Concussions Contribute To Neurodegenerative Disorders
By Nicholas Bakalar, New York Times
A traumatic brain injury, even a mild concussion, increases the risk for Parkinson’s disease, a new study reports.
Researchers identified all patients diagnosed with T.B.I. in a Veterans Health Administration database — 162,935 men and women — and matched them with the same number of people with similar health and behavioral characteristics but who had not had a brain injury. The study is in Neurology.
Of the T.B.I. cases, half were mild, involving a blow to the head with some subsequent symptoms but with little or no unconsciousness. The rest were moderate to severe, involving extended unconsciousness or long-term symptoms.
After controlling for age, race, income and many medical and psychiatric diseases, they found that compared with those who had had no T.B.I., those with a mild T.B.I. had a 56 percent increased risk for Parkinson’s disease; those with moderate to severe T.B.I. had an 83 percent increased risk.
“We don’t have brain autopsies, so we don’t know what the underlying biology is,” said the lead author, Dr. Raquel C. Gardner, an assistant professor of neurology at the University of California, San Francisco. “But in Parkinson’s you see abnormal protein accumulation, and there’s some evidence that T.B.I. is linked to deposits of these abnormal proteins. This study provides the most definitive evidence that there is this association.”
Read The Full Article About TBI and Neurological Disorders.
The new findings could be problematic for the increasingly-embattled NFL, which has spent years – and billions of dollars – trying to dismiss the idea that tackle football is not as dangerous to players as scientists claim. The findings come amid a huge swell in research showing that attempts to curb the rate of concussions may not be enough: even subconcussive hits, or just one debilitating hit, could sew the seeds for crippling neurodegenerative diseases including CTE, Alzheimer’s and Parkinson’s.
“Previous research has shown a strong link between moderate to severe traumatic brain injury and an increased risk of developing Parkinson’s disease but the research on mild traumatic brain injury has not been conclusive, said Senior study author Professor Kristine Yaffe, of the University of California, San Francisco. “Our research looked at a very large population of U.S. veterans who had experienced either mild, moderate or severe traumatic brain injury in an effort to find an answer to whether a mild traumatic brain injury can put someone at risk.”
Moderate to severe traumatic brain injury was defined as a loss of consciousness for more than 30 minutes, alteration of consciousness of more than 24 hours or amnesia for more than 24 hours.
Mild traumatic brain injury was defined as loss of consciousness for zero to 30 minutes, alteration of consciousness of a moment to 24 hours or amnesia for zero to 24 hours.
The researchers identified 325,870 veterans from three US Veterans Health Administration medical databases. Half of the study participants had been diagnosed with either a mild, moderate or severe traumatic brain injury and half had not.
The study participants, who ranged in age from 31 to 65, were followed for an average of 4.6 years. At the start of the study, none had Parkinson’s disease or dementia. All traumatic brain injuries were diagnosed by a physician.
A total of 1,462 of the participants were diagnosed with Parkinson’s disease at least one year and up to 12 years after the start of the study. The average time to diagnosis was 4.6 years.
A total of 949 of the participants with traumatic brain injury (0.58 percent) developed Parkinson’s disease, compared to 513 of the participants with no traumatic brain injury (0.31 percent).
A total of 360 out of 76,297 with mild traumatic brain injury (0.47 percent) developed the disease and 543 out of 72,592 with moderate to severe traumatic brain injury (0.75 percent) developed the disease.
After researchers adjusted for age, sex, race, education and other health conditions such as diabetes and high blood pressure, they found that:
- Those with any kind of traumatic brain injury had a 71 percent increased risk of Parkinson’s disease;
- Those with moderate to severe traumatic brain injury had an 83 percent increased risk, and those with mild traumatic brain injury had a 56 percent increased risk of Parkinson’s; and
- Researchers found that those with any form of traumatic brain injury were diagnosed with Parkinson’s disease an average of two years earlier than those without traumatic brain injury.
“This study highlights the importance of concussion prevention, long-term follow-up of those with concussion, and the need for future studies to investigate if there are other risk factors for Parkinson’s disease that can be modified after someone has a concussion,” said study lead author Assistant Professor Raquel Gardner, also of the University of California, San Francisco. “While our study looked at veterans, we believe the results may have important implications for athletes and the general public as well.”
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