
- School of Mechanical Engineering, Purdue University, West Lafayette, Indiana
- Concussion Neuroimaging Consortium, Florida State University, Florida; Harvard University, Massachusetts; Michigan State University, Michigan; Northwestern University, Illinois; Ohio State University, Ohio; Purdue University, Indiana; The Pennsylvania State University, Pennsylvania; University of Central Florida, Florida; University of Nebraska, Nebraska
| | - Semyon M. Slobounov
- Department of Kinesiology, The Pennsylvania State University, University Park, Pennsylvania
- Concussion Neuroimaging Consortium, Florida State University, Florida; Harvard University, Massachusetts; Michigan State University, Michigan; Northwestern University, Illinois; Ohio State University, Ohio; Purdue University, Indiana; The Pennsylvania State University, Pennsylvania; University of Central Florida, Florida; University of Nebraska, Nebraska
| | - Hans C. Breiter
- Warren Wright Adolescent Center, Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- Laboratory of Neuroimaging and Genetics, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
- Concussion Neuroimaging Consortium, Florida State University, Florida; Harvard University, Massachusetts; Michigan State University, Michigan; Northwestern University, Illinois; Ohio State University, Ohio; Purdue University, Indiana; The Pennsylvania State University, Pennsylvania; University of Central Florida, Florida; University of Nebraska, Nebraska
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20
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Lee HH, Ma HP, Ou JC, Ong JR, Chen KY, Wu CC, Chiu WT, Liao KH, Lin CM, Lin SY, Wu D, Huang YH, Wang YH, Hu CJ, Hong CT. Association Between Acid-Sensing Ion Channel 3 Gene Variants and Balance Impairment in People With Mild Traumatic Brain Injury. Front Neurol 2019; 10:88. [PMID: 30804886 PMCID: PMC6378888 DOI: 10.3389/fneur.2019.00088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 01/22/2019] [Indexed: 11/13/2022] Open
Abstract
Introduction: Dizziness and balance impairment are common symptoms of mild traumatic brain injury (mTBI). Acid-sensing ion channel 3 (ASIC3) is expressed in the vestibular and proprioceptive systems and associated with balance functions. However, whether the genetic variants of ASIC3 are associated with people who suffer dizziness and balance impairment after mTBI remained unknown. Materials and methods: A total of 200 people with mTBI and 109 non-mTBI controls were recruited. Dizziness, balance functions, and the ability to perform daily activities were assessed by Dizziness Handicap Inventory (DHI), and objective balance functions were investigated by the postural stability test. Three diseases-related genetic variants of ASIC3 were determined through polymerase chain reaction and followed by restriction fragment length polymorphism. The Student's t-test and Mann-Whitney U-test were used for normal and abnormal distributed data, respectively. The regression was applied to adjust gender and age. The normality of continuous data was evaluated by Shapiro-Wilk test. Results: In the mTBI people, the rs2288645-A allele carriers exhibited a significantly worse physical domain DHI score (A-allele carriers: 11.39 ± 8.42, non-A carriers: 8.76 ± 7.87, p = 0.03). The rs4148855-GTC deletion carriers an exhibited significantly worse overall postural stability (GTC deletion carriers: 0.53 ± 0.33, non-carriers: 0.46 ± 0.20, p = 0.03). In the controls, rs2288646-A allele carriers were significant worse in the medial-to-lateral postural stability (A-allele carriers: 0.31 ± 0.17, non-A carriers: 0.21 ± 0.10, p = 0.01). Conclusion: The present study demonstrated that ASIC3 genetic variants were associated with certain aspects of balance functions and dizziness questionnaires in people of mTBI and non-mTBI. It provides a possible evidence that ASIC3 could be a new target for the management of the balancing disorders. However, further investigations are warranted to elucidate the underlying mechanisms and clinical significance.
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Affiliation(s)
- Hsun-Hua Lee
- College of Medicine, Graduate Institute of Clinical Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Dizziness and Balance Disorder Center, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan
| | - Hon-Ping Ma
- Department of Emergency Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Department of Emergency Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,College of Public Health and Nutrition, Graduate Institute of Injury Prevention and Control, Taipei Medical University, Taipei, Taiwan
| | - Ju-Chi Ou
- Department of Emergency Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Jiann Ruey Ong
- Department of Emergency Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Department of Emergency Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Kai-Yun Chen
- College of Medical Science and Technology, Graduate Institute of Neural Regenerative Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chung-Che Wu
- Department of Neurosurgery, Taipei Medical University, Taipei, Taiwan
| | - Wen-Ta Chiu
- College of Public Health and Nutrition, Graduate Institute of Injury Prevention and Control, Taipei Medical University, Taipei, Taiwan
| | - Kuo-Hsing Liao
- Department of Neurosurgery, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Chien-Min Lin
- Department of Neurosurgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Shu-Yu Lin
- Graduate Institute of Biomedical Informatics, Taipei Medical University, Taipei, Taiwan
| | - Dean Wu
- Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Dizziness and Balance Disorder Center, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan.,Sleep Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Yao-Hsien Huang
- Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Dizziness and Balance Disorder Center, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan
| | - Yuan-Hung Wang
- College of Medicine, Graduate Institute of Clinical Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chaur-Jong Hu
- Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Dizziness and Balance Disorder Center, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan
| | - Chien-Tai Hong
- Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Dizziness and Balance Disorder Center, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan
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21
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McGrew CA. Sports-related Concussion - Genetic Factors. Curr Sports Med Rep 2019; 18:20-22. [PMID: 30624331 DOI: 10.1249/jsr.0000000000000555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Genetic biomarkers have been evaluated for validity in predicting risk for sports-related concussion as well as prognosticating recovery from this injury. Research results from predominantly small-scale pilot studies thus far are mixed and preliminary findings have not been adequately replicated. Currently, the use of such genetic biomarkers should be considered investigational and not for routine clinical use.
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Affiliation(s)
- Christopher A McGrew
- Department of Family and Community Medicine, Department of Orthopedics and Rehabilitation, University of New Mexico Health Sciences Center, Albuquerque, NM
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22
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Loganovsky KN, Bomko MO, Abramenko IV, Kuts KV, Belous NI, Masiuk SV, Gresko MV, Loganovska TK, Antypchuk KY, Perchuk IV, Kreinis GY, Chumak SA. NEUROPSYCHOBIOLOGICAL MECHANISMS OF AFFECTIVE AND COGNITIVE DISORDERS IN THE CHORNOBYL CLEAN-UP WORKERS TAKING INTO ACCOUNT THE SPECIFIC GENE POLYMORPHISMS. PROBLEMY RADIATSIINOI MEDYTSYNY TA RADIOBIOLOHII 2018; 23:373-409. [PMID: 30582858 DOI: 10.33145/2304-8336-2018-23-373-409] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Indexed: 06/09/2023]
Abstract
Relevance of the present work is determined by the considerable prevalence of both affective and cognitive disor-ders in the victims due to the Chornobyl accident, the pathogenesis of which is insufficiently studied.Objective is to identify the neuropsychiobiological mechanisms of the formation of the remote affective and cog-nitive disorders following exposure to ionizing radiation taking into account the specific gene polymorphisms.Design, object and methods of research. The retrospective and prospective cohort study with the external andinternal control groups. The randomized sample of the male participants in liquidation of the consequences of theaccident (Chornobyl clean-up workers, liquidators) at the Chornobyl nuclear power plant (ChNPP) in 1986-1987(n = 198) recruited from the Clinico-epidemiological registry (CER) of NRCRM aged 39-87 (M ± SD: 60.0-8.5 years)with the external irradiation dose ranged 0.6-5900.0 mSv (M ± SD: 456.0 ± 760.0 mSv) was examined. The compar-ison group (n = 110) consisted of the unexposed patients of the Radiation Psychoneurology Department with thecorresponding age and sex (the external control group). The internal control group included the liquidators irradi-ated at doses < 50.0 mSv (n = 42). The standard diagnostic neuropsychiatric scales, psychodiagnostic questionnairesand tests, neuropsychological methods (including the Wechsler Adult Intelligence Scale (WAIS) with premorbid IQ(pre-IQ) assessment), neuropsychiatric and psychophysiological methods (quantitative EEG (qEEG) and the audito-ry cognitive evoked potentials (Event-Related Potentials, ERP) were applied. The genotypes of the serotonin trans-porter gene SLC6A4 were determined by the 5_HTTLPR and rs25531 polymorphisms. The methods of descriptive and vari-ation statistics, non-parametric criteria, regression-correlation analysis, survival analysis by Kaplan - Meier and riskanalysis were used.Results. Cerebrovascular diseases, organic mental and depressive disorders, mainly of radiation-stress-relatednature, prevail among the liquidators. The overall risk of neuropsychiatric pathology increases (Pv < 0.001) with theirradiation dose. The verbal memory and learning are impaired, as well as the full IQ is reduced at the expense of theverbal one. The frequency of both mild cognitive impairment and dementia is risen. The cognitive impairment atdoses > 0.3 Sv is dose-dependent (r = 0.4-0.7; p = 0.03-0.003). Affective disorders (depression) and neurocogni-tive deficit are more severe at higher doses of irradiation (> 50 mSv). In the left posterior temporal region(Wernicke's area) the qEEG indices changes become dose-dependent at doses greater than 0.25-0.3 Sv. The dis-turbed brain information processes lateralized to the Wernicke's area are observed even at doses > 50 mSv. The car-riers of intermediate and low-level genotypes (LА/S, LА/LG, LG/LG, LG/S, S/S) of the serotonin transporter gene SLC6A4have more depressive disorders, especially severe ones, and tend to have more frequent and severe cognitive andstress-related disorders.The debut of depressive disorders in the carriers of the intermediate and low-activity genotypes occurs much earli-er (Log-Rank Test = 4.43, p = 0.035) in comparison with the carriers of the high-performance genotype LА/ LА.Conclusions. The radiation-induced dysfunction of the cortico-limbic system in the left dominant hemisphere ofthe human brain with a specific involvement of the hippocampus is considered to be the key cerebral basis of post-radiation organic brain damage. The association of genotypes by 5_HTTLPR and rs25531 polymorphisms of the SLC6A4gene with affective and cognitive disorders suggests the presence of neuropsychobiological features of these dis-orders associated with ionizing radiation depending on the certain gene polymorphisms.
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Affiliation(s)
- K N Loganovsky
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», Melnykova str., 53, Kyiv, 04050, Ukraine
| | - M O Bomko
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», Melnykova str., 53, Kyiv, 04050, Ukraine
| | - I V Abramenko
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», Melnykova str., 53, Kyiv, 04050, Ukraine
| | - K V Kuts
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», Melnykova str., 53, Kyiv, 04050, Ukraine
| | - N I Belous
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», Melnykova str., 53, Kyiv, 04050, Ukraine
| | - S V Masiuk
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», Melnykova str., 53, Kyiv, 04050, Ukraine
| | - M V Gresko
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», Melnykova str., 53, Kyiv, 04050, Ukraine
| | - T K Loganovska
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», Melnykova str., 53, Kyiv, 04050, Ukraine
| | - K Yu Antypchuk
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», Melnykova str., 53, Kyiv, 04050, Ukraine
| | - I V Perchuk
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», Melnykova str., 53, Kyiv, 04050, Ukraine
| | - G Yu Kreinis
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», Melnykova str., 53, Kyiv, 04050, Ukraine
| | - S A Chumak
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», Melnykova str., 53, Kyiv, 04050, Ukraine
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23
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Esopenko C, Simonds AH, Anderson EZ. The synergistic effect of concussions and aging in women? Disparities and perspectives on moving forward. Concussion 2018; 3:CNC55. [PMID: 30364380 PMCID: PMC6195093 DOI: 10.2217/cnc-2018-0004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 06/11/2018] [Indexed: 12/14/2022] Open
Affiliation(s)
- Carrie Esopenko
- Department of Rehabilitation & Movement Sciences, School of Health Professions, Rutgers, The State University of New Jersey, New Brunswick, NJ, 08901, USA.,Department of Health Informatics, School of Health Professions, Rutgers, The State University of New Jersey, New Brunswick, NJ, 08901, USA.,Department of Rehabilitation & Movement Sciences, School of Health Professions, Rutgers, The State University of New Jersey, New Brunswick, NJ, 08901, USA.,Department of Health Informatics, School of Health Professions, Rutgers, The State University of New Jersey, New Brunswick, NJ, 08901, USA
| | - Adrienne H Simonds
- Department of Rehabilitation & Movement Sciences, School of Health Professions, Rutgers, The State University of New Jersey, New Brunswick, NJ, 08901, USA.,Department of Rehabilitation & Movement Sciences, School of Health Professions, Rutgers, The State University of New Jersey, New Brunswick, NJ, 08901, USA
| | - Ellen Z Anderson
- Department of Rehabilitation & Movement Sciences, School of Health Professions, Rutgers, The State University of New Jersey, New Brunswick, NJ, 08901, USA.,Department of Health Informatics, School of Health Professions, Rutgers, The State University of New Jersey, New Brunswick, NJ, 08901, USA.,Department of Rehabilitation & Movement Sciences, School of Health Professions, Rutgers, The State University of New Jersey, New Brunswick, NJ, 08901, USA.,Department of Health Informatics, School of Health Professions, Rutgers, The State University of New Jersey, New Brunswick, NJ, 08901, USA
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24
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Mc Fie S, Abrahams S, Patricios J, Suter J, Posthumus M, September AV. Inflammatory and apoptotic signalling pathways and concussion severity: a genetic association study. J Sports Sci 2018; 36:2226-2234. [PMID: 29509495 DOI: 10.1080/02640414.2018.1448570] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
The objective was to investigate the relationship between IL-1B rs16944, IL-6 rs1800795, and CASP8 rs3834129 genetic polymorphisms and concussion severity. Rugby players from high school, senior amateur, and professional teams completed a concussion severity questionnaire and donated a DNA sample. Participants (n = 163) were split into symptom severity groups around the median number and duration of symptoms. The frequency of participants with high symptom counts (more than five symptoms) increased across the IL-1B (C/C: 35%; C/T: 51%; T/T: 56%; P = 0.047) and the IL-6 (C/C: 31%; C/G: 44%; G/G: 58%; P = 0.027) genotypes. The C-C inferred interleukin allele construct frequency, created from combining the IL-1B and IL-6 genotype data, was lower in participants reporting a high symptom count (18%), compared to those with a low symptom count (fewer than six symptoms, 36%, P = 0.002). Similarly, the C-C inferred interleukin allele construct frequency was lower in those reporting prolonged symptom duration (more than one week, 16%), as opposed to short symptom duration (less than one week, 34%, P = 0.015). This study provides evidence of novel inflammatory pathway genetic associations with concussion severity, which supports the hypothesis implicating neuroinflammation in the development of concussion symptoms.
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Affiliation(s)
- Sarah Mc Fie
- a Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Science , University of Cape Town , Cape Town , South Africa
| | - Shameemah Abrahams
- a Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Science , University of Cape Town , Cape Town , South Africa
| | - Jon Patricios
- b Morningside Sports Medicine Clinic , Johannesburg , South Africa.,c Section of Sports Medicine , University of Pretoria , Pretoria , South Africa.,d Department of Emergency Medicine , University of the Witwatersrand , Johannesburg , South Africa
| | - Jason Suter
- e Sports Science Sports and Exercise Medicine Clinic , Cape Town , South Africa
| | - Michael Posthumus
- a Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Science , University of Cape Town , Cape Town , South Africa
| | - Alison V September
- a Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Science , University of Cape Town , Cape Town , South Africa
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25
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Gallo V, McElvenny D, Hobbs C, Davoren D, Morris H, Crutch S, Zetterberg H, Fox NC, Kemp S, Cross M, Arden NK, Davies MAM, Malaspina A, Pearce N. BRain health and healthy AgeINg in retired rugby union players, the BRAIN Study: study protocol for an observational study in the UK. BMJ Open 2017; 7:e017990. [PMID: 29282262 PMCID: PMC5770902 DOI: 10.1136/bmjopen-2017-017990] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 10/20/2017] [Accepted: 10/23/2017] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Relatively little is known about the long-term health of former elite rugby players, or former sportspeople more generally. As well as the potential benefits of being former elite sportspersons, there may be potential health risks from exposures occurring during an individual's playing career, as well as following retirement. Each contact sport has vastly different playing dynamics, therefore exposing its players to different types of potential traumas. Current evidence suggests that these are not necessarily comparable in terms of pathophysiology, and their potential long-term adverse effects might also differ. There is currently limited but increasing evidence that poorer age-related and neurological health exists among former professional sportsmen exposed to repetitive concussions; however the evidence is limited on rugby union players, specifically. METHODS AND ANALYSIS We present the protocol for a cross-sectional study to assess the association between self-reported history of concussion during a playing career, and subsequent measures of healthy ageing and neurological and cognitive impairment. We are recruiting a sample of approximately 200 retired rugby players (former Oxford and Cambridge University rugby players and members of the England Rugby International Club) aged 50 years or more, and collecting a number of general and neurological health-related outcome measures though validated assessments. Biomarkers of neurodegeneration (neurofilaments and tau) will be also be measured. Although the study is focusing on rugby union players specifically, the general study design and the methods for assessing neurological health are likely to be relevant to other studies of former elite sportspersons. ETHICS AND DISSEMINATION The study has been approved by the Ethical Committee of London School of Hygiene and Tropical Medicine (reference: 11634-2). It is intended that results of this study will be published in peer-reviewed medical journals, communicated to participants, the general public and all relevant stakeholders.
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Affiliation(s)
- Valentina Gallo
- School of Public Health, Imperial College London, London, UK
- Epidemiology and Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
- Centre for Primary Care and Public Health, Queen Mary, University of London, London, UK
| | - Damien McElvenny
- Research Division, Institute of Occupational Medicine, Edinburgh, UK
| | - Catherine Hobbs
- Epidemiology and Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - Donna Davoren
- Epidemiology and Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - Huw Morris
- Department of Clinical Neuroscience, University College London, London, UK
| | - Sebastian Crutch
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Henrik Zetterberg
- Department of molecular neuroscience, UCL Institute of Neurology, London, UK
- UK Dementia Research Institute, London, UK
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Nick C Fox
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | | | | | - Nigel K Arden
- Arthritis Research UK Centre for Sport, exercise and osteoarthritis, University of Oxford, Oxford, UK
| | - Madeleine A M Davies
- Arthritis Research UK Centre for Sport, exercise and osteoarthritis, University of Oxford, Oxford, UK
| | - Andrea Malaspina
- Department of Neuroscience and Trauma, Blizard Institute, Queen Mary, University of London, London, UK
| | - Neil Pearce
- Epidemiology and Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
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26
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Dretsch MN, Daniel TA, Goodman AM, Katz JS, Denney T, Deshpande G, Robinson JL. Differential neural activation when voluntarily regulating emotions in service members with chronic mild traumatic brain injury. APPLIED NEUROPSYCHOLOGY-ADULT 2017; 26:76-88. [PMID: 28925716 DOI: 10.1080/23279095.2017.1362406] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
The objective of this study was to characterize the functional activation of the neural correlates of voluntary regulation of emotion in soldiers both with and without chronic mild traumatic brain injury (mTBI). Using functional magnetic resonance imaging (fMRI) and a battery of cognitive and psychological health measures, we assessed differences between active-duty U.S. soldiers with chronic mTBI (n = 37) and without (Controls, n = 35). Participants were instructed to maintain (passively view), enhance, and suppress emotions associated with negative and neutral visual stimuli. The mTBI group showed significantly greater clinical symptoms, but only a mild decrement in attention. Group contrasts, while controlling for posttraumatic stress disorder (PTSD) symptoms, revealed a differential neural activation pattern compared to controls, but only during the enhance condition. Specifically, the mTBI group showed greater activation in the precentral gyrus, postcentral gyrus, inferior parietal lobe, insula, and superior temporal gyrus. Finally, the effect of PTSD symptoms during the enhance condition was associated with accentuated activation of the frontal and limbic regions implicated in both emotion regulation and PTSD. Hyperactivation of neural regions in the mTBI group during the enhance condition may reflect vigilance towards negative contextual stimuli and/or poor strategy that might result in suboptimal allocation of resources to regulate emotions.
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Affiliation(s)
- Michael N Dretsch
- a US Army Aeromedical Research Laboratory , Fort Rucker , Alabama , USA.,b Human Dimension Division , Headquarters Training and Doctrine Command , Fort Eustis , Virginia , USA
| | - Thomas A Daniel
- c Department of Psychology , Auburn University , Auburn , Alabama , USA
| | - Adam M Goodman
- c Department of Psychology , Auburn University , Auburn , Alabama , USA
| | - Jeffrey S Katz
- c Department of Psychology , Auburn University , Auburn , Alabama , USA.,d Auburn University MRI Research Center, Department of Electrical & Computer Engineering , Auburn University , Auburn , Alabama , USA.,e Alabama Advanced Imaging Consortium , Auburn University and University of Alabama , Birmingham , Alabama , USA
| | - Thomas Denney
- c Department of Psychology , Auburn University , Auburn , Alabama , USA.,d Auburn University MRI Research Center, Department of Electrical & Computer Engineering , Auburn University , Auburn , Alabama , USA.,e Alabama Advanced Imaging Consortium , Auburn University and University of Alabama , Birmingham , Alabama , USA
| | - Gopikrishna Deshpande
- c Department of Psychology , Auburn University , Auburn , Alabama , USA.,d Auburn University MRI Research Center, Department of Electrical & Computer Engineering , Auburn University , Auburn , Alabama , USA.,e Alabama Advanced Imaging Consortium , Auburn University and University of Alabama , Birmingham , Alabama , USA
| | - Jennifer L Robinson
- c Department of Psychology , Auburn University , Auburn , Alabama , USA.,d Auburn University MRI Research Center, Department of Electrical & Computer Engineering , Auburn University , Auburn , Alabama , USA.,e Alabama Advanced Imaging Consortium , Auburn University and University of Alabama , Birmingham , Alabama , USA
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27
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Terrell TR, Abramson R, Barth JT, Bennett E, Cantu RC, Sloane R, Laskowitz DT, Erlanger DM, McKeag D, Nichols G, Valentine V, Galloway L. Genetic polymorphisms associated with the risk of concussion in 1056 college athletes: a multicentre prospective cohort study. Br J Sports Med 2017; 52:192-198. [PMID: 28918391 DOI: 10.1136/bjsports-2016-097419] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2016] [Revised: 06/25/2017] [Accepted: 07/14/2017] [Indexed: 12/21/2022]
Abstract
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-6RAsp358Ala 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.
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Affiliation(s)
- Thomas Roland Terrell
- Department of Family Medicine, Primary Care Sports Medicine, University of Tennessee Graduate School of Medicine, Knoxville, Tennessee, USA.,Family Medicine and Sports Medicine Center, Covenant Medical Group, Knoxville, Tennessee, USA
| | - Ruth Abramson
- Department of Neuropsychiatry and Behavioral Sciences, University of South Carolina School of Medicine, Columbia, South Carolina, USA
| | - Jeffery T Barth
- Department of Psychiatry and Neurobehavioral Sciences, Brain Injury and Sports Concussion Institute, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Ellen Bennett
- Department of Neurology, Duke University Medical Center, Durham, North Carolina, USA
| | - Robert C Cantu
- Boston University School of Medicine, Boston, Massachusetts, USA.,Center for the Study of Chronic Traumatic Encephalopathy, Boston, Massachusetts, USA
| | - Richard Sloane
- Duke University Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, North Carolina, USA
| | - Daniel T Laskowitz
- Neurobiology and Anesthesiology, Duke University Hospital, Durham, NC, USA.,Neurology and Anesthesiology, Duke University Medical Center, Durham, North Carolina, USA
| | - David M Erlanger
- Rusk Institute of Rehabilitation Medicine, New York, USA.,University Langone Medical Center, New York, USA
| | - Douglas McKeag
- Department of Family Medicine, University of Oregon Health Science Center, Portland, Oregon, USA
| | - Gregory Nichols
- Oak Ridge Associated Universities, Oak Ridge, Tennessee, USA
| | - Verle Valentine
- Sanford Orthopaedics and Sports Medicine, Sanford Health Care, Sioux Falls, South Dakota, USA
| | - Leslie Galloway
- Department of Ecology and Evolutionary Biology, University of Tennessee, Knoxville, Tennessee, USA.,Environmental Sciences Division, Toxicology and Risk Analysis, Oak Ridge National Laboratory, Oak Ridge, Tennessee, USA
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28
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Mc Fie S, Abrahams S, Patricios J, Suter J, Posthumus M, September AV. The association between COMT rs4680 and 5-HTTLPR genotypes and concussion history in South African rugby union players. J Sports Sci 2017; 36:920-933. [DOI: 10.1080/02640414.2017.1346274] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Sarah Mc Fie
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Science, University of Cape Town, Cape Town, South Africa
| | - Shameemah Abrahams
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Science, University of Cape Town, Cape Town, South Africa
| | - Jon Patricios
- Morningside Sports Medicine Clinic, Johannesburg, South Africa
- Section of Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- Department of Emergency Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Jason Suter
- Sports Science and Exercise Medicine Clinic, Cape Town, South Africa
| | - Michael Posthumus
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Science, University of Cape Town, Cape Town, South Africa
| | - Alison V. September
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Science, University of Cape Town, Cape Town, South Africa
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29
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McCrea M, Meier T, Huber D, Ptito A, Bigler E, Debert CT, Manley G, Menon D, Chen JK, Wall R, Schneider KJ, McAllister T. Role of advanced neuroimaging, fluid biomarkers and genetic testing in the assessment of sport-related concussion: a systematic review. Br J Sports Med 2017; 51:919-929. [DOI: 10.1136/bjsports-2016-097447] [Citation(s) in RCA: 134] [Impact Index Per Article: 19.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2017] [Indexed: 01/17/2023]
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