Severe head injury and amyotrophic lateral sclerosis

Peters, Tracy L.; Fang, Fang; Weibull, Caroline E.; Sandler, Dale P.; Kamel, Freya; Ye, Weimin

doi:10.3109/21678421.2012.754043

Cited by 39 publications

(34 citation statements)

References 28 publications

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“…These findings contrast previous case series (Chen et al., ; Pupillo et al., ; Schmidt, Kwee, Allen, & Oddone, ; Seelen et al., ; Strickland et al., ) and a meta‐analysis (Chen et al., ). However, in two studies excess occurrence was significant only within 1 year after head injury (Peters et al., ; Turner et al., ), rather suggesting accidents provoked by early signs of ALS than ALS secondary to head trauma (Turner et al., ). Furthermore, studies with higher class of evidence (based on medical records rather than patients’ recall) showed no excess of head trauma prior to symptom onset (Armon & Nelson, ).…”

Section: Discussionmentioning

confidence: 99%

“…While head injuries were linked to increased risk for ALS in some studies (Chen, Richard, Sandler, Umbach, & Kamel, ; Pupillo et al., ; Strickland, Smith, Dolliff, Goldman, & Roelofs, ), others observed a significant association only within 1 year after head injury (Peters et al., ; Turner, Abisgold, Yeates, Talbot, & Goldacre, ), rather suggesting accidents provoked by early signs of the disease. Some studies report that (vigorous) physical activities have been associated with an increased risk for ALS (Beghi et al., ; Gotkine, Friedlander, & Hochner, ), while others did not find any excess risk (Huisman et al., ; Longstreth, Mcguire, Koepsell, Wang, & van Belle, ; Veldink et al., ) or even reported a protective effect (Pupillo et al., ).…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of potential sports‐associated risk factors in Swiss amyotrophic lateral sclerosis patients

et al. 2017

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ObjectivesAmyotrophic lateral sclerosis (ALS) has been reported to occur with increased incidence amongst physically active people. The role of extrinsic risk factors as physical activity, head trauma and drug/pesticide‐exposure in the pathophysiology of ALS and especially in the context of practising sports remains controversial.Materials and MethodsWe retrospectively studied exposure to extrinsic factors in 92 ALS patients in the presymptomatic stage. Metabolic equivalents (METs) were calculated and the association of physical activity, drug intake, head trauma and participation in specific sports (football [soccer], ice hockey) with age at symptom‐onset was evaluated.ResultsNinety‐five percent of patients considered themselves physically active before symptom‐onset. Total MET‐values varied broadly and there was no correlation between vigorous physical activity and age at symptom‐onset. Mild traumatic brain injury (prevalence = 16.7%) was the most frequent diagnosis after head/neck injury. A history of ≥1 head/neck injuries was associated with a younger age at symptom‐onset (61.8 ± 11.0 vs. 54.1 ± 13.0, p = .013). In former football and ice hockey players the rate of vigorous physical activities was increased (p < .05), whereas total MET‐values, frequency of head injuries and analgesic intake were not different compared to other ALS patients.ConclusionsHistory of head injuries was the only extrinsic risk factor associated with accelerated neurodegeneration in ALS. There was no evidence for extrinsic factors predisposing former football and ice hockey players to ALS. Our data therefore support the hypothesis that not increased physical activity per se, but other unknown environmental factors and/or genetic profile or lifestyle‐promoting physical fitness increases ALS susceptibility.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prevalence of potential sports‐associated risk factors in Swiss amyotrophic lateral sclerosis patients

et al. 2017

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“…This definition is consistent with findings from previous epidemiologic studies of head injury and ALS. 2,5 Head injury within 1 year of ALS diagnosis was excluded as these injuries are thought to occur as a result of falls from the ALS disease process. 5 Otherwise, patients were classified as having no significant history of head injury.…”

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confidence: 99%

“…2,5 Head injury within 1 year of ALS diagnosis was excluded as these injuries are thought to occur as a result of falls from the ALS disease process. 5 Otherwise, patients were classified as having no significant history of head injury. To determine if the study results were dependent on the definition of head injury, secondary analyses were also performed comparing patients with ALS who reported any history of head injury to patients with ALS with no history of head injury.…”

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confidence: 99%

Head injury does not alter disease progression or neuropathologic outcomes in ALS

et al. 2015

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Objectives: To study the effects of head injury on disease progression and on neuropathologic outcomes in amyotrophic lateral sclerosis (ALS).Methods: Patients with ALS were surveyed to obtain head injury history, and medical records were reviewed. Linear regression was performed to determine if head injury was a predictor for mean monthly decline of Amyotrophic Lateral Sclerosis Functional Rating Scale-revised (ALSFRS-R), while controlling for confounders. Head injury history was obtained from family members of ALS autopsy cases. The frequency of tau proteinopathy, brain TDP-43 inclusions, and pathologic findings of Alzheimer disease (AD) were examined in ALS cases with head injury compared to cases without. Logistic regression was performed with each neuropathologic diagnosis as an outcome measure and head injury as a predictor variable. Results:No difference was seen in rate of decline of the ALSFRS-R between patients with head injury (n 5 24) and without (n 5 76), with mean monthly decline of 20.9 for both groups (p 5 0.18). Of 47 ALS autopsy cases (n 5 9 with head injury, n 5 38 without), no significant differences were seen in the frequency of tau proteinopathy (11% with head injury; 24% without), TDP-43 in the brain (44% with head injury; 45% without), or AD pathology (33% with head injury; 26% without). Independent logistic regression models showed head injury was not a predictor of tau pathology (p 5 0.42) or TDP-43 in the brain (p 5 0.99).Conclusions: Head injury was not associated with faster disease progression in ALS and did not result in a specific neuropathologic phenotype. The tau pathology described with chronic traumatic encephalopathy was found in ALS autopsy cases both with and without head injury. Head injury has been considered as a risk factor for amyotrophic lateral sclerosis (ALS), although epidemiologic studies on this topic yield mixed results 1-7 depending on the population studied and the ability to control for confounding variables. Recurrent head injuries can be associated with chronic traumatic encephalopathy (CTE), a condition clinically associated with dementia, parkinsonism, and behavior changes. Neuropathologic findings in CTE include tau-positive neurites, glia, and neurofibrillary tangles throughout the brain, particularly concentrated in cortical sulci and in perivascular regions. 8A 2010 neuropathologic study 9 described the autopsy findings of 12 professional athletes who experienced multiple head injuries and received a clinical diagnosis of CTE. Of the 12 athletes with CTE, 3 also had a clinical diagnosis of ALS. As expected, all 12 cases demonstrated the tau pathology described with CTE. Ten of the 12 cases demonstrated TDP-43 proteinopathy in the brain. The implications of this study have been debated, 10-12 but the authors proposed that head injury incites TDP-43 and tau-mediated neurotoxicity in certain vulnerable individuals, which can cause an ALS phenotype and accelerate neurodegeneration. If this hypothesis is true,

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“…While no non-genetic causes have been definitely identified, male sex [1], cigarette smoking [2], physical activity [3], physical trauma [4,5], and certain chemicals [6] have all been unevenly implicated as potential risk factors. Associations have also been found with certain occupations, including veterinarians, medical workers, athletes, power-plant operators and military personnel [7].…”

Section: Introductionmentioning

confidence: 99%

Occupational formaldehyde and amyotrophic lateral sclerosis

Seals

Kioumourtzoglou

Gredal³

et al. 2017

Eur J Epidemiol

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Background Prior studies have yielded inconsistent evidence regarding the association between formaldehyde exposure and amyotrophic lateral sclerosis (ALS). Methods We conducted a population case-control study in the Danish National Registries on the relationship between occupationally-derived formaldehyde exposure and ALS. Occupational history was obtained from a comprehensive and prospectively recorded pension database of all paid work in Denmark since 1964, and was linked to a job-exposure matrix to derive individual exposure estimates. Each case was matched to 4 age- and sex-matched population controls alive on the date of the case diagnosis via risk set sampling, and odds ratios (OR) and confidence intervals (CI) were calculated via conditional logistic regression, adjusting for potential confounders. Results There were 3,650 incident cases of amyotrophic lateral sclerosis in the Danish National Patient Register from 1982 to 2009. Among controls, 25% were ever employed in jobs with a positive prevalence of formaldehyde exposure. Exposure to formaldehyde was associated with a 1.3-fold increased rate of ALS (95% CI: 1.2–1.4). Conclusion This study suggests that formaldehyde exposure, or employment in formaldehyde-exposed occupations, is related to the risk of ALS.

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Severe head injury and amyotrophic lateral sclerosis

Cited by 39 publications

References 28 publications

Prevalence of potential sports‐associated risk factors in Swiss amyotrophic lateral sclerosis patients

Prevalence of potential sports‐associated risk factors in Swiss amyotrophic lateral sclerosis patients

Head injury does not alter disease progression or neuropathologic outcomes in ALS

Occupational formaldehyde and amyotrophic lateral sclerosis

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