Concussion Increase Risk MS

DOES CONCUSSION INCREASE THE RISK OF MS?

Last week we saw the media pick up on a study just published about a potential link between head injuries and the risk of developing MS.

Previous studies have looked for any potential connection between head injury and the risk of later developing MS. Some of these studies have found evidence for a link, but others found no connection. A combined analysis of the data from several good quality studies ultimately concluded that there was no strong evidence that head injuries increased the risk of MS.

Now a Swedish group have used the data from the Swedish MS Registry which has been collecting data on every person with a diagnosis of MS in Sweden since 1964, to try to provide a clearer answer on this topic.

Their research suggests a connection between concussion in adolescence and later risk of developing MS. However, one of the most important things to note from this study, is that 97% of people with MS had no history of concussions. This means that it is likely to be a contributing factor only in a very small portion of MS cases, and for most people, other environmental and genetic risk factors reviewed here are likely to have a stronger influence.

In this study, [published in the journal Annals of Neurology researchers looked at the medical records of 7292 people with MS and 72920 people without MS. They looked at how many in the MS group had had a previous diagnosis of concussion compared to those in the non-MS group and at what age did the concussion occur. To rule out the possibility that any physical general trauma might lead to MS they also compared broken limb bones between the groups.

There was no connection between either concussion or a broken limb sustained in childhood (age o to 10 years) and a later diagnosis of MS. However, when they looked at concussions that occurred during adolescence (ages 11-20 years) they found a small but statistically significant increase in the risk of later developing MS. The increased risk was only modest for one episode of concussion, but was much clearer for two or more episodes of concussion.

The researchers acknowledged that an underlying, un-diagnosed MS could have increased the risk of a person having a traumatic injury, for example through an effect on mobility, coordination and balance – a phenomenon known in science as ‘reverse causation. However, because there was no association between broken limb bones and a later diagnosis of MS, they conclude that this could not the case.

A strength of this study was that it used hospital records rather than relying on people’s recollections of past trauma and injury. However, as the number of people having two or more concussions in the study was a relatively rare event it makes the interpretation of the statistical analysis challenging.

The authors of the study discuss a number of reasons how severe head injuries may increase the risk of developing MS. This includes damage to the nervous tissue itself which may lead to an inappropriate immune response, as well as the possibility that the head trauma sets off a state of inflammation in the brain that predisposes the person to MS.

While the proportion of people with MS in this study who have a clear history of a severe head injury is very small, the researchers do suggest that the study provides further impetus to protect adolescents from head injuries in sports and other physical activities. However, preventing MS will require a much broader approach to tackle the other known risk factors that are more strongly connected to MS (read more about these here). Article courtesy of MS Research Australia www.msra.org.au

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Julia Howell

Trustee

Julia is a qualified nurse and midwife, with a varied career including specialising in eating disorders, primary healthcare, and management.    

Julia, in partnership with a GP, set up an outpatient clinical trials unit (Southern Clinical Trials). Under her leadership this grew into a network of 6 sites across NZ. This network merged with another one in 2021 to form PCRN, NZ’s largest clinical trials network. Julia is currently working as joint COO for PCRN.

Julia’s daughter was diagnosed with MS aged 14 and she has been intimately involved with her management over the years.

 

Jan Campbell

Trustee

Born in Ōtautahi Jan trained as a nurse in Christchurch, as a midwife in Winchester, UK and has a degree in philosophy with particular interest in healthcare and business ethics.

After working in the public health system in the UK and NZ, Jan joined Roche Pharmaceuticals based in Auckland in 1999. As a respected senior leader and Medical Director, she established a medical division over the ensuing 20 years responsible for significant investment in clinical trials in NZ, developing a top-class global medicine information service, compassionate medicine supply for kiwis in need, pharmacovigilance oversight and a team working closely with patients, specialists, MEDSAFE and PHARMAC to support the safe and appropriate use of Roche medicines.

As a retiree Jan has volunteered for Mercy Hospice in Auckland and the WBoP Museum in Katikati. Now living in Ōtepoti, Jan sits on both the MS Research Trust and MSNZ executive committees with a keen interest to ensure people with MS get a fair go in NZ.

Dr Elza Cloete

Trustee

Elza is a Neonatal Paediatrician at Christchurch Women’s Hospital. Originally from South Africa, she moved to New Zealand in 2006 and completed her specialist training in Auckland.

Subsequent to that she embarked on doctoral studies at the University of Auckland’s Liggins Institute and obtained a PhD investigating congenital heart disease in new-born babies.

Elza received the Vice-Chancellor’s award for best doctoral thesis for her research and is the author of several research publications. She moved to Christchurch in 2020 for a work opportunity in clinical practice.

Elza was diagnosed with MS in 2012 and brings a consumer perspective and research experience to the Trust.

Dr Ernie Willoughby

Trustee

Dr Willoughby has been a consultant neurologist at Auckland City Hospital (1979 to 2021 – now retired, emeritus) and clinical associate professor at Auckland University School of Medicine.

He directed the MS clinic at Auckland Hospital, has had a long association with the Auckland and NZ MS Societies, and is a member of the International Medical and Scientific Board of the MS International Federation.

Dr Brian Linehan

Independent Trustee

Dr Brian Linehan is a retired pathologist who was previously Managing Director of Medlab Hamilton.

He is currently Chairman of the Tranmere group of investment companies and a Director of a number of other private companies. In 2014, he retired after 12 years on the Council of the University of Waikato where he was Pro-Chancellor.

He is a past Chairman of the New Zealand Medical Association, past Chairman of NZMA Ethics Committee, past President and Chairman of CMAAO (Combined Medical Associations of Asia and Oceania) and past Chairman of IANZ (International Accreditation NZ).

Brian was diagnosed with MS in 2007 but is still active and mobile.

Peter Wood - JP, BCom, AGNZ, ACIS, FNZTA

Treasurer

Peter gained his commerce degree at Victoria University of Wellington and has been practising as a Chartered Accountant initially in Wellington and then in Tauranga.

Peter was a respected and trusted advisor to many businesspeople.
He is now resident in Auckland and consultants to a limited number business clients.

He has also served his community through involvement with Jaycees, Lions and Rotary clubs and a number of charitable trusts.

Peter is currently the Treasurer of Multiple Sclerosis Auckland and a trustee of the Multiple Sclerosis Auckland Trust. Peter is a Justice of the Peace and a member Governance New Zealand and is a Fellow of the NZ Trustees’ Association.

Neil Woodhams

Trustee

Neil is an independent health management consultant who has had an extensive career in health management as a senior manager or consultant to government, DHBs, primary care and community providers. 

Neil is President of MS New Zealand and a trustee of the MS Auckland Region Trust. Neil was also President of MS Auckland until he stepped down from this role mid-2020 to concentrate on his national roles.

Neil’s wife was diagnosed with MS in 1994. One of his four sons was also diagnosed in 2010.

Neil strongly believes in the objectives of the NZ Multiple Sclerosis Research Trust and has advocated for the establishment of the Trust for over 10 years.

Sir William Gallagher

Trustee

Sir William is renowned as a motivational, pragmatic and hands-on businessman in and outside of New Zealand and has a reputation both as a dynamic leader and one of NZ’s most astute businessmen.

Still very involved in the daily operation, he maintains regular contact with customers in the 130 countries in which Gallagher products are sold spending up to 150 days a year on the road representing the company and its philosophies and emphasising the ethics and integrity of his professional and personal dealings.

His achievements have been officially recognised by a string of awards, the latest to mark his commitment to enterprise and leadership skills being his Knighthood in the 2010 New Year’s Honours List. He was also the 1996 winner of the prestigious Excellence in Communication Leadership award, the first time in its history that it had been awarded outside of North America. He also received an MBE in 1987 followed by a Companion of the New Zealand Order of Merit (CNZM) in 1998.

Sir William Gallagher - KNZM, MBE. HonD

Patron

Sir William is renowned as a motivational, pragmatic and hands-on businessman in and outside of New Zealand and has a reputation both as a dynamic leader and one of NZ’s most astute businessmen.

Still very involved in the daily operation, he maintains regular contact with customers in the 130 countries in which Gallagher products are sold spending up to 150 days a year on the road representing the company and its philosophies and emphasising the ethics and integrity of his professional and personal dealings.

His achievements have been officially recognised by a string of awards, the latest to mark his commitment to enterprise and leadership skills being his Knighthood in the 2010 New Year’s Honours List. He was also the 1996 winner of the prestigious Excellence in Communication Leadership award, the first time in its history that it had been awarded outside of North America. He also received an MBE in 1987 followed by a Companion of the New Zealand Order of Merit (CNZM) in 1998.