APOE genotype and concussion in varsity athletes: Can genetics predict brain injury
Bibliographic record
Abstract
Concussion is a common sport-related injury and it is hypothesized that an epsilon-4 allele in the apolipoprotein E gene (APOE egr;4) may increase concussion susceptibility. Understanding the association between APOE egr;4 and concussion may be useful for targeting prevention strategies to APOE egr;4 carriers. The association between the presence of an APOE egr;4 allele in the APOE genotype and the incidence of concussion was studied in a prospective cohort study conducted from September 2002 to April 2006. Participants included University of Toronto varsity athletes participating in sports deemed high risk for concussion. Full informed consent was volunteered from 318 athletes with no concussion in the two years prior. Collected blood samples were genotyped and the presence of APOE egr;4 was described dichotomously. There was no loss to follow-up. Full informed consent involved agreement not to receive individual genetic results. A framework was developed using ethical principles to assist in the decision not to disclose individual genetic information to participants. The main outcome measure in the cohort study was time-to-concussion. It was measured two ways: athletic-exposures (number of games and practices) and number of games played. Only the first concussion sustained by an individual was included in the analysis. Sport-medicine professionals present on the sidelines identified the concussions. To assess misclassification, athletes self-reported if they incurred a concussion missed by the sport-medicine professional. The unadjusted hazard for concussion was 18% greater in APOE egr;4 carriers than in those without the APOE egr;4 allele (Hazard ratio (HR): 1.18 (95% confidence interval (CI): 0.52, 2.69)). Adjustment for sex, weight, height, and team type resulted in a HR of 1.06 (95% CI: 0.41, 2.72) indicating little effect from confounding factors. The HR including the self-reported concussions was 0.96 (95% CI: 0.50, 1.85) for the unadjusted HR and 0.81 (95% CI: 0.38, 1.73) for the adjusted HR. The number of games exposure measure produced similar results. In conclusion, no evidence for an association between the presence of an APOE egr;4 allele in the APOE genotype and the incidence of concussion was found. At this time, we do not recommend pre-season genetic testing for varsity athletes as a mechanism for targeting prevention strategies.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".