Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden.
Amyotroph Lateral Scler Frontotemporal Degener. 2013 May;14(4):267-72. doi: 10.3109/21678421.2012.754043. Epub 2013 Jan 4.
Our objective was to examine whether severe head injury, subtypes of head injury, or repeated head injuries are associated with ALS risk based on the Swedish population and health registers. We conducted a case-control study, nested within a cohort of 5,764,522 individuals who were born in Sweden during 1901-1970 and followed between 1991 and 2007. The study included 4004 ALS patients identified from the Swedish Patient Register during follow-up and 20,020 randomly selected controls matched by gender and birth year. We evaluated hospitalization for severe head injury that was recorded in the inpatient register before ALS diagnosis. Conditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Results showed that there was an association of ALS risk with severe head injury ≤ 1 year before diagnosis (OR: 3.9, 95% CI 2.6-6.1). No association was observed for severe head injury > 3 years before ALS diagnosis, nor was ALS associated with subtypes of head injury or repeated injuries occurring > 3 years before diagnosis. In conclusion, our findings from the Swedish registers provide no strong support for an etiological relationship between severe head injury in adulthood and ALS risk.
我们的目的是基于瑞典人群和健康登记，检验严重头部损伤、头部损伤亚型或反复头部损伤是否与 ALS 风险相关。我们进行了一项病例对照研究，嵌套在一个由 5764522 名出生于 1901-1970 年、1991-2007 年随访的队列内。该研究包括在随访期间从瑞典患者登记处确定的 4004 名 ALS 患者和 20020 名性别和出生年份匹配的随机选择对照。我们评估了在 ALS 诊断前住院记录中记录的严重头部损伤。使用条件逻辑回归估计比值比 (OR) 和 95%置信区间 (CI)。结果表明，ALS 风险与诊断前≤1 年的严重头部损伤有关 (OR: 3.9, 95%CI 2.6-6.1)。在 ALS 诊断前>3 年的严重头部损伤或头部损伤亚型或重复损伤与 ALS 无关，也没有观察到与 ALS 有关。总之，我们从瑞典登记处获得的发现并不能强有力地支持成人严重头部损伤与 ALS 风险之间的病因关系。
