Trauma and amyotrophic lateral sclerosis: a european population-based case-control study from the EURALS consortium
Abstract
OBJECTIVES: To assess the association between amyotrophic lateral sclerosis (ALS) and previous traumatic events, age of trauma, and site of injury. METHODS: A population-based case-control study was performed in five European countries (Italy, Ireland, France, United Kingdom, Serbia). Newly diagnosed ALS patients and matched controls were interviewed to collect relevant demographic factors and exposures. Key clinical features at diagnosis were collected in ALS patients. Trauma was any accidental event causing an injury. Injuries were dated and classified according to cause, severity, type, site, and complications. All exposures were censored five years before symptoms onset. Risks were computed as odds ratios (OR) with 95% confidence intervals (CI) using univariate and multivariate conditional logistic regression models. RESULTS: Five hundred and seventy-five ALS patients and 1150 controls were interviewed. Disabling traumatic events predominated in the cases (OR 1.54 (95% CI 1.24-1.92)) and maintained significance after adjustment, with a significant gradient. A history of 2 + head injuries was associated with an almost three-fold increased risk of ALS. The risk was almost two-fold when trauma occurred at age 35-54 years. Site of injury was uneventful. CONCLUSIONS: Traumatic events leading to functional disability or confined to the head are risk factors for ALS. Traumatic events experienced at age 35-54 years carry the highest risk.
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- Authors
- Pupillo, E., Poloni, M., Bianchi, E., Giussani, G., Logroscino, G., Zoccolella, S., Chiò, A., Calvo, A., Corbo, M., Lunetta, C., Marin, B., Mitchell, D., Hardiman, O., Rooney, J., Stevic, Z., Bandettini di Poggio, M., Filosto, M., Cotelli, M. S., Perini, M., Riva, N., Tremolizzo, L., Vitelli, E., Damiani, D., Beghi, E., & The EURALS Consortium†
- Affiliations
- Laboratorio di Malattie Neurologiche, IRCCS-Istituto Mario Negri, Milano, Italy,
- University of Bari Aldo Moro (IT)
- University of Turin (IT)
- Department of Neurorehabilitation Sciences, Casa Cura Policlinico, CCP, Milano, Italy,
- Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda (IT)
- INSERM, U1094, Tropical Neuroepidemiology, Limoges, France,
- Trinity College Dublin (IE)
- Clinic of Neurology Clinical Center Serbia, School of Medicine, Belgrade, Serbia,
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genova, Genova, Italy,
- Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia (IT)
- Department of Neurology, Ospedale di Esine, Brescia, Italy,
- Azienda Ospedaliera Sant’Antonio Abate di Gallarate (IT)
- IRCCS Ospedale San Raffaele (IT)
- University of Milano-Bicocca (IT)
- Ospedale Maggiore di Lodi (IT)
- Corresponding author
- Beghi, Ettore
- ORCID
- Venue
- Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration
- Publisher
- Informa UK Limited
- Published
- 2017-10-24
- Volume
- 19
- Issue
- 1-2
- Pages
- 118-125
- ISSN
- 2167-8421 (ISSN-L)
- 2167-9223
- OpenAlex
- W2765188850
- Semantic Scholar
- 7bee75740103c2a6410b3ef81d657d2b7998543d
- Cited by
- 38
- References
- 26
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 2 · 2023: 4 · 2022: 7 · 2021: 4 · 2020: 6 · 2019: 6 · 2018: 4
- FWCI
- 3.03
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration (publishedVersion)
- PubMed (publishedVersion)
- HAL (submittedVersion)
- BOA (University of Milano-Bicocca) (submittedVersion)
- Institutional Research Information System (Università degli Studi di Brescia) (submittedVersion)
- Institutional Research Information System University of Turin (University of Turin) (submittedVersion)
- CINECA IRIS Institutional Research Information System (University of Bari Aldo Moro) (submittedVersion)
- Funders
- American ALS Association (1524)
- European Community’s Health Seventh Framework Programme (259867)
- Topics
- Health Sciences › Medicine › Neurology › Amyotrophic Lateral Sclerosis Research
- Health Sciences › Medicine › Pathology and Forensic Medicine › Spinal Cord Injury Research
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Keywords
- amyotrophic lateral sclerosis, traumatic brain injury, traumatic events, risk factors, disability
- MeSH terms
- Adult, Age Factors, Aged, Amyotrophic Lateral Sclerosis, Ethnicity, Female, France, United Kingdom, Craniocerebral Trauma, Humans, Ireland, Italy, Male, Middle Aged, Risk Factors, Logistic Models, Odds Ratio, Case-Control Studies, Serbia
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