Supplementary Files
Keywords
Demyelinating Diseases
Multiple Sclerosis
Meta-Analysis
How to Cite
Abstract
Background
Although several observational studies investigated the relationship between physical trauma and demyelinating diseases, the relationship is still controversial in the literature. Thus, we decided to conduct a systematic review and meta-analysis to investigate this relationship.
Methods
On the 22nd of June 2023, PubMed, Scopus, Web of Sciences, and CENTRAL were searched using terms about demyelinating diseases and physical trauma. Studies were included if they investigated the association between physical trauma and the development of a demyelinating disease.
Results
The total number of the included participants was 2,411,312 from 57 articles. The analysis showed that physical trauma was significantly associated with higher odds of demyelinating disease development (OR=2.51; 95%CI: 1.87-3.37). In addition, both childhood and premorbid traumas were significantly associated with increased risk of demyelinating diseases (OR=2.97; 95%CI: 2.64-3.35, OR=3.51; 95%CI: 2.97-4.14). Fractures (OR=3.17; 95%CI: 2.85-3.52), head (OR=3.61; 95%CI: 2.84-4.59), and spinal traumas (OR=9.06; 95%CI: 1.21-68.01) were significantly associated with increased risk of demyelinating diseases as well.
Conclusion
In conclusion, we found a significant association between physical trauma and the risk of developing demyelinating diseases. However, several gaps in the literature should be addressed by future studies including the low number of studies investigating demyelinating diseases other than MS.
References
Haagsma, J.A., et al., The global burden of injury: incidence, mortality, disability-adjusted life years and time trends from the Global Burden of Disease study 2013. Inj Prev, 2016. 22(1): p. 3-18.
Murray, C.J.L., et al., The Global burden of disease : a comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020 : summary / edited by Christopher J. L. Murray, Alan D. Lopez. 1996, World Health Organization: Geneva.
World Health, O., The global burden of disease : 2004 update. 2008, World Health Organization: Geneva.
Injuries, W.H.O. and V.P. Department, The injury chart book: a graphical overview of the global burden of injuries. 2002: World Health Organization.
World Health, O., Global health risks : mortality and burden of disease attributable to selected major risks. 2009, World Health Organization: Geneva.
Sauaia, A., et al., Temporal trends of postinjury multiple-organ failure: still resource intensive, morbid, and lethal. J Trauma Acute Care Surg, 2014. 76(3): p. 582-92, discussion 592-3.
Delic, V., et al., Biological links between traumatic brain injury and Parkinson’s disease. Acta Neuropathologica Communications, 2020. 8(1): p. 45.
Charles, E., et al., [Links between life events, traumatism and dementia; an open study including 565 patients with dementia]. Encephale, 2006. 32(5 Pt 1): p. 746-52.
Eid, K., et al., Association of adverse childhood experiences with the development of multiple sclerosis. 2022. 93(6): p. 645-650.
Love, S., Demyelinating diseases. J Clin Pathol, 2006. 59(11): p. 1151-9.
Walton, C., et al., Rising prevalence of multiple sclerosis worldwide: Insights from the Atlas of MS, third edition. Mult Scler, 2020. 26(14): p. 1816-1821.
Pandit, L. and S. Mustafa, Epidemiology and clinical features of demyelinating disorders in India. Neurology and Clinical Neuroscience, 2021. 9(4): p. 266-273.
Duncan, M., et al., Psychosocial impact of paediatric demyelinating disorders: a scoping review. Developmental Medicine & Child Neurology, 2020. 62(11): p. 1250-1258.
Lunny, C.A., S.N. Fraser, and J.A. Knopp-Sihota, Physical trauma and risk of multiple sclerosis: A systematic review and meta-analysis of observational studies. Journal of the Neurological Sciences, 2014. 336(1): p. 13-23.
Kurland, L.T., Trauma and multiple sclerosis. Ann Neurol, 1994. 36 Suppl: p. S33-7.
Spitzer, C., et al., Childhood Trauma in Multiple Sclerosis: A Case-Control Study. 2012. 74(3): p. 312-318.
Page, M.J., et al., The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. 2021. 372: p. n71.
Brooke, B.S., T.A. Schwartz, and T.M. Pawlik, MOOSE Reporting Guidelines for Meta-analyses of Observational Studies. JAMA Surgery, 2021. 156(8): p. 787-788.
Wells, G.A., et al., The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. 2000.
Alayande, B., et al., Disparities in Access to Trauma Care in Sub-Saharan Africa: a Narrative Review. Curr Trauma Rep, 2022. 8(3): p. 66-94.
Loretti, A., Armed conflicts, health and health services in Africa. An epidemiological framework of reference. Med Confl Surviv, 1997. 13(3): p. 219-28.
Hittle, M., et al., Population-Based Estimates for the Prevalence of Multiple Sclerosis in the United States by Race, Ethnicity, Age, Sex, and Geographic Region. JAMA Neurology, 2023. 80(7): p. 693-701.
Lew, H.L., et al., Review of sports-related concussion: Potential for application in military settings. J Rehabil Res Dev, 2007. 44(7): p. 963-74.
Savović, J., et al., Influence of reported study design characteristics on intervention effect estimates from randomized, controlled trials. Ann Intern Med, 2012. 157(6): p. 429-38.
Felitti, V.J., et al., Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study. Am J Prev Med, 1998. 14(4): p. 245-58.
Houtepen, L.C., et al., Associations of adverse childhood experiences with educational attainment and adolescent health and the role of family and socioeconomic factors: A prospective cohort study in the UK. PLoS Med, 2020. 17(3): p. e1003031.
Bjørnevik, K., et al., Level of education and multiple sclerosis risk after adjustment for known risk factors: The EnvIMS study. Mult Scler, 2016. 22(1): p. 104-11.
Hedström, A.K., et al., Factors affecting the risk of relapsing-onset and progressive-onset multiple sclerosis. J Neurol Neurosurg Psychiatry, 2021. 92(10): p. 1096-1102.
Horwitz, N.H., Lectures on the diseases of the nervous system. Jean Martin Charcot. Lectures on the localisation of cerebral and spinal diseases. Jean Martin Charcot. Neurosurgery, 1995. 37(5): p. 1022-5.
Goodin, D.S., et al., The relationship of MS to physical trauma and psychological stress: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology, 1999. 52(9): p. 1737-45.
Poser, C.M., Trauma to the central nervous system may result in formation or enlargement of multiple sclerosis plaques. Arch Neurol, 2000. 57(7): p. 1074-7, discussion 1078.
Heim, C., et al., The link between childhood trauma and depression: insights from HPA axis studies in humans. Psychoneuroendocrinology, 2008. 33(6): p. 693-710.
Karanikas, E., N.P. Daskalakis, and A. Agorastos, Oxidative Dysregulation in Early Life Stress and Posttraumatic Stress Disorder: A Comprehensive Review. Brain Sci, 2021. 11(6).
Baumeister, D., et al., Childhood trauma and adulthood inflammation: a meta-analysis of peripheral C-reactive protein, interleukin-6 and tumour necrosis factor-α. Mol Psychiatry, 2016. 21(5): p. 642-9.
McDonald, I., et al., The clinical feature and diagnosis of multiple sclerosis, in McAlpine's multiple sclerosis. 1991, Churchill Livingstone, Edinburgh. p. 287-346.
Wan, A., et al., Childhood Maltreatment and Psychiatric Comorbidity in Immune-Mediated Inflammatory Disorders. Psychosom Med, 2022. 84(1): p. 10-19.
Sonu, S., S. Post, and J.J.P.m. Feinglass, Adverse childhood experiences and the onset of chronic disease in young adulthood. 2019. 123: p. 163-170.
Spitzer, C., et al., Childhood trauma in multiple sclerosis: a case-control study. 2012. 74(3): p. 312-318.
Dube, S.R., et al., Cumulative childhood stress and autoimmune diseases in adults. Psychosom Med, 2009. 71(2): p. 243-50.
Jones, C.M., M.T. Merrick, and D.E. Houry, Identifying and Preventing Adverse Childhood Experiences: Implications for Clinical Practice. JAMA, 2020. 323(1): p. 25-26.
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