Abstract Details

Title Physical Trauma and Risk of ALS: A Population-Based Study

Topic Anterior Horn

Presentation(s) P05 - (-)

Poster/Presentation
Number 072

Objective

Background BACKGROUND: Clinical observations and case-control studies have indicated that physical trauma could be a risk factor for ALS; however, many of these studies were small and relied on self-report of trauma history. We conducted the largest and most comprehensive registry-based study of trauma and ALS.

Design/Methods DESIGN/METHODS: Our study base is the entire population of Denmark from the years 1982 to 2009. From this population we selected all 3,650 incident ALS cases as documented in the Danish Hospital Registry, and a random sample of 100:1 age- and sex-matched controls from the Danish Central Person Registry. Trauma history from 1977 was assessed from the Danish National Hospital Registry, and each trauma was classified into one of six classes (open wounds, fractures, dislocations, nerve injuries, contusion and crushing, concussions). Prior trauma for each was considered dichotomously, both unlagged and lagged five years.

Results RESULTS: A history of any prior trauma was significantly associated with ALS (OR=1.31; 95% CI 1.00-1.26). On 5 yr-lagged analysis, however, a history of any prior trauma was not associated with ALS (OR=1.01; 95% CI 0.92-1.11). The effect of prior trauma is confined to the 365 days prior to ALS diagnosis. None of the specific traumas lagged five years showed any significant association with ALS risk, although dislocations were borderline associated (OR=1.14; 95% CI 0.97-1.34).

Conclusions CONCLUSIONS: This national nested case-control study is the largest study of hospital admission for trauma and risk of subsequent ALS. Results are consistent with earlier results from smaller studies suggesting that the observed increase in ALS risk in the year following a trauma is driven by either reverse causation or over-ascertainment. There is little evidence that history of hospital-diagnosed concussion elevates ALS risk. These results apply only to trauma resulting in hospitalization.

Authors/Disclosures
Ryan M. Seals (Harvard School of Public Health) PRESENTER	No disclosure on file
Johnni Hansen, PhD (Danish Cancer Society Research Center)	Dr. Hansen has nothing to disclose.
	No disclosure on file
Ole Gredal	No disclosure on file
Marc Weisskopf, PhD (Harvard TH Chan School of Public Health)	Prof. Weisskopf has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Kaiser Permanente Research Biobank. The institution of Prof. Weisskopf has received research support from ALS Network. The institution of Prof. Weisskopf has received research support from NIH. The institution of Prof. Weisskopf has received research support from Paralyzed Veterans of America. The institution of Prof. Weisskopf has received research support from CDC/ATSDR. The institution of Prof. Weisskopf has received research support from JPB Foundation.

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