Meta-analytic evaluation of the association between head injury and risk of amyotrophic lateral sclerosis

被引:23
作者
Watanabe, Yukari [1 ,2 ]
Watanabe, Takamitsu [3 ]
机构
[1] Queen Mary Univ London, Blizard Inst, 4 Newark St, London E1 2AT, England
[2] Univ Tokyo, Grad Sch Med, Dept Orthopaed Surg, Bunkyo Ku, 7-3-1 Hongo, Tokyo 1130033, Japan
[3] UCL, Inst Cognit Neurosci, 17 Queen Sq, London WC1N 3AZ, England
关键词
Amyotrophic lateral sclerosis; Motor neuron disease; Head trauma; Reverse causation; MOTOR-NEURON DISEASE; PHYSICAL-ACTIVITY; MULTIPLE-SCLEROSIS; PARKINSON DISEASE; BRAIN-INJURY; TRAUMA; ALS; EPIDEMIOLOGY; FOOTBALL; PROGRESSION;
D O I
10.1007/s10654-017-0327-y
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Head injury is considered as a potential risk factor for amyotrophic lateral sclerosis (ALS). However, several recent studies have suggested that head injury is not a cause, but a consequence of latent ALS. We aimed to evaluate such a possibility of reverse causation with meta-analyses considering time lags between the incidence of head injuries and the occurrence of ALS. We searched Medline and Web of Science for case-control, cross-sectional, or cohort studies that quantitatively investigated the head-injury-related risk of ALS and were published until 1 December 2016. After selecting appropriate publications based on PRISMA statement, we performed random-effects meta-analyses to calculate odds ratios (ORs) and 95% confidence intervals (CI). Sixteen of 825 studies fulfilled the eligibility criteria. The association between head injuries and ALS was statistically significant when the meta-analysis included all the 16 studies (OR 1.45, 95% CI 1.21-1.74). However, in the meta-analyses considering the time lags between the experience of head injuries and diagnosis of ALS, the association was weaker (OR 1.21, 95% CI 1.01-1.46, time lag ae 1 year) or not significant (e.g. OR 1.16, 95% CI 0.84-1.59, time lag ae 3 years). Although it did not deny associations between head injuries and ALS, the current study suggests a possibility that such a head-injury-oriented risk of ALS has been somewhat overestimated. For more accurate evaluation, it would be necessary to conduct more epidemiological studies that consider the time lags between the occurrence of head injuries and the diagnosis of ALS.
引用
收藏
页码:867 / 879
页数:13
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