Concussion in adolescence and the risk of developing multiple sclerosis
ECTRIMS Online Library. Povolo C. 09/11/19; 278757; P396
Christopher A. Povolo
Christopher A. Povolo

Abstract: P396

Type: Poster Sessions

Abstract Category: Clinical aspects of MS - Epidemiology

C.A. Povolo1, J.N. Reid2, S.Z. Shariff2, B. Welk2, S.A. Morrow1

1Clinical Neurological Sciences, London Health Sciences Centre, 2Institute for Clinical Evaluative Sciences, London, ON, Canada

Introduction: Multiple Sclerosis (MS) is an inflammatory disease of the central nervous system where both genetic and environmental factors confer risk. Physical trauma has been investigated as a risk factor for MS. Previous research suggested that concussions sustained in adolescence may be causally linked to MS.
Objective and Aim: To delineate if there is an association between adolescent (age 11-18 years) concussions and future MS diagnosis.
Methods: This retrospective study, using linked administrative databases (from Ontario, Canada), identified 97,965 adolescents who sustained ≥ 1 concussion and presented to an emergency department between 1992-2011. These cases were matched 1:3 with individuals who had not sustained a concussion based on age, sex, address, and index date. The primary outcome (MS diagnosis) was based on a validated MS diagnosis definition of ≥ 1 hospitalization or ≥ 5 physician billings within 2 years.
Results: In the stratified cox regression analysis, we found no significant increased risk of MS after < 15 years of follow-up among those who sustained a concussion; however, in those with ≥ 15 years of follow-up, a concussion during adolescence was associated with a significantly increased risk of MS (HR = 1.85, p = 0.005). Sex-specific analysis revealed that only males who sustained a concussion in adolescence had a raised risk of MS (HR = 1.58, p = 0.02) ≥ 8 years of follow-up. In our sensitivity analysis, utilizing a more sensitive definition for diagnosing MS (≥ 3 hospital or physician claims using all available years of data), there was an increased risk of MS (HR = 1.37, p = 0.008) in those with ≥ 8 years of follow-up since suffering a concussion.
Conclusions: This study supports an association between concussions in adolescence and future MS diagnoses, highlighting the potentially serious long-term effects of concussions.
Disclosure: Funding: This study was funded by an independent Investigator Initiated Trial (IIT) grant from Roche Canada.
Conflict of interest:
Christopher A. Povolo: nothing to disclose
Jennifer N. Reid: nothing to disclose
Salimah Z. Shariff: nothing to disclose
Blayne Welk: nothing to disclose
Sarah A. Morrow has,in the past 3 years, served on advisory boards for Biogen Idec, EMD Serono, Genzyme Canada, Novartis, Roche; has received Investigator Initiated Grant Funds from Biogen Idec, Novartis, Roche; has acted as site PI for multi-center trials funded by Novartis, Genzyme, Roche, and AbbVie.

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