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NEUROLOGY 1995;45:555-557
© 1995 American Academy of Neurology

Synergistic Effects of Traumatic Head Injury and Apolipoprotein-epsilon4 in Patients With Alzheimer's Disease

R. Mayeux, MD, R. Ottman, PhD, G. Maestre, MD, C. Ngai, BS, M.-X. Tang, PhD, H. Ginsberg, MD, M. Chun, MD, B. Tycko, MD, PhD and M. Shelanski, MD, PhD

Article abstract-The apolipoprotein-epsilon4 allele increases the risk of Alzheimer's disease (AD), but cerebral deposition of beta-amyloid with age, a genetic mutation, or head injury may contribute to the pathogenesis of this disease. We examined the risks of AD associated with traumatic head injury and apolipoprotein-epsilon4 in 236 community-dwelling elderly persons. A 10-fold increase in the risk of AD was associated with both apolipoprotein-epsilon4 and a history of traumatic head injury, compared with a two-fold increase in risk with apolipoprotein-epsilon4 alone. Head injury in the absence of an apolipoprotein-epsilon4 allele did not increase risk. These data imply that the biological effects of head injury may increase the risk of AD, but only through a synergistic relationship with apolipoprotein-epsilon4.

NEUROLOGY 1995;45: 555-557




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