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Background/aimTo evaluate the association of genetic polymorphisms APOE,APOEG-219T promoter, microtubule associated protein(MAPT)/tauexon 6 Ser53Pro, MAPT/tauHist47Tyr,IL-6572 G/C andIL-6RAsp358Alawith the risk of concussion in college athletes.MethodsA 23-centre prospective cohort study of 1056 college athletes with genotyping was completed between August 2003 and December 2012. All athletes completed baseline medical and concussion questionnaires, and post-concussion data were collected for athletes with a documented concussion.ResultsThe study cohort consisted of 1056 athletes of mean±SD age 19.7±1.5 years,89.3% male, 59.4% Caucasian, 35.0% African-American, 5.6% other race. The athletes participated in American football, soccer, basketball, softball, men’s wrestling and club rugby. A total of 133 (12.1% prevalence) concussions occurred during an average surveillance of 3 years per athlete. We observed a significant positive association betweenIL-6RCC (p=0.001) and a negative association betweenAPOE4 (p=0.03) and the risk of concussion. Unadjusted and adjusted logistic regression analysis showed a significant association betweenIL-6RCC and concussion (OR 3.48; 95% CI 1.58 to 7.65; p=0.002) and between the APOE4 allele and concussion (OR 0.61; 95% CI 0.38 to 0.96; p=0.04), which persisted after adjustment for confounders.ConclusionsIL-6RCC was associated with a three times greater concussion risk andAPOE4 with a 40% lower risk.

Objective To investigate associations of APOE and Tau gene polymorphisms with sports-related acute concussions and baseline to post-concussion neuropsychological test score changes. Design Multi-center prospective cohort study. Setting Scholarship athletes at 21 universities and 4 high schools Participants: 3218 athletes playing football (70%) or soccer (23%). Assessment of Risk Factors APOE , APOE G-219T promoter (APOEProm), Tau exon 6 Ser53Pro (TauSer), and Tau exon 6 Hist47Tyr (TauHis) genetic polymorphisms. Main Outcome Measurements (1) Acute concussions and (2) differences between baseline and 24–72 h post-concussion Headminder Neuropsychological Test Scores of Simple and Complex Reaction Time (SRT and CRT, respectively) and Processing Speed. Results There were a total of 131 athletes with incident concussions and genetic data and neuropsychological test scores. There were no statistically significant differences in frequencies of acute concussions according to genotypes by χ 2 test. By t-test, the mean baseline to post-concussion neuropsychological changes were statistically significantly greater for CRT and SRT in those with the TauSer ‘TT’ genotype and for CRT in those with the APOEProm ‘TT’ genotype, and borderline significantly greater in those with the TauSer ‘TT’ genotype (p=0.09). Conclusions The statistically significantly worse mean baseline to post-concussion neuropsychological test scores in those with the APOEProm and TauSer polymorphisms suggests a possible genetic influence on post-concussion neurocognitive recovery. These preliminary findings provide no evidence for associations of the four APOE and Tau gene polymorphisms investigated with acute concussions, although the small sample size and lack of control for confounders are limitations. Acknowledgements Grant funding was provided through the NOCSAE (National Operating Committee for Safety Athletic Equipment) and the American Medical Society for Sports Medicine (AMSSM) Foundations. The opinions expressed in this abstract are not those of NOCSAE or AMSSM. Competing interests None.