Cited by 279Amyotrophic Lateral Sclerosis ResearchTraumatic Brain Injury ResearchSports injuries and prevention

The DOI matches its Crossref record; 34 of the 35 references it cites were found in a registry or an index; none of the 10 sources its claims cite is checked for support yet.

Head Injury and Amyotrophic Lateral Sclerosis

Open access
Chen, H., Richard, M., Sandler, D. P., Umbach, D. M., Kamel, F.·2007·American Journal of Epidemiology

Abstract

Recent data showed that soccer players in Italy had an unusually high risk of amyotrophic lateral sclerosis (ALS) and that repeated head trauma might have contributed to this increase. The authors examined whether head injury was related to ALS risk in a case-control study of 109 New England ALS cases diagnosed in 1993-1996 and 255 matched controls. They also conducted a meta-analysis of the published literature. Overall, ever having experienced a head injury was nonsignificantly associated with a higher ALS risk. When compared with persons without a head injury, a statistically significant ALS risk elevation was found for participants with more than one head injury (odds ratio (OR) = 3.1, 95 percent confidence interval (CI): 1.2, 8.1) and patients who had had a head injury during the past 10 years (OR = 3.2, 95 percent CI: 1.0, 10.2). For participants who had had multiple head injuries with the latest occurring in the past 10 years, risk was elevated more than 11-fold. The meta-analysis also indicated a moderately elevated risk of ALS among persons with previous head injuries (OR = 1.7, 95 percent CI: 1.3, 2.2). In this study population, physical injuries to other body parts, including the trunk, arms, or legs, were not related to ALS risk. These data support the notion that head injury may increase the risk of ALS.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

In a New England case-control study, head injury was not significantly associated with ALS overall, but repeated head injuries and recent head injuries were associated with higher ALS risk. A meta-analysis of published studies plus the current study found a pooled odds ratio of 1.7 for ALS among persons with previous head injury.

Key findings

  • Ever having had a head injury was nonsignificantly associated with ALS (adjusted OR = 1.4, 95% CI: 0.8, 2.6).
  • ALS risk was elevated for more than one head injury (adjusted OR = 3.1, 95% CI: 1.2, 8.1) and for head injury in the past 10 years (adjusted OR = 3.2, 95% CI: 1.0, 10.2); multiple head injuries with the latest in the past 10 years showed more than an 11-fold higher risk (adjusted OR = 11.3, 95% CI: 1.1, 114.3).
  • The meta-analysis found a pooled OR of 1.7 (95% CI: 1.3, 2.2; p < 0.001) for ALS among persons with previous head injuries.
  • Injuries to other body sites, including trunk, arms, or legs, were not related to higher ALS risk.

Methods

  • Case-control study of 109 ALS cases diagnosed in 1993–1996 from two New England referral centers and 255 frequency-matched controls; structured questionnaire assessed injuries severe enough to require medical attention, with unconditional logistic regression adjusted for matching factors, smoking, and education.
  • Meta-analysis of published studies since 1980 identified through MEDLINE and reference lists; one study was excluded because a risk estimate could not be calculated, and a fixed-effects model was used because no statistical heterogeneity was found (p for heterogeneity = 0.1).

Limitations

  • The paper states that cases were interviewed in person and controls by telephone, raising concern about potential bias; analyses were limited by small sample sizes, so chance cannot be excluded; exposure assessment was not independently validated; the meaning of “severe injury” was open to interpretation; and defining head injury as requiring medical attention may limit generalizability.
  • Evident from the text: the 11-fold estimate came from a post-hoc exploratory analysis based on small numbers, and in the meta-analysis, except for the current study, risk estimates were not adjusted for potential confounders and nearly all studies lacked sufficient details for further analysis.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1093/aje/kwm153

Cites

34 of 34 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

12 Own result · 7 Sources not found · 7 Own method · 7 Own interpretation

Show all 19 claims

  • It may state two separate claims as one. 11
  • Probably not a substantial claim. 4
14 of 14
  • The paper relies on this without support.

    Self-reported severe head injury requiring medical attention accurately reflects true head injury exposure.

    “Finally, exposure assessment in the current study was not independently validated, and the meaning of severe injury was, to some extent, open to individual interpretation.”
  • The paper relies on this without support.

    The unadjusted risk estimates from the published studies included in the meta-analysis are valid enough to combine into a summary estimate.

    “Except in the current study, risk estimates were not adjusted for potential confounders.”
  • The paper relies on this without support.

    The New England case-control study population is representative enough to generalize the observed association to the American population.

    “In summary, in line with the recent observations of higher ALS risk among Italian soccer players, we found that recent repeated head injury was related to a higher risk of ALS in an American population.”
3 of 3

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Citations

Cites

Show all 35 references

Research works printed but not linked: 1

  1. Deapen DM, Henderson BE. A case-control study of amyo- trophic lateral sclerosis. Am J Epidemiol 1986;123:790-9.

Cited by

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Metadata

Authors
Chen, H., Richard, M., Sandler, D. P., Umbach, D. M., & Kamel, F.
Affiliations
  • National Institutes of Health (US)
  • Westat (United States) (US)
  • National Institute of Environmental Health Sciences (US)
Venue
American Journal of Epidemiology
Published
2007-06-27
Volume
166
Issue
7
Pages
810-816
ISSN
  • 0002-9262 (ISSN-L)
  • 1476-6256
OpenAlex
W2152476219
Cited by
279
References
35
Citations by year
2026: 8 · 2025: 11 · 2024: 12 · 2023: 15 · 2022: 11 · 2021: 19 · 2020: 19 · 2019: 16 · 2018: 19 · 2017: 19 · 2016: 24 · 2015: 25 · 2014: 18 · 2013: 12 · 2012: 13
FWCI
5.76
Type
journal article
Language
en
Open access
Locations
  • American Journal of Epidemiology (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institutes of Health (Z01-ES049005)
Topics
  • Health Sciences › Medicine › Clinical Neurology › Amyotrophic Lateral Sclerosis Research
  • Health Sciences › Medicine › Clinical Neurology › Traumatic Brain Injury Research
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports injuries and prevention
Keywords
amyotrophic lateral sclerosis, traumatic brain injury, repeated head trauma, ALS risk factors, soccer players, sports injuries
MeSH terms
Adult, Aged, Aged, 80 and over, Amyotrophic Lateral Sclerosis, Female, Craniocerebral Trauma, Humans, Life Style, Male, Middle Aged, New England, Risk Factors, Soccer, Confidence Intervals, Odds Ratio, Case-Control Studies, Risk Assessment

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A language model drew the claims from the paper on 2026-11-07, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).

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