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PubMed2003

Specific tissue Doppler predictors of preserved systolic and diastolic left ventricular function after an acute anterior myocardial infarction.

The degree of left ventricular (LV) dysfunction determines the outcome of patients suffering an acute anterior myocardial infarction (AAMI). Many recent studies have utilized tissue Doppler echocardiography (TDE) parameters in the assessment of LV function. We sought to investigate whether some variables easily obtained from TDE profiles of mitral annulus corners would predict a relatively preserved LV global function traditionally assessed with ejection fraction (EF) and deceleration time (DT), within the acute phase of AAMI. Included were 50 consecutive patients with a first AAMI. Standard echocardiography and TDE of mitral annulus were performed within 36 hours of admission. Pulsed wave sample volumes were set at the septal, lateral, anterior, and inferior corners of the mitral annulus. Preserved LV function was defined as an EF > 40% together with a DT > or = 140 ms and < 220 ms. An inferior annular systolic velocity of > 7.5 cm/s predicts preserved global left ventricular function with a sensitivity of 81% and specificity of 71%. An anterior mitral annular early diastolic velocity of > 8cm/s had a sensitivity of 69% and specificity of 85%. When these two velocities both exceed the limits above, such a combined index yielded a sensitivity of 69%, specificity of 94%, and an overall diagnostic accuracy of 86% for the estimation of preserved LV global function. The parameters derived from TDE profiles of inferior and anterior mitral annulus comers provide valuable information to predict preserved global left ventricular function during the early period of AAMI.

Adult↗

PubMed2001

What becomes of children hospitalized for enuresis? Results of a catch-up study.

BACKGROUND: . The purpose of this study was to reassess former child and adolescent psychiatric patients with nocturnal enuresis as young adults and to compare them with former patients without enuretic symptoms and with a comparison group from the general population. METHOD: We used a 'catch-up' design. From a former child and adolescent psychiatric patient cohort we identified all subjects with documented enuretic symptoms in childhood and compared them with two groups matched for gender and age - non-enuretic patients and a comparison group from the general population. Subjects were assessed as adults with standardized instruments according to the criteria of ICD-10 (SCAN, IPDE) and dimensional values for depression, satisfaction with life, global functioning and personality (NEO-FFI). RESULTS: We assessed 55 former patients with nocturnal enuresis (recruitment rate 68%) after a mean interval of 13.1 years. At catch-up the former enuretic patients had a lower frequency of personality disorders (ICD-10), lower mean depression values, higher global functioning and a lower rate of psychiatric treatment after the age of 18 years than did former non-enuretic patients. Former enuretic patients did not differ significantly from the comparison group from the general population concerning any of the outcome variables, although there was a non-significant trend for former enuretic patients to more often fulfill criteria for a psychiatric ICD-10 diagnosis at catch-up. There were no differences concerning personality among the three groups at catch-up. CONCLUSION: Although it may constitute a mild vulnerability factor for further development, nocturnal enuresis had a good long-term outcome in a cohort of treated subjects.

Adolescent↗

PubMed2002

Relevant clinical outcomes in probable vascular dementia and Alzheimer's disease with cerebrovascular disease.

Two important prerequisites for assessing therapeutic benefits in patients with vascular dementia (VaD), or Alzheimer's disease (AD) with cerebrovascular disease (CVD), are the inclusion of appropriate patients and the use of relevant outcome measures. There is substantial overlap in the clinical symptomatology, risk factors, imaging changes, pathophysiology and neurochemical mechanisms between VaD, AD and AD with CVD. While validated and acceptable clinical criteria suitable for clinical trials have been developed for VaD, there is still debate as to how mixed cases (i.e. AD with CVD) are best conceptualized. As with AD, there is consensus that outcome measures in studies of patients with VaD, or AD with CVD, should include assessments of cognitive and global function, of ability to perform activities of daily living (ADL) and of behavioral symptoms. Other measures, e.g., caregiver burden, would be desirable. Care must be taken in extrapolating AD-specific evaluations to VaD, however, because different specific domains are affected and the disease course is different. In clinical trials, cognitive performance and global function decline steadily in patients with untreated AD compared with smaller changes in patients with untreated VaD, while behavior and ADL deteriorate over 6 months in patients with either untreated AD or untreated VaD. Such differences in untreated outcome need to be considered when interpreting trial results using outcome measures that were largely designed for studies of patients with AD.

Alzheimer Disease↗

PubMed2002

The relationship between self-reported and clinical measures and the number of days to return to sport following acute lateral ankle sprains.

STUDY DESIGN: This is a prospective observational study. OBJECTIVE: To determine the relationship of self-reported and clinical measures to the number of days to return to sport following acute lateral ankle sprains. BACKGROUND: In order to direct rehabilitation, injury classification schemes should include self-reported and clinical measures that help prognosticate the number of days to return to sport (DAYS). METHODS AND MEASURES: Twenty Division II college athletes (7 men, 13 women; mean age = 19.2 +/- 1.1 years) were assessed following an acute lateral ankle sprain and upon return to sport. Athletes were assessed by three self-reported measures: global function question, Short Form-36 Physical Function scale (SF36PF), visual analog pain scale, and four clinical measures: ankle active range of motion (AROM), ankle dorsiflexion strength, ankle plantar flexion strength, ambulation status. Simple regression, multiple regression, and effect sizes (ES) were used to analyze these data. RESULTS: The simple regression revealed a statistically significant relationship between DAYS and the global function question (r2 = .22), the SF36PF (r2 = .28), and the patient's ambulation status (r2 = .27). A multiple regression using these three variables in combination was also statistically significant (P = .015) and explained approximately one-third of the variance in DAYS, (r2 = .37). All dependent variables revealed large or moderate ES. CONCLUSION: Self-reported functional measures in conjunction with the athlete's ambulation status are important factors in predicting the number of days to return to sport following acute lateral ankle sprains. Further research using large sample sizes and other clinical and functional measures is necessary.

Acute Disease↗

PubMed2001

[Psychotherapeutic testimony be refugees from Bosnia-Herzegovina: a pilot study].

GOAL: The authors wished to describe the need of the psychotherapy by the witnessing in the group of the adult refugees who have survived the genocide in B&H. METHODOLOGY: The subjects of the study were 20 refugees from B&H with the residence in Chicago, which gave the written assent for participation in the study of the psychotherapy by witnessing. All the participants were this method, what in the average were 6 sessions, the approximative duration 90 minutes, once a week or once in two weeks. The participants were tested by the application of the standardized instruments for PTSP, depression, traumatic events, the global functioning and the previous therapy, after the last seance and after 2 and 6 months. RESULT: The estimations done after the therapy showed significantly the decrease in the percentage of the diagnoses of PTSP (repeated living, escaping, increase arousing attention). The symptom of the depression have also significantly lower, and the estimation of the global functioning was significantly higher. To the testing after 2 and 6 months showed that the further significant decreasing of the symptoms and the significant increase of the functioning. CONCLUSION: This pilot study offers the preliminary proves that psychotherapy by the witnessing of the symptoms of PTSP and also the depression as well as to the improvement of the functioning in the survived political and war violence.

Adult↗

PubMedDate not supplied

[Inpatient treated, mono-symptomatic childhood enuresis--results of follow-up in adulthood].

32 formerly monosyndromatic enuretic patients who had been treated for this condition between 1980 and 1992 were compared with a matched control group from the general population in respect of sociobiography, psychopathological and dimensional factors (depressiveness, satisfaction with life, global functioning). Most of the former patients did not fulfil diagnostic criteria for an ICD-10 diagnosis at follow-up, although there was a 37% vs. 9% difference between former patients and controls in this respect--without a clear diagnostic pattern of such disorders. Furthermore, former patients had slightly higher depression scores and slightly lower global functioning than controls at follow-up. These results confirm that childhood enuresis has a low negative predictive value concerning the development of psychiatric disorders, although it may constitute a vulnerability factor.

Adolescent↗

PubMed2005

Dementia with cerebrovascular disease: the benefits of early treatment.

Patients with vascular dementia (VaD) and Alzheimer's disease with cerebrovascular disease (AD + CVD) have dementia associated with underlying CVD. Although diagnosis of VaD is challenging, VaD is typically characterized by a stepwise progression of dementia that is closely associated with stroke and focal neurological findings, and a symptom profile that often includes executive dysfunction leading to decreased ability to perform instrumental activities of daily living (IADL). In contrast, AD + CVD patients typically present with progressive deterioration of cognition/memory that may also be influenced by concurrent cerebrovascular events. Early diagnosis and intervention are desirable to prevent further decline due to subsequent vascular events. Management of CVD can limit deterioration of cognitive symptoms in VaD patients, and treatment benefits with cholinesterase inhibitors may be realized as improvement above baseline levels in dementia symptoms. Results from a combined analysis of two 24-week, placebo-controlled clinical trials show that donepezil-treated VaD patients improve in cognition, global function, and performance of IADL. In contrast, AD + CVD patients may continue to decline despite management of CVD, and treatment benefits should be recognized as initial improvements followed by stabilization or slowed decline of dementia symptoms over time. In post-marketing studies, donepezil-treated AD and AD + CVD patients show similar benefits in cognition, global function, and quality of life. The results of these studies support the use of donepezil in treatment of patients with VaD or AD + CVD.

Cerebrovascular Disorders↗

PubMedDate not supplied

Efficacy of brief dynamic psychotherapy for children with emotional disorders.

BACKGROUND: Child psychiatry has enjoyed a long tradition of using brief psychotherapy with children, but research on its efficacy and effectiveness in the setting of routine clinical care is remarkably sparse; the aim of this study was to evaluate the efficacy of an original model of brief psychodynamic psychotherapy (BPP) for children with emotional disorders in a clinical outpatient setting. METHODS: A sample of 30 subjects (6.3-10.9 years old) was divided into an experimental BPP group and a control group. Each subject was evaluated at the beginning, after 6 months and at an 18-months follow-up. Outcome measures were Children's Global Assessment Scale and Child Behavior Check-List. Statistical and clinical significance of change were evaluated. RESULTS: At the first evaluation, the experimental group showed a better improvement in global functioning; at follow-up, the two groups improved to a comparable degree, but only the mean of the experimental group moved to a functional range. The experimental group showed a significant reduction in total behavioral problems and externalizing problems at the follow-up. CONCLUSIONS: The better improvement of the experimental group in two outcome measures suggests that BPP is efficient in emotional disorders. The hypothesis that BPP introduces changes at long term (sleeper effects) is suggested. The improvement in global functioning of the two groups is discussed in relation to specific characteristics of emotional disorders. Finally, limitations of the study are discussed and in particular the bias introduced by lack of randomization.

Affective Symptoms↗

PubMed2004

Pulmonary rehabilitation improves functional capacity in patients 80 years of age or older.

OBJECTIVES: There is limited evidence that pulmonary rehabilitation improves exercise capacity in older patients with chronic respiratory disease. The objective of the present study was to determine whether patients 80 years of age or older gain similar benefits from pulmonary rehabilitation as do younger patients. DESIGN: Outcomes were compared in 230 consecutive inpatients with moderate to severe lung disease who participated in a comprehensive pulmonary rehabilitation program during a one-year period. Outcomes included 6 min walk test distance (6MWT), the number of stairs completed in 2 min (2MST), Borg dyspnea scores after exertion and objective functional scores. RESULTS: There were no differences between older (80 to 91 years, n=43) and younger patients (n=187) with respect to sex, forced expiratory volume in 1 s (mean 0.77 L versus 0.72 L) or number of chronic medical diagnoses (2.4 versus 2.7). Older patients were less frequently survivors of mechanical ventilation (2.3% versus 16%). Baseline 6MWT (133 m versus 144 m; P=0.48) and 2MST (5.2 laps versus 6.5 laps; P=0.067) were similar but global function was lower (85 versus 89; P=0.040) in older patients than in younger patients, respectively. After pulmonary rehabilitation, all outcomes improved significantly regardless of age (all before-after comparisons P<0.0001). Younger patients improved with a higher discharge 6MWT (231 m versus 185 m; P=0.004) and similar discharge 2MST (9.3 laps versus 7.9 laps; P=0.070) compared with older patients. Global function at discharge remained lower in older patients than younger patients (91 versus 94; P=0.002). The duration of rehabilitation and length of stay were similar between the two groups. CONCLUSION: A comprehensive inpatient pulmonary rehabilitation program is beneficial in selected patients 80 years of age or older.

Aged↗

PubMed2005

Intermittent explosive disorder-integrated research diagnostic criteria: convergent and discriminant validity.

Research on intermittent explosive disorder (IED) has been hindered by vague and restrictive DSM-IV diagnostic criteria. Integrated research criteria have been developed for IED (IED-IR) that address the DSM-IV criteria's shortcomings. The purpose of this study was to examine the convergent and discriminant validity of the IED-IR criteria set by comparing adults meeting these criteria (n=56) to healthy controls (n=56) and to individuals with an Axis I major mental disorder (n=33) or an Axis II personality disorder (n=22) diagnoses on measures of aggression (self-report and behavioral) and global functioning. IED-IR individuals demonstrated higher levels of aggression compared to the other three groups, and were rated as more impaired than the healthy control and Axis I individuals. Subgroup analyses showed that IED-IR subjects who did not meet DSM IED criteria did not differ from DSM IED subjects on self-report measures of aggressiveness or global functioning. Furthermore, the IED-IR subjects evidenced more behavioral aggression than their DSM-IED counterparts.

Adolescent↗

PubMedDate not supplied

Benefits of adjunct modafinil in an open-label, pilot study in patients with schizophrenia.

Patients with schizophrenia experience cognitive impairments associated with hypofunctioning of the frontal cortex. Modafinil, a novel wake-promoting agent, works through the sleep-wake centers of the brain to activate the cortex. This 4-week, open-label, pilot study evaluated adjunct modafinil in patients with schizophrenia or schizoaffective disorder. Eleven patients received once-daily oral doses of modafinil (100 mg/day, days 1-14; 100 or 200 mg/day, days 15-28) in addition to antipsychotic therapy. Modafinil significantly improved patients' global functioning as assessed by a blinded clinician (week 2, P = 0.026; week 4, P = 0.012) and the investigator (week 3, P = 0.035). Modafinil significantly improved overall clinical condition, with 64% and 82% of patients rated as clinically improved at week 4 by a blinded clinician and the investigator respectively. Eighty-nine percent of patients considered themselves to be clinically improved. Modafinil significantly improved fatigue (P = 0.025, week 3) and tended to improve cognitive functioning scores. Control of positive symptoms was well maintained. Treatment-emergent adverse events included dry mouth (n = 2) and hallucinations (n = 2). One patient discontinued the study because of hallucinations that were considered to be possibly related to inadequate antipsychotic therapy. Although preliminary, these results suggest modafinil may be an effective and well-tolerated adjunct treatment that improves global functioning and clinical condition, and reduces fatigue in patients with schizophrenia or schizoaffective disorder. Additional controlled studies are warranted.

Adult↗

PubMed2002

Group and individual cognitive-behavioral therapy for childhood anxiety disorders: a randomized trial.

OBJECTIVE: To compare the efficacy of group and individual cognitive-behavioral therapy (CBT) in children with Axis I anxiety disorders. It was hypothesized that certain subgroups would respond preferentially to one modality. METHOD: Seventy-eight children aged 8-12 years with diagnosed anxiety disorders were randomly assigned to a 12-week, manual-based program of group or individual CBT, both with parental involvement. Outcomes included child anxiety (child and parent report) and global functioning as estimated by clinicians. Repeated-measures analyses of variance (ANOVAs) were done. The sample was then dichotomized by self-reported social anxiety (high/low) and parent-reported hyperactivity (high/low) using median splits, and diagnostically by generalized anxiety disorder versus phobic disorders. ANOVAs were repeated. RESULTS: Children and parents reported significantly decreased anxiety and clinicians reported significantly improved global functioning regardless of treatment modality. Children reporting high social anxiety reported greater gains in individual treatment than in group treatment (p <.01). Parent reports of hyperactivity and diagnostic differences were not associated with differential treatment response by modality. CONCLUSIONS: Children with anxiety disorders appear to improve with CBT, whether administered in a group or individual format. A subgroup of children reporting high social anxiety may respond preferentially to individual treatment. Replication of these findings is indicated.

Anxiety Disorders↗

PubMed2000

Approach towards an integrative drug treatment of Alzheimer's disease.

At present pharmacotherapy of Alzheimer's disease (AD) is limited to acetylcholinesterase inhibitors. These drugs produce small, but consistent improvements of memory and global function, some are also positively influencing activities of daily living. This therapeutic approach neglects the complexity of AD and the fact that most of the degenerating neurons are not cholinergic. Acetylcholinesterase inhibitors are symptomatic drugs, with no influence on disease progression. There is a need for disease modifying compounds, or preventive drugs. Data are indicating that vitamin E has some ability to influence the disease progression. The potency of non-steroidal anti-inflammatory drugs (NSAIDs) or estrogen as preventive agents has to be explored further in prospective clinical studies. The initial hope in the use of naturally occurring neurotrophic factors, like nerve growth factor, to rescue cholinergic neurons from degeneration and to restore cognitive function has been disappointed in first, small clinical studies. The peptidergic drug Cerebrolysin exhibiting neurotrophic stimulation, neuroimmunotrophic regulation and induction of BBB glucose transporter expression, might be able to address the pathological changes of AD at different levels simultaneously. In addition to an impressive preclinical database, results from 3 placebo-controlled, double-blind studies demonstrate significant improvements of cognitive performance, global function and activities of daily living in AD patients. In all studies persisting improvements, up to 6 months after drug withdrawal, indicate a powerful disease modifying activity.

Alzheimer Disease↗

PubMedDate not supplied

Predictors of 1-year treatment outcome in bulimia nervosa.

We examined predictors of outcome 1 year after completion of a randomized clinical trial assessing the additive efficacy of two forms of exposure with response prevention to a core of cognitive-behavioral therapy (CBT) for bulimia nervosa (BN). One hundred one women who met DSM-III-R criteria for BN, and who completed the clinical trial, were available for follow-up at 1 year. Predictor variables were assessed prospectively and partitioned temporally to reflect lifetime history (including personality), pretreatment clinical status, and posttreatment clinical status. Outcome was based on the frequency of binging and purging in the 3 months before assessment based on carefully constructed lifechart interviews. A series of stepwise logistic regressions were performed to determine independent predictors of 1-year outcome while controlling for treatment received. Demographic variables were unrelated to treatment outcome. A history of obesity was predictive of poor outcome, whereas a history of alcohol dependence decreased the odds of poor outcome. High self-directedness on the Temperament and Character Inventory (TCI) predicted favorable outcome at 1 year, whereas personality disorder symptoms were not predictive. Pretreatment global functioning, bulimia scores on the Eating Disorders Inventory (EDI), and the presence of major depression predicted poor outcome. Posttreatment binging, food restriction, and urges to binge on a cue reactivity assessment predicted poor outcome at 1 year. The character trait of self-directedness is a strong predictor of good outcome for CBT, and methods to enhance this trait may be worthy of investigation. Low global functioning and the presence of major depression at presentation may require additional treatment than focused CBT for BN. Our results argue for treatment goals that include abstinence from binging and restricting and decreases in urges to binge in response to high-risk cues.

Adolescent↗

PubMedDate not supplied

Effects of galantamine versus donepezil on sleep in patients with mild to moderate Alzheimer disease and their caregivers: a double-blind, head-to-head, randomized pilot study.

OBJECTIVE: To examine the effects of galantamine and donepezil on patient and caregiver sleep. METHODS: In this randomized, 8-week, double-blind, parallel-group, multicenter, pilot comparison of galantamine and donepezil, safety and efficacy data were collected. Objective and subjective changes in sleep of patients (N = 63) and their caregivers were measured. Clinicians assessed changes in patient global function. As this was a pilot study, only descriptive statistics are presented. RESULTS: In general, neither galantamine nor donepezil, at stable doses, were associated with decrements in actigraphy sleep measurements. However, mean scores in all measures of sleep showed a tendency for minimal improvements in galantamine-treated patients and minimal decrements in the donepezil-treated patients. The same tendencies were present in caregiver sleep measures. Global function either improved or remained stable in a higher percentage of patients treated with galantamine than with donepezil. Galantamine and donepezil were both well tolerated and safe. CONCLUSIONS: This pilot study was the first to compare the effects of these drugs on sleep in patients or caregivers. Both drugs were safe and well tolerated. Neither galantamine nor donepezil negatively affected sleep; however, on every measure, there were suggestions of slightly more benefit associated with galantamine treatment. Although these results are suggestive of a differential effect of the drugs on sleep, further research is needed to confirm the clinical significance.

Adult↗

PubMed2002

Bacillus subtilis functional genomics: global characterization of the stringent response by proteome and transcriptome analysis.

The stringent response in Bacillus subtilis was characterized by using proteome and transcriptome approaches. Comparison of protein synthesis patterns of wild-type and relA mutant cells cultivated under conditions which provoke the stringent response revealed significant differences. According to their altered synthesis patterns in response to DL-norvaline, proteins were assigned to four distinct classes: (i) negative stringent control, i.e., strongly decreased protein synthesis in the wild type but not in the relA mutant (e.g., r-proteins); (ii) positive stringent control, i.e., induction of protein synthesis in the wild type only (e.g., YvyD and LeuD); (iii) proteins that were induced independently of RelA (e.g., YjcI); and (iv) proteins downregulated independently of RelA (e.g., glycolytic enzymes). Transcriptome studies based on DNA macroarray techniques were used to complement the proteome data, resulting in comparable induction and repression patterns of almost all corresponding genes. However, a comparison of both approaches revealed that only a subset of RelA-dependent genes or proteins was detectable by proteomics, demonstrating that the transcriptome approach allows a more comprehensive global gene expression profile analysis. The present study presents the first comprehensive description of the stringent response of a bacterial species and an almost complete map of protein-encoding genes affected by (p)ppGpp. The negative stringent control concerns reactions typical of growth and reproduction (ribosome synthesis, DNA synthesis, cell wall synthesis, etc.). Negatively controlled unknown y-genes may also code for proteins with a specific function during growth and reproduction (e.g., YlaG). On the other hand, many genes are induced in a RelA-dependent manner, including genes coding for already-known and as-yet-unknown proteins. A passive model is preferred to explain this positive control relying on the redistribution of the RNA polymerase under the influence of (p)ppGpp.

Bacillus subtilis↗

PubMed1997

Baseline quality of life of patients with advanced prostate cancer. European Organization for Research and Treatment of Cancer (EORTC), Genito-Urinary Tract Cancer Cooperative Group (GUT-CCG)

Quality of life (QoL) is now commonly studied in prostate cancer. However, little is known about the appropriateness of the various QoL instruments in this group of patients. The purpose of this work was to study the baseline QoL assessment of patients with prostate cancer who were randomised into three EORTC phase III studies. The three trials included locoregional prostate cancer patients, poor prognosis metastatic patients and hormone resistance patients, respectively. In the three trials, patients were asked to complete a questionnaire assessing their physical and psychosocial functioning and their symptom levels. These questionnaires included questions from the EORTC QLQ-C30 (version 1): the physical functioning, role functioning, global health/QoL scales and a single pain item. The psychometric properties of the scales were assessed and an analysis was performed to investigate if differences existed in the scale scores between the three groups of patients, 638 baseline questionnaires were available for patients entered into the three trials. The Gutman coefficients of reproducibility and scalability were 0.94 and 0.71, respectively, for the physical functioning scale and 0.97 and 0.90, respectively, for the role functioning scale. The Cronbach's alpha reliability coefficients were 0.68, 0.48 and 0.90 for the physical functioning, role functioning and global health/QoL scales, respectively. The four scales were able to distinguish clearly between the patient populations under study. The physical functioning, role functioning, global health/QoL scales and the single pain item scale from the EORTC QLQ-C30 (version 1) are valid measures when used in the setting of prostate cancer.

Activities of Daily Living↗

PubMed2004

Six-month recovery from mild to moderate Traumatic Brain Injury: the role of APOE-epsilon4 allele.

The possession of at least one APOE-epsilon4 allele may be linked to poor outcome in patients with predominantly severe traumatic brain injury (TBI). In mild TBI, which accounts for approximately 85% of all cases, the role of the APOE-epsilon4 allele is less clear. Studies completed to date have relied on brief cognitive assessments or coarse measures of global functioning, thereby limiting their conclusions. Our study investigated the influence of the APOE-epsilon4 allele in a prospective sample of 90 adults with mild to moderate TBI in whom neuropsychiatric outcome 6 months after injury was assessed as follows: (i) a detailed neuropsychological battery; (ii) an index of emotional distress (General Health Questionnaire); (iii) a diagnosis of major depression (Structured Clinical Interview for DSM-IV); (iv) a measure of global functioning (Glasgow Outcome Scale); (v) an index of psychosocial outcome (Rivermead Head Injury Follow-up Questionnaire); and (vi) symptoms of persistent post-concussion disorder (Rivermead Post-Concussion Symptoms Questionnaire). No association was found between the presence of the APOE-epsilon4 allele and poor outcome across all measures. Given the homogeneous nature of our sample (mild to moderate injury severity), the uniform follow-up period (6 months) and the comprehensive markers of recovery used, our data suggest that the APOE-epsilon4 allele does not adversely impact outcome in this group of TBI patients.

Adult↗