Head injuries and Parkinson's disease in a case-control study

• Published in: Occupational and environmental medicine (London, England) Vol. 70; no. 12; pp. 839 - 844
• Main Authors: Harris, M Anne, Shen, Hui, Marion, Stephen A, Tsui, Joseph K C, Teschke, Kay
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd 01.12.2013; BMJ Publishing Group; BMJ Publishing Group LTD
• Subjects: Adult; Adult and adolescent clinical studies; Age; Aged; Antiparkinsonians; Automobile accidents; Biological and medical sciences; Brain concussion; British Columbia - epidemiology; Case control studies; Case studies; Concussion; Consciousness; Craniocerebral trauma; Craniocerebral Trauma - complications; Craniocerebral Trauma - epidemiology; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Disease risk; Family medical history; Female; Head; Head injuries; Humans; Hypotheses; Injuries; Injuries of the nervous system and the skull. Diseases due to physical agents; Interviews; Male; Medical sciences; Middle Aged; Motor vehicles; Nervous system (semeiology, syndromes); Nervous system as a whole; Neurology; Occupational health; Organic mental disorders. Neuropsychology; Parkinson disease; Parkinson Disease - epidemiology; Parkinson Disease - etiology; Parkinson's disease; Physical trauma; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Recall; Restless legs syndrome; Risk Factors; Studies; Traumas. Diseases due to physical agents; Unconsciousness; Workplace; British Columbia; Canada, British Columbia; Human; Nervous system diseases; Craniocerebral; Central nervous system disease; Parkinson disease; Degenerative disease; Case control study; Head trauma; Epidemiology; Public health; Cerebral disorder; Extrapyramidal syndrome
• ISSN: 1351-0711; 1470-7926
• DOI: 10.1136/oemed-2013-101444

Background Head injury is a hypothesised risk factor for Parkinson's disease, but there is a knowledge gap concerning the potential effect of injury circumstances (eg, work-related injuries) on risk. The objective of this study is to address this gap while addressing issues of recall bias and potential for reverse causation by prediagnosis symptoms. Methods We conducted a population based case-control study of Parkinson's disease in British Columbia, Canada (403 cases, 405 controls). Interviews queried injury history; whether injuries occurred at work, in a motor vehicle accident or during sports. Participants were also asked to report their suspicions about the causes of Parkinson's disease to provide an indicator of potential recall bias. Associations were estimated with logistic regression, adjusted for age, sex and smoking history. Results Associations were strongest for injuries involving concussion (OR: 2.08, 95% CI 1.30 to 3.33) and unconsciousness (OR: 2.64, 95% CI 1.39 to 5.03). Effects remained for injuries that occurred long before diagnosis and after adjustment for suspicion of head injury as a cause of Parkinson's disease. Injuries that occurred at work were consistently associated with stronger ORs, although small numbers meant that estimates were not statistically significant. Conclusions This study adds to the body of literature suggesting a link between head injury and Parkinson's disease and indicates further scrutiny of workplace incurred head injuries is warranted.