Title : Genetic and cytokine influences on cognitive recovery following traumatic brain injury: A longitudinal study
Abstract:
Objectives: This study aimed to investigate the relationship between APOE genotype, cytokine levels, and cognitive outcomes in patients recovering from traumatic brain injury (TBI). The objectives were to assess the impact of APOE ε2 and ε4 variants on cytokine profiles and determine their association with cognitive recovery at multiple time points, up to one year following injury.
Methods: A diverse cohort of 20 TBI patients with moderate to severe injuries was longitudinally assessed over a two-year period. Genetic analysis determined APOE genotype, distinguishing between ε2, ε3, and ε4 variants. Cytokine profiles were assessed through enzyme-linked immunosorbent assays (ELISA) to measure multiple cytokines, including IL-6, TNF-alpha, IL-8, and IL-1b. Cognitive outcomes were evaluated using neuropsychological assessments, including the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and the Montreal Cognitive Assessment (MoCA).
Results: APOE genotype significantly influenced cytokine levels, with ε2 carriers demonstrating lower pro-inflammatory cytokine levels, including IL-6 and TNF-alpha, compared to ε4 carriers. ε4 carriers exhibited a more pronounced neuroinflammatory profile, potentially contributing to differential cognitive recovery patterns. Spearman's and Pearson's correlations unveiled complex associations between cytokine levels and cognitive domains. Pro-inflammatory cytokines, such as IL-8 and IL-1b, showed mixed correlations with cognitive outcomes, while anti-inflammatory cytokines like IL-10 displayed limited associations. Longitudinal analyses revealed dynamic relationships between cytokines and cognition, emphasizing the evolving nature of TBI recovery.
Conclusions: This study elucidates the intricate interplay between APOE genotype, cytokine profiles, and cognitive outcomes in TBI patients. APOE ε2 and ε4 variants were associated with distinct cytokine profiles, potentially contributing to differential cognitive trajectories. Pro-inflammatory cytokines demonstrated complex relationships with cognitive domains, suggesting that neuroinflammation plays a nuanced role in TBI recovery. These findings underscore the importance of considering genetic and cytokine factors in tailoring personalized rehabilitation strategies for TBI patients. Further research is warranted to delineate the mechanisms driving these relationships and to translate these insights into improved clinical interventions for TBI recovery.