All authors in the EURALS Consortium are given in the Appendix.
Trauma and amyotrophic lateral sclerosis: a case–control study from a population-based registry
Article first published online: 27 APR 2012
© 2012 The Author(s) European Journal of Neurology © 2012 EFNS
European Journal of Neurology
Volume 19, Issue 12, pages 1509–1517, December 2012
How to Cite
Pupillo, E., Messina, P., Logroscino, G., Zoccolella, S., Chiò, A., Calvo, A., Corbo, M., Lunetta, C., Micheli, A., Millul, A., Vitelli, E., Beghi, E. and EURALS Consortium (2012), Trauma and amyotrophic lateral sclerosis: a case–control study from a population-based registry. European Journal of Neurology, 19: 1509–1517. doi: 10.1111/j.1468-1331.2012.03723.x
- Issue published online: 17 NOV 2012
- Article first published online: 27 APR 2012
- Manuscript Accepted: 13 MAR 2012
- Manuscript Received: 4 JAN 2012
- American ALS Association (ALSA. Grant Number: 526D/8
- Istituto Superiore di Sanità. Grant Numbers: 1524, 526D/8
- amyotrophic lateral sclerosis;
- risk factors;
Background and purpose
Published reports on the association between amyotrophic lateral sclerosis (ALS) and trauma are controversial suggesting the need for a new case–control study done in a large population.
A case–control study was undertaken in Italy to assess this association. Cases were patients with newly diagnosed ALS from four population-based registries. For each case, two hospital controls were selected, matched for age, sex, and province of residence, one with a neurological (non-degenerative) disease and one with a non-neurological disease (other than orthopedic or surgical). Traumatic events (defined as accidental events causing injuries requiring medical care) were recorded with details on type, site, timing, severity, and complications. The risks were assessed as odds ratios (ORs) with 95% confidence intervals (CI), crude and adjusted for age, sex, education, interviewee (patient or surrogate), physical activity, smoking, alcohol, and coffee.
The study population comprised 377 patients in each of the three groups. One or more traumatic events were reported by 225 cases (59.7%), 191 neurological controls (50.7%), and 179 non-neurological controls (47.5%) (P < 0.01) (OR 1.63; 95% CI 1.25–2.14) (P < 0.01). The ORs were 3.07 (95% CI 1.86–5.05) for patients reporting 3+ traumatic events and 2.44 (95% CI 1.36–4.40) for severe traumatic events. The ORs remained significant when the analysis was limited to events that occurred 5+ and 10+ years before ALS onset, to incident ALS, and direct informant.
Antecedent trauma, repeated trauma, and severe trauma may be risk factors for ALS.