Genetic differences in response to brain injury may reasonably be expected to play a role in
the initial consequences of traumatic brain injury and in the rate of recovery from such
Polymorphisms in the Apolipoprotein E gene encode functional variants which differentially
determine the rate at which neuronal repair can occur, and are associated with differences
in expression of neurodegenerative processes, including traumatic brain injury. It is
proposed that the accuracy of prediction of outcome after head injury will be significantly
increased by inclusion of APOE genotype alone, or in combination with other variables such
as severity of head injury, cognitive, electroencephalographic or neuroradiologic measures,
or treatment strategies.
Patients enrolled in the DVHIP are subject to the following recruitment criteria:
1. Mild, moderate or severe closed head injury, where the cut off between mild and
moderate is defined by GCS<12. PTA>24 hrs or - foca cerebral contusion on CT/MRI or
Loss of Consciousness (LOC) > 12 hours.
Note: the definition of mild, moderate or severe head injury differs widely between
centers and is absolutely not critical for the work proposed as we will use
continuous measures of severity throughout.
2. Within three months of first assessment. (In practice, patients may be recruited
after 3 months. We will deal with this issue by covarying the time from injury to
first assessment in our analyses).
3. Rancho Los Amigos cognitive level of 5-7 at first assessment.
4. Volunteer informed consent signed by patient of family.
5. Military or veterans health care beneficiary.
6. Age 17-55
1. Unwillingness to participate in rehabilitation program or cooperate with
2. History of prior severe traumatic brain injury of other severe neurologic or
psychiatric condition, such as psychosis, stroke, multiple sclerosis, or spinal cord