Concussion in adolescence and the risk of multiple sclerosis: a retrospective cohort study.
Povolo CA, Reid JN, Shariff SZ, Welk B, Morrow SA.
Mult Scler 2020 (Epub ahead of print).
Physical trauma, specifically concussions sustained during adolescence, has been hypothesized to be a risk factor for multiple sclerosis (MS).
To examine the association between adolescent concussions and future MS diagnosis.
This retrospective study using linked administrative databases from Ontario, Canada, identified 97,965 adolescents (age 11-18 years) who sustained ⩾1 concussion and presented to an emergency department between 1992 and 2011. Cases were matched 1:3 with individuals who had not sustained a concussion based on age, sex, address, and index date. The primary outcome was MS diagnosis, using a validated MS diagnosis definition: ⩾1 hospitalization or ⩾5 physician billings within 2 years.
A concussion during adolescence was associated with a significantly increased risk of multiple sclerosis (hazard ratio (HR) = 1.29, p = 0.03). Sex-specific analysis revealed that only males who sustained a concussion in adolescence had a raised risk of MS (HR = 1.41, p = 0.04).
This study supports an association between concussions in adolescence and future MS diagnoses, highlighting the potentially serious long-term effects of concussions.