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Synergistic Effects Of Traumatic Head Injury And Apolipoprotein-epsilon4 In Patients With Alzheimer's Disease

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

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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