Kathryn M Taylor1, Marie-Helene Saint-Hilaire2, Lewis Sudarsky3, David K Simon4, Bonnie Hersh5, David Sparrow6, Howard Hu7, Marc G Weisskopf8. 1. Harvard T.H. Chan School of Public Health, Dept of Environmental Health, 401 Park Dr., Landmark Building, 3rd Floor, Boston MA 02215, USA. Electronic address: kmt691@mail.harvard.edu. 2. Department of Neurology, Boston University Medical Center, 72 East Concord Street, C3, Boston, MA 02118, USA. Electronic address: neuromsh@bu.edu. 3. Department of Neurology, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA. Electronic address: lsudarsky@partners.com. 4. Beth Israel Deaconess Medical Center and Harvard Medical School, Department of Neurology 330 Brookline Avenue, Boston, MA 02215, USA. Electronic address: dsimon1@bidmc.harvard.edu. 5. Harvard Vanguard Medical Associates, 133 Brookline Avenue, Boston, MA 02215, USA. Electronic address: bonnie_hersh@vmed.org. 6. VA Boston Healthcare System, Jamaica Plain, 150 South Huntington Avenue, Boston, MA 02130, USA; Boston University Schools of Public Health and Medicine, 715 Albany Street, Boston, MA 02118, USA. Electronic address: david.sparrow@va.gov. 7. Departments of Epidemiology, Global Health, and Environmental Health, University of Toronto Dalla Lana School of Public Health, 6th Floor, 155 College Street, Toronto, Ontario, Canada. Electronic address: howard.hu@utoronto.ca. 8. Department of Epidemiology and Environmental Health, Harvard TH Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA. Electronic address: mweissko@hsph.harvard.edu.
Abstract
INTRODUCTION: The literature on the effect of head injuries on the risk of PD is inconclusive. Some researchers have hypothesized that studies that have seen an effect are simply capturing injury related to pre-clinical PD. However in animal models brain inflammation, which can be initiated by head trauma, has been shown to produce PD-like effects. Furthermore, animal studies have found that early life inflammation in particular is of relevance for PD pathology. METHODS: We conducted an unmatched case-control study of 379 neurologist confirmed PD patients and 230 controls from the greater Boston, Massachusetts area with questionnaire data on history of head injury and other covariates. We used multivariable logistic regression to estimate adjusted odds ratios (OR) and their corresponding 95% confidence intervals (CI) for PD. RESULTS: When we excluded injuries that occurred less than 10 years prior to the diagnosis of PD (in order to avoid reverse causation), we found an increased risk of PD associated with a head injury that resulted in a loss of consciousness, but it did not reach statistical significance (OR = 1.57; 95% CI = 0.89-2.80). We found a significant (p = 0.04) effect of age at first head injury. For every 5 year earlier age at first head injury with loss of consciousness the OR for PD was 1.37 (95% CI: 1.01-1.86). CONCLUSION: Our results suggest that head injury in early life increases the risk of PD.
INTRODUCTION: The literature on the effect of head injuries on the risk of PD is inconclusive. Some researchers have hypothesized that studies that have seen an effect are simply capturing injury related to pre-clinical PD. However in animal models brain inflammation, which can be initiated by head trauma, has been shown to produce PD-like effects. Furthermore, animal studies have found that early life inflammation in particular is of relevance for PD pathology. METHODS: We conducted an unmatched case-control study of 379 neurologist confirmed PDpatients and 230 controls from the greater Boston, Massachusetts area with questionnaire data on history of head injury and other covariates. We used multivariable logistic regression to estimate adjusted odds ratios (OR) and their corresponding 95% confidence intervals (CI) for PD. RESULTS: When we excluded injuries that occurred less than 10 years prior to the diagnosis of PD (in order to avoid reverse causation), we found an increased risk of PD associated with a head injury that resulted in a loss of consciousness, but it did not reach statistical significance (OR = 1.57; 95% CI = 0.89-2.80). We found a significant (p = 0.04) effect of age at first head injury. For every 5 year earlier age at first head injury with loss of consciousness the OR for PD was 1.37 (95% CI: 1.01-1.86). CONCLUSION: Our results suggest that head injury in early life increases the risk of PD.
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