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Influence of Catechol-O-methyltransferase on Executive Functioning Longitudinally After Early Childhood Traumatic Brain Injury: Preliminary Findings

Kurowski, Brad G. MD, MS; Backeljauw, Barynia BS; Zang, Huaiyu MS; Zhang, Nanhua PhD; Martin, Lisa J. PhD; Pilipenko, Valentina PhD; Yeates, Keith PhD, ABPP/CN; Taylor, H. Gerry PhD; Wade, Shari PhD

Journal of Head Trauma Rehabilitation: May/June 2016 - Volume 31 - Issue 3 - p E1–E9
doi: 10.1097/HTR.0000000000000162
Original Articles
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Objective: To elucidate the association of a functional catechol-O-methyltransferase (COMT) genotype (rs4680) with recovery of executive functions up to 18 months after early childhood traumatic brain injury (TBI) compared with an orthopedic injury (OI) group.

Setting: Outpatient.

Participants: A total of 134 children with a moderate to severe TBI (n = 63) or OI (n = 71) between the ages of 3 and 6 years who were followed 18 months postinjury.

Design: Case-comparison, longitudinal cohort

Main Measures: The Behavior Rating Inventory of Executive Function, developmental NEuroPSYchological Assessment (NEPSY) of Verbal Fluency, and a modified Stroop Test for young children (Shape School).

Results: The low-activity COMT enzyme genotype (AA) was associated with better scores on the developmental NEPSY of Verbal Fluency (F = 3.80; P = .02) and the Shape School (F = 2.89; P = .06) in all participants when controlling for injury type (TBI vs OI) over the first 18 months after injury. Injury type (TBI vs OI) did not significantly moderate the effect of the COMT genotypes on executive function recovery.

Conclusion: This study provides preliminary evidence for a role of COMT genotypes in long-term recovery of executive function after pediatric TBI and OI. Larger studies are needed to determine the exact link between genetic variation in the COMT gene and TBI recovery in children.

Divisions of Physical Medicine and Rehabilitation (Drs Kurowski and Wade and Ms Backeljauw), Biostatistics and Epidemiology (Mr H. Zang and Dr N. Zhang), and Human Genetics (Drs Martin and Pilipenko), Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, Ohio; and Department of Psychology, University of Calgary, Calgary, Alberta, Canada (Dr Yeates); and Division of Developmental and Behavioral Pediatrics and Psychology, Department of Pediatrics, Case Western Reserve University and Rainbow Babies and Children's Hospital, University Hospitals Case Medical Center, Cleveland, Ohio (Dr Taylor).

Corresponding Author: Brad G. Kurowski, MD, MS, Division of Physical Medicine and Rehabilitation, Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, 3333 Burnet Ave, MLC 4009, Cincinnati, OH 45229 (brad.kurowski@cchmc.org).

Funding for this study was supported in part by the Rehabilitation Medicine Scientist Training Program (K-12 HD001097-16), National Institute for Child Health and Human Development (K23HD074683-01A1 and R01 HD42729), and grant 8 UL1 TR000077 from the National Center for Advancing Translational Sciences of the National Institutes of Health (NIH). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or other supporting agencies.

The authors declare no conflicts of interest.

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