Concussion in adolescence and the risk of multiple sclerosis: A retrospective cohort study

Abstract

Background: Physical trauma, specifically concussions sustained during adolescence, has been hypothesized to be a risk factor for multiple sclerosis (MS). Objective: To examine the association between adolescent concussions and future MS diagnosis. Methods: This retrospective study using linked administrative databases from Ontario, Canada, identified 97,965 adolescents (age 11–18 years) who sustained ⩾1 concussion and presented to an emergency department between 1992 and 2011. Cases were matched 1:3 with individuals who had not sustained a concussion based on age, sex, address, and index date. The primary outcome was MS diagnosis, using a validated MS diagnosis definition: ⩾1 hospitalization or ⩾5 physician billings within 2 years. Results: A concussion during adolescence was associated with a significantly increased risk of MS (hazard ratio (HR) = 1.29, p = 0.03). Sex-specific analysis revealed that only males who sustained a concussion in adolescence had a raised risk of MS (HR = 1.41, p = 0.04). Conclusion: This study supports an association between concussions in adolescence and future MS diagnoses, highlighting the potentially serious long-term effects of concussions.

Pediatric traumatic brain injury and early age multiple sclerosis in Finland: A nationwide register‐based cohort study

“…(Montgomery et al., 2017 ) A Canadian study of nearly 100,000 pTBI patients had similar findings to Swedes. They found out that TBI in adolescence (age 11−18) increases the risk of multiple sclerosis (HR = 1.29), but unlike our results, they demonstrated that the risk was higher among males (HR = 1.41), whereas our study demonstrated over 1.5 times higher risk for women (Povolo et al., 2021 ). The Canadian study was also similar in study design to ours and they studied retrospectively TBI patient cohort.…”

“…Compared to the few other previously published studies, our find- our results, they demonstrated that the risk was higher among males (HR = 1.41), whereas our study demonstrated over 1.5 times higher risk for women (Povolo et al, 2021). The Canadian study was also similar in study design to ours and they studied retrospectively TBI patient cohort.…”

“…A meta-analysis of 21 case−control studies found a significant relation between head trauma under age 20 and multiple sclerosis (Lunny et al, 2014). Concussion in adolescence was also associated with an increased risk of multiple sclerosis in a Swedish nationwide register-based study (Montgomery et al, 2017) and also in a Canadian regional retrospective cohort study that studied only Ontario province (Povolo et al, 2021). All three referenced studies showed an approximate 1.2 times greater risk of developing multiple sclerosis in patients with pTBI.…”

Fixing Functional GI Disorders Using Microbes: Easier Said Than Done

“…Secondly, medical records could be examined to attempt to determine when the triggers occurred that disrupt the equilibrium sufficiently to cause one or more of the undesired FGID manifestations. Such utilization of patient records can be very informative ( 20 ).…”

Head trauma results in manyfold increased risk of multiple sclerosis in genetically susceptible individuals

“… 5 The interactions with HLA genes suggest that the mechanisms of these environmental factors relate to the adaptive immune system. 6 Recent large register-based studies have reported an increased risk of MS following traumatic brain injury, 7 8 particularly if repeated and requiring longer hospital care. 8 Traumatic brain injury, following a physical impact to the head, may result in long-lasting dysfunction of the blood–brain barrier and neuroinflammation.…”