Raquel C Gardner1, Amy L Byers2, Deborah E Barnes2, Yixia Li2, John Boscardin2, Kristine Yaffe2. 1. From the San Francisco Veterans Affairs Medical Center (R.C.G., A.L.B., D.E.B., Y.L., J.B., K.Y.), and Departments of Neurology (R.C.G., K.Y.), Psychiatry (A.L.B., D.E.B., K.Y.), Epidemiology & Biostatistics (D.E.B., J.B., K.Y.), and Medicine (J.B.), University of California, San Francisco. Raquel.Gardner@ucsf.edu. 2. From the San Francisco Veterans Affairs Medical Center (R.C.G., A.L.B., D.E.B., Y.L., J.B., K.Y.), and Departments of Neurology (R.C.G., K.Y.), Psychiatry (A.L.B., D.E.B., K.Y.), Epidemiology & Biostatistics (D.E.B., J.B., K.Y.), and Medicine (J.B.), University of California, San Francisco.
Abstract
OBJECTIVE: Our aim was to assess risk of Parkinson disease (PD) following traumatic brain injury (TBI), including specifically mild TBI (mTBI), among care recipients in the Veterans Health Administration. METHODS: In this retrospective cohort study, we identified all patients with a TBI diagnosis in Veterans Health Administration databases from October 2002 to September 2014 and age-matched 1:1 to a random sample of patients without TBI. All patients were aged 18 years and older without PD or dementia at baseline. TBI exposure and severity were determined via detailed clinical assessments or ICD-9 codes using Department of Defense and Defense and Veterans Brain Injury Center criteria. Baseline comorbidities and incident PD more than 1 year post-TBI were identified using ICD-9 codes. Risk of PD after TBI was assessed using Cox proportional hazard models adjusted for demographics and medical/psychiatric comorbidities. RESULTS: Among 325,870 patients (half with TBI; average age 47.9 ± 17.4 years; average follow-up 4.6 years), 1,462 were diagnosed with PD during follow-up. Compared to no TBI, those with TBI had higher incidence of PD (no TBI 0.31%, all-severity TBI 0.58%, mTBI 0.47%, moderate-severe TBI 0.75%). In adjusted models, all-severity TBI, mTBI, and moderate-severe TBI were associated with increased risk of PD (hazard ratio [95% confidence interval]: all-severity TBI 1.71 [1.53-1.92]; mTBI 1.56 [1.35-1.80]; moderate-severe TBI 1.83 [1.61-2.07]). CONCLUSIONS: Among military veterans, mTBI is associated with 56% increased risk of PD, even after adjusting for demographics and medical/psychiatric comorbidities. This study highlights the importance of TBI prevention, long-term follow-up of TBI-exposed veterans, and the need to determine mechanisms and modifiable risk factors for post-TBI PD.
OBJECTIVE: Our aim was to assess risk of Parkinson disease (PD) following traumatic brain injury (TBI), including specifically mild TBI (mTBI), among care recipients in the Veterans Health Administration. METHODS: In this retrospective cohort study, we identified all patients with a TBI diagnosis in Veterans Health Administration databases from October 2002 to September 2014 and age-matched 1:1 to a random sample of patients without TBI. All patients were aged 18 years and older without PD or dementia at baseline. TBI exposure and severity were determined via detailed clinical assessments or ICD-9 codes using Department of Defense and Defense and Veterans Brain Injury Center criteria. Baseline comorbidities and incident PD more than 1 year post-TBI were identified using ICD-9 codes. Risk of PD after TBI was assessed using Cox proportional hazard models adjusted for demographics and medical/psychiatric comorbidities. RESULTS: Among 325,870 patients (half with TBI; average age 47.9 ± 17.4 years; average follow-up 4.6 years), 1,462 were diagnosed with PD during follow-up. Compared to no TBI, those with TBI had higher incidence of PD (no TBI 0.31%, all-severity TBI 0.58%, mTBI 0.47%, moderate-severe TBI 0.75%). In adjusted models, all-severity TBI, mTBI, and moderate-severe TBI were associated with increased risk of PD (hazard ratio [95% confidence interval]: all-severity TBI 1.71 [1.53-1.92]; mTBI 1.56 [1.35-1.80]; moderate-severe TBI 1.83 [1.61-2.07]). CONCLUSIONS: Among military veterans, mTBI is associated with 56% increased risk of PD, even after adjusting for demographics and medical/psychiatric comorbidities. This study highlights the importance of TBI prevention, long-term follow-up of TBI-exposed veterans, and the need to determine mechanisms and modifiable risk factors for post-TBI PD.
Authors: Gale G Whiteneck; Jeffrey P Cuthbert; John D Corrigan; Jennifer A Bogner Journal: J Head Trauma Rehabil Date: 2016 Jan-Feb Impact factor: 2.710
Authors: Samuel M Goldman; Caroline M Tanner; David Oakes; Grace S Bhudhikanok; Anjali Gupta; J William Langston Journal: Ann Neurol Date: 2006-07 Impact factor: 10.422
Authors: Christine L Mac Donald; Jason Barber; Mary Jordan; Ann M Johnson; Sureyya Dikmen; Jesse R Fann; Nancy Temkin Journal: JAMA Neurol Date: 2017-07-01 Impact factor: 18.302
Authors: Connie Marras; Cesar A Hincapié; Vicki L Kristman; Carol Cancelliere; Sophie Soklaridis; Alvin Li; Jörgen Borg; Jean-Luc af Geijerstam; J David Cassidy Journal: Arch Phys Med Rehabil Date: 2014-03 Impact factor: 3.966
Authors: Gregory J McHugo; Sarah Krassenbaum; Sachiko Donley; John D Corrigan; Jennifer Bogner; Robert E Drake Journal: J Head Trauma Rehabil Date: 2017 May/Jun Impact factor: 2.710
Authors: A Seidler; W Hellenbrand; B P Robra; P Vieregge; P Nischan; J Joerg; W H Oertel; G Ulm; E Schneider Journal: Neurology Date: 1996-05 Impact factor: 9.910
Authors: E Julia Chosy; Noele Gross; Marnie Meyer; Catherine Y Liu; Steven D Edland; Lenore J Launer; Lon R White Journal: J Alzheimers Dis Date: 2020 Impact factor: 4.472
Authors: Michael A Sugarman; Ann C McKee; Thor D Stein; Yorghos Tripodis; Lilah M Besser; Brett Martin; Joseph N Palmisano; Eric G Steinberg; Maureen K O'Connor; Rhoda Au; Michael McClean; Ronald Killiany; Jesse Mez; Michael W Weiner; Neil W Kowall; Robert A Stern; Michael L Alosco Journal: Alzheimers Dement Date: 2019-03-07 Impact factor: 21.566
Authors: Murray B Stein; Sonia Jain; Joseph T Giacino; Harvey Levin; Sureyya Dikmen; Lindsay D Nelson; Mary J Vassar; David O Okonkwo; Ramon Diaz-Arrastia; Claudia S Robertson; Pratik Mukherjee; Michael McCrea; Christine L Mac Donald; John K Yue; Esther Yuh; Xiaoying Sun; Laura Campbell-Sills; Nancy Temkin; Geoffrey T Manley; Opeolu Adeoye; Neeraj Badjatia; Kim Boase; Yelena Bodien; M Ross Bullock; Randall Chesnut; John D Corrigan; Karen Crawford; Ramon Diaz-Arrastia; Sureyya Dikmen; Ann-Christine Duhaime; Richard Ellenbogen; V Ramana Feeser; Adam Ferguson; Brandon Foreman; Raquel Gardner; Etienne Gaudette; Joseph T Giacino; Luis Gonzalez; Shankar Gopinath; Rao Gullapalli; J Claude Hemphill; Gillian Hotz; Sonia Jain; Frederick Korley; Joel Kramer; Natalie Kreitzer; Harvey Levin; Chris Lindsell; Joan Machamer; Christopher Madden; Alastair Martin; Thomas McAllister; Michael McCrea; Randall Merchant; Pratik Mukherjee; Lindsay D Nelson; Florence Noel; David O Okonkwo; Eva Palacios; Daniel Perl; Ava Puccio; Miri Rabinowitz; Claudia S Robertson; Jonathan Rosand; Angelle Sander; Gabriela Satris; David Schnyer; Seth Seabury; Mark Sherer; Murray B Stein; Sabrina Taylor; Arthur Toga; Nancy Temkin; Alex Valadka; Mary J Vassar; Paul Vespa; Kevin Wang; John K Yue; Esther Yuh; Ross Zafonte Journal: JAMA Psychiatry Date: 2019-03-01 Impact factor: 21.596
Authors: Jason W Adams; Victor E Alvarez; Jesse Mez; Bertrand R Huber; Yorghos Tripodis; Weiming Xia; Gaoyuan Meng; Caroline A Kubilus; Kerry Cormier; Patrick T Kiernan; Daniel H Daneshvar; Alicia S Chua; Sarah Svirsky; Raymond Nicks; Bobak Abdolmohammadi; Laney Evers; Todd M Solomon; Jonathan D Cherry; Nurgul Aytan; Ian Mahar; Sherral Devine; Sanford Auerbach; Michael L Alosco; Christopher J Nowinski; Neil W Kowall; Lee E Goldstein; Brigid Dwyer; Douglas I Katz; Robert C Cantu; Robert A Stern; Rhoda Au; Ann C McKee; Thor D Stein Journal: J Neuropathol Exp Neurol Date: 2018-09-01 Impact factor: 3.685