Sports and trauma as risk factors for Motor Neurone Disease: New Zealand case-control study

Grace Xia Chen; Jeroen Douwes; Leonard H van den Berg; Bill Glass; David McLean; Andrea Martine 't Mannetje

doi:10.1111/ane.13615

Sports and trauma as risk factors for Motor Neurone Disease: New Zealand case-control study

Acta Neurol Scand. 2022 Jun;145(6):770-785. doi: 10.1111/ane.13615. Epub 2022 Mar 31.

Authors

Grace Xia Chen¹, Jeroen Douwes, Leonard H van den Berg², Bill Glass, David McLean¹, Andrea Martine 't Mannetje

Affiliations

¹ Research Centre for Hauora and Health, Massey University, Wellington, New Zealand.
² Brain Centre Rudolf Magnus, Department of Neurology, University Medical Centre, Utrecht, The Netherlands.

Abstract

Objectives: To assess whether sports, physical trauma and emotional trauma are associated with motor neurone disease (MND) in a New Zealand case-control study (2013-2016).

Methods: In total, 321 MND cases and 605 population controls were interviewed collecting information on lifetime histories of playing sports, physical trauma (head injury with concussion, spine injury) and emotional trauma (14 categories). ORs were estimated using logistic regression adjusting for age, sex, ethnicity, socioeconomic status, education, smoking status, alcohol consumption and mutually adjusting for all other exposures.

Results: Head injury with concussion ≥3 years before diagnosis was associated with MND (OR 1.51, 95% CI: 1.09-2.09), with strongest associations for two (OR 4.01, 95% CI: 1.82-8.86), and three or more (OR 2.34, 95% CI: 1.00-5.45) head injuries. Spine injury was not associated with MND (OR 0.81, 95% CI: 0.48-1.36). Compared to never playing sports, engaging in sports throughout childhood and adulthood increased MND risk (OR 1.81, 95% CI: 1.01-3.25), as was more than 12 years playing football/soccer (OR 2.35, 95% CI: 1.19-4.65). Reporting emotionally traumatic events in more than three categories was associated with MND (OR 1.88, 95% CI: 1.17-3.03), with physical childhood abuse the only specific emotional trauma associated with MND (OR 1.82, 95% CI: 1.14-2.90), particularly for those reporting longer abuse duration (OR_{(5-8 years)} 2.26, 95% CI: 1.14-4.49; OR_{(>8 years)} 3.01, 95% CI: 1.18-7.70). For females, having witnessed another person being killed, seriously injured or assaulted also increased MND risk (OR 2.68, 95% CI: 1.06-6.76).

Conclusions: This study adds to the evidence that repeated head injury with concussion, playing sports in general, and playing football (soccer) in particular, are associated with an increased risk of MND. Emotional trauma, that is physical abuse in childhood, may also play a role.

Keywords: ALS; emotional trauma; head injury; neurodegenerative disorders; neuroepidemiology.

MeSH terms

Adult
Athletic Injuries* / complications
Athletic Injuries* / diagnosis
Athletic Injuries* / epidemiology
Brain Concussion*
Case-Control Studies
Child
Craniocerebral Trauma* / epidemiology
Craniocerebral Trauma* / etiology
Female
Humans
Motor Neuron Disease* / epidemiology
Motor Neuron Disease* / etiology
New Zealand / epidemiology
Risk Factors