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. 2016 Jan;78(1):68-78.
doi: 10.1097/PSY.0000000000000253.

Association of Epidemiologic Factors and Genetic Variants Influencing Hypothalamic-Pituitary-Adrenocortical Axis Function With Postconcussive Symptoms After Minor Motor Vehicle Collision

Lauriane Auvergne  1 , Andrey V Bortsov, Jacob C Ulirsch, David A Peak, Jeffrey S Jones, Robert A Swor, Robert M Domeier, David C Lee, Niels K Rathlev, Phyllis L Hendry, Samuel A McLean
Affiliations

Association of Epidemiologic Factors and Genetic Variants Influencing Hypothalamic-Pituitary-Adrenocortical Axis Function With Postconcussive Symptoms After Minor Motor Vehicle Collision

Lauriane Auvergne et al. Psychosom Med. 2016 Jan.

Abstract

Objectives: To determine the influence of epidemiologic factors and the influence of genetic variants affecting FKBP5, a protein known to modulate hypothalamic-pituitary-adrenocortical axis function, on the severity of somatic symptoms commonly termed "postconcussive" 6 and 12 months after motor vehicle collision (MVC).

Methods: European Americans 18 to 65 years of age who presented to one of eight emergency departments (EDs) after MVC were enrolled. Exclusion criteria included hospital admission. Blood samples were collected in the ED for genotyping. Participants completed evaluations including an adapted Rivermead Post-Concussive Symptoms Questionnaire in the ED and at 6 weeks, 6 months, and 1 year. Repeated-measures analysis of covariance was used to evaluate the association between epidemiologic factors (sociodemographic, pre-MVC health, collision characteristics, head injury, peritraumatic pain, and stress), FKBP5 genetic variants, and postconcussive symptom severity.

Results: Among 943 patients recruited in the ED, follow-up was completed on 835 (88%) at 6 months and 857 (90%) at 1 year. Self-reported head impact during collision was not associated with chronic postconcussive symptom severity. After correction for multiple testing, three FKBP5 single-nucleotide polymorphisms (rs3800373, rs7753746, and rs9380526) predicted chronic postconcussive symptom severity, with an average symptom severity of 1.10 (95% confidence interval = 0.96-1.24), 1.36 (1.21-1.51), and 1.55 (1.23-1.88) for one, two, or three copies of minor allele at rs3800373 (p = .001). Similar effect sizes were observed for the minor alleles of rs7753746 and rs9380526.

Conclusions: Postconcussive symptoms after minor MVC are not generally related to the severity of mild brain injury. This study shows that neurobiologic stress systems may play a role in the pathogenesis of postconcussive symptoms.

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Conflict of interest statement

The authors of this manuscript have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1. Progression of Average PC Symptom Severity over Time
Progression of twelve PC symptoms depicted over time (pre-MVC, shortly after MVC, at six weeks, six months, and one year post-MVC). Dashed line represents the absence of data at the ED timepoint for insomnia. ED=emergency department, MVC=motor vehicle collision, PC=post-concussive
See this image and copyright information in PMC

References

    1. Bazarian JJ, McClung J, Shah MN, Ting Cheng Y, Flesher W, Kraus J. Mild traumatic brain injury in the United States, 1998–2000. Brain Injury. 2005;19:85–91. - PubMed
    1. McAllister TW. Mild Brain Injury. In: Silver JM, McAllister TW, Yudofsky SC, editors. Textbook of Traumatic Brain Injury. 2nd ed. Arlington, VA: American Psychiatric Publishing, Inc.; 2011.
    1. Carroll LJ, Cassidy JD, Peloso PM, Borg J, von Holst H, Holm L, Paniak C, Pepin M. Prognosis for mild traumatic brain injury: Results of the WHO Collaborating Centre Task Force on Mild Traumatic Brain Injury. J Rehabil Med. 2004:84–105. - PubMed
    1. Reuben A, Sampson P, Harris AR, Williams H, Yates P. Postconcussion syndrome (PCS) in the emergency department: predicting and pre-empting persistent symptoms following a mild traumatic brain injury. EMJ. 2013 - PubMed
    1. Cassidy JD, Cancelliere C, Carroll LJ, Cote P, Hincapie CA, Holm LW, Hartvigsen J, Donovan J, Nygren-de Boussard C, Kristman VL, Borg J. Systematic review of self-reported prognosis in adults after mild traumatic brain injury: results of the International Collaboration on Mild Traumatic Brain Injury Prognosis. Arch Phys Med Rehabil. 2014;95:S132–S151. - PubMed

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