Is head trauma a risk factor for amyotrophic lateral sclerosis? An evidence based review
Abstract
Our objective was to evaluate the epidemiological literature regarding the association between trauma to the head and ALS, in order to determine if trauma to the head is a risk factor for ALS. A Medline literature search was conducted for the period between 1980 and October 2010 using the search terms: ('head trauma' OR 'head injury') AND (ALS OR 'amyotrophic lateral sclerosis' OR MND OR 'motor neuron disease'). The references of primary articles and reviews were checked to assure completeness of the search. Articles with primary data and reference groups were reviewed. The American Academy of Neurology evidence based method for classification of evidence for inferring causality and assigning level of conclusion was used. Twelve of 14 articles published since 1980 met the inclusion criteria. One class II article and three class III articles showed an association between a single instance of head trauma and ALS that did not exceed what might be seen due to chance alone. Eight class IV evidence articles could not inform conclusions. We concluded that evidence based analysis of the epidemiologic literature does not permit concluding that a single instance of head trauma is a risk factor for, or causes, ALS (Level U conclusion).
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Studies with higher class of evidence (based on medical records rather than patients' recall) showed no excess of head trauma prior to symptom onset.
“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, 2012).”
From Prevalence of potential sports‐associated risk factors in Swiss amyotrophic lateral sclerosis patients (2017) · cites this paper as Armon & Nelson, 2012
Cites
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Head Injury and Amyotrophic Lateral Sclerosis
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ALS in Italian professional soccer players: The risk is still present and could be soccer-specific
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Association of ALS with head injury, cigarette smoking and APOE genotypes
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Severe head injury and amyotrophic lateral sclerosis
Peters, T. L., Fang, F., Weibull, C. E., Sandler, D. P., Kamel, F., & Ye, W. (2013) · Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration · doi:10.3109/21678421.2012.754043 · Cited by 45 · see citing works
Head injury does not alter disease progression or neuropathologic outcomes in ALS
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“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, 2012).”
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Impact of traumatic brain injury on amyotrophic lateral sclerosis: from bedside to bench
Franz, C. K., Joshi, D., Daley, E. L., Grant, R. A., Dalamagkas, K., Leung, A., Finan, J. D., & Kiskinis, E. (2019) · Journal of Neurophysiology · doi:10.1152/jn.00572.2018 · Cited by 26 · see citing works
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Hawas, Y., Abdelmageed, A., Messak, M., Ziada, A., Gamal, M., Ghanem, T. I. E., Abdelwahab, M. M., Meshref, M., & Kashbour, M. O. (2026) · Neuroepidemiology · doi:10.1159/ned/adwag050
- Authors
- Armon, C., & Nelson, L. M.
- Affiliations
- Tufts University (US)
- Stanford Medicine (US)
- Corresponding author
- Armon, Carmel
- Venue
- Amyotrophic Lateral Sclerosis
- Publisher
- Informa UK Limited
- Published
- 2012-03-16
- Volume
- 13
- Issue
- 4
- Pages
- 351-356
- ISSN
- 1471-180X (ISSN-L)
- 1748-2968
- OpenAlex
- W1971748774
- Cited by
- 52
- References
- 6
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 2 · 2023: 2 · 2022: 2 · 2021: 3 · 2020: 1 · 2019: 3 · 2018: 4 · 2017: 8 · 2016: 5 · 2015: 8 · 2014: 4 · 2013: 6 · 2012: 1
- FWCI
- 0.85
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Amyotrophic Lateral Sclerosis (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Neurology › Amyotrophic Lateral Sclerosis Research
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Health Sciences › Medicine › Pathology and Forensic Medicine › Spinal Cord Injury Research
- Keywords
- head trauma, traumatic brain injury, risk factors, motor neuron disease, causality, classification of evidence
- MeSH terms
- Amyotrophic Lateral Sclerosis, Craniocerebral Trauma, Humans, Risk Factors, Causality
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