Concussion in adolescence and the risk of multiple sclerosis: A retrospective cohort study

Mult Scler. 2021 Feb;27(2):180-187. doi: 10.1177/1352458520908037. Epub 2020 Feb 24.

Abstract

Background: Physical trauma, specifically concussions sustained during adolescence, has been hypothesized to be a risk factor for multiple sclerosis (MS).

Objective: To examine the association between adolescent concussions and future MS diagnosis.

Methods: 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.

Results: A concussion during adolescence was associated with a significantly increased risk of MS (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).

Conclusion: This study supports an association between concussions in adolescence and future MS diagnoses, highlighting the potentially serious long-term effects of concussions.

Keywords: Multiple sclerosis; concussion; prevalence; risk factor.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Brain Concussion* / epidemiology
  • Female
  • Humans
  • Male
  • Multiple Sclerosis* / epidemiology
  • Ontario
  • Retrospective Studies
  • Risk Factors