Scott Montgomery1,2,3, Ayako Hiyoshi1, Sarah Burkill2,4, Lars Alfredsson5,6, Shahram Bahmanyar2,4, Tomas Olsson7. 1. Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden. 2. Clinical Epidemiology Unit, Department of Medicine, Karolinska Institute, Solna, Sweden. 3. Department of Epidemiology and Public Health, University College London, London, United Kingdom. 4. Center for Pharmacoepidemiology, Department of Medicine, Karolinska Institute, Solna, Sweden. 5. Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden. 6. Center for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden. 7. Department of Clinical Neuroscience, Center for Molecular Medicine, Karolinska Institute, Stockholm, Sweden.
Abstract
OBJECTIVE: To assess whether concussion in childhood or adolescence is associated with subsequent multiple sclerosis (MS) risk. Previous research suggests an association, but methodological limitations included retrospective data collection and small study populations. METHODS: The national Swedish Patient Register (hospital diagnoses) and MS Register were used to identify all MS diagnoses up to 2012 among people born since 1964, when the Patient Register was established. The 7,292 patients with MS were matched individually with 10 people without MS by sex, year of birth, age/vital status at MS diagnosis, and region of residence (county), resulting in a study population of 80,212. Diagnoses of concussion and control diagnoses of broken limb bones were identified using the Patient Register from birth to age 10 years or from age 11 to 20 years. Conditional logistic regression was used to examine associations with MS. RESULTS: Concussion in adolescence was associated with a raised risk of MS, producing adjusted odds ratios (95% confidence intervals) of 1.22 (1.05-1.42, p = 0.008) and 2.33 (1.35-4.04, p = 0.002) for 1 diagnosis of concussion and >1 diagnosis of concussion, respectively, compared with none. No notable association with MS was observed for concussion in childhood, or broken limb bones in childhood and adolescence. INTERPRETATION: Head trauma in adolescence, particularly if repeated, is associated with a raised risk of future MS, possibly due to initiation of an autoimmune process in the central nervous system. This further emphasizes the importance of protecting young people from head injuries. Ann Neurol 2017;82:554-561.
OBJECTIVE: To assess whether concussion in childhood or adolescence is associated with subsequent multiple sclerosis (MS) risk. Previous research suggests an association, but methodological limitations included retrospective data collection and small study populations. METHODS: The national Swedish Patient Register (hospital diagnoses) and MS Register were used to identify all MS diagnoses up to 2012 among people born since 1964, when the Patient Register was established. The 7,292 patients with MS were matched individually with 10 people without MS by sex, year of birth, age/vital status at MS diagnosis, and region of residence (county), resulting in a study population of 80,212. Diagnoses of concussion and control diagnoses of broken limb bones were identified using the Patient Register from birth to age 10 years or from age 11 to 20 years. Conditional logistic regression was used to examine associations with MS. RESULTS: Concussion in adolescence was associated with a raised risk of MS, producing adjusted odds ratios (95% confidence intervals) of 1.22 (1.05-1.42, p = 0.008) and 2.33 (1.35-4.04, p = 0.002) for 1 diagnosis of concussion and >1 diagnosis of concussion, respectively, compared with none. No notable association with MS was observed for concussion in childhood, or broken limb bones in childhood and adolescence. INTERPRETATION: Head trauma in adolescence, particularly if repeated, is associated with a raised risk of future MS, possibly due to initiation of an autoimmune process in the central nervous system. This further emphasizes the importance of protecting young people from head injuries. Ann Neurol 2017;82:554-561.
Authors: Benjamin L Brett; Jonathan Savitz; Morgan Nitta; Lezlie España; T Kent Teague; Lindsay D Nelson; Michael A McCrea; Timothy B Meier Journal: Brain Behav Immun Date: 2020-07-24 Impact factor: 7.217
Authors: Katarina Tengvall; Jesse Huang; Cecilia Hellström; Patrick Kammer; Martin Biström; Burcu Ayoglu; Izaura Lima Bomfim; Pernilla Stridh; Julia Butt; Nicole Brenner; Angelika Michel; Karin Lundberg; Leonid Padyukov; Ingrid E Lundberg; Elisabet Svenungsson; Ingemar Ernberg; Sigurgeir Olafsson; Alexander T Dilthey; Jan Hillert; Lars Alfredsson; Peter Sundström; Peter Nilsson; Tim Waterboer; Tomas Olsson; Ingrid Kockum Journal: Proc Natl Acad Sci U S A Date: 2019-08-02 Impact factor: 11.205
Authors: Kelsi A Smith; Ayako Hiyoshi; Sarah Burkill; Shahram Bahmanyar; Johan Öckinger; Lars Alfredsson; Tomas Olsson; Scott Montgomery Journal: BMJ Neurol Open Date: 2020-06-16
Authors: Mary K Horton; Shannon McCurdy; Xiaorong Shao; Kalliope Bellesis; Terrence Chinn; Catherine Schaefer; Lisa F Barcellos Journal: PLoS One Date: 2022-01-13 Impact factor: 3.240