TY - JOUR
T1 - Multicenter cohort study on association of genotypes with prospective sports concussion
T2 - Methods, lessons learned, and recommendations
AU - Terrell, Thomas R.
AU - Bostick, Roberd
AU - Barth, Jeffrey
AU - Sloane, Richard
AU - Cantu, Robert C.
AU - Bennett, Ellen
AU - Galloway, Leslie
AU - Laskowitz, Daniel
AU - Erlanger, Dave
AU - Mckeag, Doug
AU - Valentine, Verle
AU - Nichols, Gregory
N1 - Publisher Copyright:
© 2014 Edizioni Minerva Medica.
PY - 2017/1/1
Y1 - 2017/1/1
N2 - BACKGROUND: Approximately 3.8 million sports related TBIs occur per year. Genetic variation may affect both TBI risk and post-TBI clinical outcome. Limited research has focused on genetic risk for concussion among athletes. We describe the design, methods, and baseline characteristics of this prospective cohort study designed to investigate a potential association between genetic polymorphisms of apolipoprotein E gene, APOE promoter G-219T, and Tau gene exon 6 polymorphisms (Ser53 Pro and Hist47Tyr) with: 1) the risk of prospective concussion; 2) concussion severity; and 3) postconcussion neurocognitive recovery. METHODS: The prospective cohort study included a final population of 2947 college, high school, and professional athletes. Baseline data collection included a concussion/medical history questionnaire, neuropsychological (NP) testing, and genetic sampling for the genetic polymorphisms. Data collection on new concussions experienced utilized post-concussion history/mental status form, Lovell post-concussion symptom score, Standardized Assessment of Concussion (SAC) and/or the Sports Concussion Assessment Tool (SCAT)-1/SCAT-2, and post-concussion NP testing. RESULTS: This paper is focused on discussing the important methodological considerations, organizational challenges and lessons learned in the completion of a multi-center prospective cohort study. A total of 3740 subjects enrolled, with a total of 335 concussions experienced. CONCLUSIONS: Of critical importance to the success of a study of this type is to successfully recruit committed institutions with qualified local study personnel, obtain "buy-in" from study sites, and cultivate strong working relationships with study sites. The use of approved incentives may improve study site recruitment, enhance retention, and enhance compliance with study protocols. Future publications will detail the specific findings of this study. Collaborative research is very likely needed given the nature of this study population.
AB - BACKGROUND: Approximately 3.8 million sports related TBIs occur per year. Genetic variation may affect both TBI risk and post-TBI clinical outcome. Limited research has focused on genetic risk for concussion among athletes. We describe the design, methods, and baseline characteristics of this prospective cohort study designed to investigate a potential association between genetic polymorphisms of apolipoprotein E gene, APOE promoter G-219T, and Tau gene exon 6 polymorphisms (Ser53 Pro and Hist47Tyr) with: 1) the risk of prospective concussion; 2) concussion severity; and 3) postconcussion neurocognitive recovery. METHODS: The prospective cohort study included a final population of 2947 college, high school, and professional athletes. Baseline data collection included a concussion/medical history questionnaire, neuropsychological (NP) testing, and genetic sampling for the genetic polymorphisms. Data collection on new concussions experienced utilized post-concussion history/mental status form, Lovell post-concussion symptom score, Standardized Assessment of Concussion (SAC) and/or the Sports Concussion Assessment Tool (SCAT)-1/SCAT-2, and post-concussion NP testing. RESULTS: This paper is focused on discussing the important methodological considerations, organizational challenges and lessons learned in the completion of a multi-center prospective cohort study. A total of 3740 subjects enrolled, with a total of 335 concussions experienced. CONCLUSIONS: Of critical importance to the success of a study of this type is to successfully recruit committed institutions with qualified local study personnel, obtain "buy-in" from study sites, and cultivate strong working relationships with study sites. The use of approved incentives may improve study site recruitment, enhance retention, and enhance compliance with study protocols. Future publications will detail the specific findings of this study. Collaborative research is very likely needed given the nature of this study population.
KW - Apolipoprotein E
KW - Brain concussion
KW - Brain injuries
KW - Football
KW - Neuropsychological tests
KW - Polymorphism, genetic
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U2 - 10.23736/S0022-4707.16.05092-1
DO - 10.23736/S0022-4707.16.05092-1
M3 - Article
C2 - 25242101
AN - SCOPUS:85013124627
SN - 0022-4707
VL - 57
SP - 77
EP - 89
JO - Journal of Sports Medicine and Physical Fitness
JF - Journal of Sports Medicine and Physical Fitness
IS - 1-2
ER -