Genetics

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Alcoholism and MS have genetic influences that are well described and are not reviewed here. Whether genetics plays a role in the development of dementia in these disorders is unknown. Individuals who inherit an abnormality in the thiamine-dependent enzyme transketolase may be predisposed to the cognitive effects of thiamine deficiency, Wernicke-Korsakoff syndrome (Blass & Gibson, 1977). The apolipoprotein epsilon 4 allele (apo E4) has gained significant attention as a risk factor for Alzheimer's disease (AD). It has been studied in sporadic AD, late-onset familial AD, and in AD that arises following head trauma (see Chapter 1). Preliminary evidence suggests that it may also influence acute recovery from traumatic brain injury (Lichtman, Seliger, Tycko, & Marder, 2000; Teasdale, Nicoll, Murray, & Fiddes, 1997). In addition, apo E4 may increase susceptibility to dementia pugilistica. Jordan et al. (1997) evaluated 30 professional boxers for evidence of brain injury. Among those with the greatest number of professional bouts, the boxers possessing at least one apo E4 allele had more severe impairment. Apo E polymorphism did not alter the risk of cognitive impairment in 89 subjects with MS studied by Oliveri et al. (1999). Little is known about the role of genetics in the other acquired dementias discussed in this chapter.

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