Having several concussions as a teenager doubled the risk of Multiple Sclerosis – Sept 2017

Concussion in adolescence and risk of multiple sclerosis.

Ann Neurol. 2017 Sep 4. doi: 10.1002/ana.25036. [Epub ahead of print]
Montgomery S1,2,3, Hiyoshi A1, Burkill S2,4, Alfredsson L5,6, Bahmanyar S2,4, Olsson T7.

  • Based on 80,000 Swedish teens who visited a hospital for a concussion
  • Less risk of MS if only a single concussion or younger than a teenager

Some details of study are at:
Concussions in Teenagers Tied to Multiple Sclerosis Risk NYT Oct 2017

VitaminDWiki

Possible reasons include:
1) Great drop in Glutamate following a concussion
2) Great drop in Vitamin D following a trauma
3) Increased risk of concussion if had low Omega-3%%%4) Increased risk of concussion due to slower muscle response associated with low vitamin D
5) Low Vitamin D independently associated with increased MS risk

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OBJECTIVE:
To assess whether concussion in childhood or adolescence is associated with subsequent multiple sclerosis (MS) risk. Previous research suggests an association, but methodological limitations included retrospective data collection and small study populations.

METHODS:
The national Swedish Patient Register (hospital diagnoses) and MS Register were used to identify all MS diagnoses up to 2012 among people born since 1964, when the Patient Register was established. The 7,292 patients with MS were matched individually with 10 people without MS by sex, year of birth, age/vital status at MS diagnosis, and region of residence (county), resulting in a study population of 80,212. Diagnoses of concussion and control diagnoses of broken limb bones were identified using the Patient Register from birth to age 10 years or from age 11 to 20 years. Conditional logistic regression was used to examine associations with MS.

RESULTS:
Concussion in adolescence was associated with a raised risk of MS, producing adjusted odds ratios (95% confidence intervals) of 1.22 (1.05-1.42, p = 0.008) and 2.33 (1.35-4.04, p = 0.002) for 1 diagnosis of concussion and >1 diagnosis of concussion, respectively, compared with none. No notable association with MS was observed for concussion in childhood, or broken limb bones in childhood and adolescence.

INTERPRETATION:
Head trauma in adolescence, particularly if repeated, is associated with a raised risk of future MS, possibly due to initiation of an autoimmune process in the central nervous system. This further emphasizes the importance of protecting young people from head injuries.

PMID: 28869671 DOI: 10.1002/ana.25036

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