PSU Researchers Make Connection Between Genes and Post-concussion Recovery

In the modern era of sports a large focus has been placed on concussions and concussion related encephalopathy.  At the forefront of this focus is the NFL and their increasing protocols to protect players.  So why is it that some players are able to return to practice days after a concussion and others may take several weeks before cleared to play?

Researchers at PSU are attempting to answer that very question with ongoing research of the role genes play in recovering from concussions. Peter Arnett, professor of psychology and director of clinical training at Penn State, and a team of researchers are examining the effect of the apolipoprotein E (APOE) gene influencing post concussion symptoms. According to Arnett, their are three different alleles for the APOE gene, their research focused on the effect of the e4 allele and how it influences concussion symptoms. The researchers at PSU collected buccal swabs from 42 athletes with concussions, as diagnosed by their team physician, for DNA analysis. Arnett and his team compared concussed athletes with the e4 allele against other concussed athletes and found that the athletes with the e4 allele scored higher on a post concussion symptom scale (PCCS). The PCCS is a scale through the imPACT computer program. This program surveys concussion symptoms to determine their severity. Athletes with the e4 allele reported greater physical and cognitive impairment following a concussion. According to Arnett this is the first study to attempt to examine the relationship between the e4 allele and post concussion symptoms.

This research adds to the growing amount of information on concussions and the effects that they have on the brain. This is the first study of its kind that examines specific alleles and how those alleles can influence the symptoms of concussions. This information could be used beyond understanding concussions in sports and be applied to soldiers who experience traumatic brain injuries from blast injuries.

Gene Found to Increase Risk of Mental Decline after Heart Surgery

In a recent research study presented on USNews.com, a gene has been discovered to increase the possibility of experiencing mental decline after heart surgery.  It has been calculated that between 30-50% of people who had heart surgery showed a decrease in mental health after the surgery.  The reason for this decline in mental function hasn’t been known until now.  It has been thought that it was a side effect of the surgery and anesthesia or a neurological disorder the patients had prior to the surgery.  The gene responsible for the decrease in mental function after heart surgery is the APOE4 gene.  The APOE4 gene stands for apolipoprotein E4 and this gene is involved with cholesterol metabolism and inflammation.  Also, the APOE4 gene has been linked to an increased risk of developing Alzheimer’s.  The scientists made this discovery after assessing the mental capabilities of 233 elderly, white patients before heart surgery and 5 years later after the surgery.  The results of the study concluded that those elderly with the APOE4 gene had long-term memory loss, attention problems, and difficulty understanding spoken or written words five years after having heart surgery.  Dr. Karsten Bartels, who was involved with the study, summarized the findings by stating “Our findings suggest that the long-term cognitive decline previously seen after surgery is related more to the patient’s genetic makeup than to the surgery itself.”  He even went on to say that if doctors know patients have the APOE4 gene, they can make the necessary precautions to protect the patient’s brain after surgery as well as helping their patients make better-informed decisions knowing the risk of having decreased mental function after heart surgery.  The findings of this study were recently presented at the annual meeting of the American Society of Anesthesiologists in San Francisco and have not yet been published in a peer-reviewed medical journal.  

            I thought that this article was extremely interesting and very important.  I had no clue that a gene could increase the risk of developing a decrease in mental function after heart surgery.  If anything, I would think that the surgery itself or the anesthesia would have been the cause of the mental decline in patients.  The importance of this discovery is that doctors can now first find out if their patients possess the APOE4 gene and then can assess the patient’s risk of developing cognitive problems after surgery.  Also, doctors can help patients make better-informed decisions regarding surgery and possibly seek alternative surgeries or treatments that can avoid the chance of developing cognitive problems later on.  Plus, this study finding can help doctors develop strategies or methods to protect their patient’s brain after surgery especially if heart surgery is the option a patient has.  One question that came to mind while reading this article was how are people of different races affected after heart surgery if they do possess the APOE4 gene?  The article stated that the study was conducted on 233 elderly, white patients, but do people of other races experience mental decline after heart surgery as well?