Trauma and amyotrophic lateral sclerosis: a european population-based case-control study from the EURALS consortium

EURALS Consortium†

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)118-125
Number of pages8
JournalAmyotrophic Lateral Sclerosis and Frontotemporal Degeneration
Volume19
Issue number1-2
DOIs
Publication statusPublished - Feb 2018

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Amyotrophic Lateral Sclerosis
Case-Control Studies
Wounds and Injuries
Population
Logistic Models
Odds Ratio
Confidence Intervals
Serbia
Craniocerebral Trauma
Ireland
Italy
France
Head
Demography

Keywords

  • Adult
  • Age Factors
  • Aged
  • Amyotrophic Lateral Sclerosis/complications
  • Case-Control Studies
  • Craniocerebral Trauma/complications
  • Ethnic Groups
  • Female
  • France
  • Humans
  • Ireland
  • Italy
  • Logistic Models
  • Male
  • Middle Aged
  • Odds Ratio
  • Risk Factors
  • Serbia
  • United Kingdom

Cite this

Trauma and amyotrophic lateral sclerosis : a european population-based case-control study from the EURALS consortium. / EURALS Consortium†.

In: Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration, Vol. 19, No. 1-2, 02.2018, p. 118-125.

Research output: Contribution to journalArticle

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title = "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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author = "{EURALS Consortium†} and Elisabetta Pupillo and Marco Poloni and Elisa Bianchi and Giorgia Giussani and Giancarlo Logroscino and Stefano Zoccolella and Adriano Chi{\`o} and Andrea Calvo and Massimo Corbo and Christian Lunetta and Benoit Marin and Douglas Mitchell and Orla Hardiman and James Rooney and Zorica Stevic and {Bandettini di Poggio}, Monica and Massimiliano Filosto and Cotelli, {Maria Sofia} and Michele Perini and Nilo Riva and Lucio Tremolizzo and Eugenio Vitelli and Danira Damiani and Ettore Beghi",
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T2 - a european population-based case-control study from the EURALS consortium

AU - EURALS Consortium†

AU - Pupillo, Elisabetta

AU - Poloni, Marco

AU - Bianchi, Elisa

AU - Giussani, Giorgia

AU - Logroscino, Giancarlo

AU - Zoccolella, Stefano

AU - Chiò, Adriano

AU - Calvo, Andrea

AU - Corbo, Massimo

AU - Lunetta, Christian

AU - Marin, Benoit

AU - Mitchell, Douglas

AU - Hardiman, Orla

AU - Rooney, James

AU - Stevic, Zorica

AU - Bandettini di Poggio, Monica

AU - Filosto, Massimiliano

AU - Cotelli, Maria Sofia

AU - Perini, Michele

AU - Riva, Nilo

AU - Tremolizzo, Lucio

AU - Vitelli, Eugenio

AU - Damiani, Danira

AU - Beghi, Ettore

PY - 2018/2

Y1 - 2018/2

N2 - 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.

AB - 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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KW - Aged

KW - Amyotrophic Lateral Sclerosis/complications

KW - Case-Control Studies

KW - Craniocerebral Trauma/complications

KW - Ethnic Groups

KW - Female

KW - France

KW - Humans

KW - Ireland

KW - Italy

KW - Logistic Models

KW - Male

KW - Middle Aged

KW - Odds Ratio

KW - Risk Factors

KW - Serbia

KW - United Kingdom

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DO - 10.1080/21678421.2017.1386687

M3 - Article

C2 - 29063790

VL - 19

SP - 118

EP - 125

JO - Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration

JF - Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration

SN - 2167-8421

IS - 1-2

ER -