Systematic review of the risk of Parkinson's disease after mild traumatic brain injury: results of the International Collaboration on Mild Traumatic Brain Injury Prognosis

Connie Marras¹, Cesar A Hincapié², Vicki L Kristman³, Carol Cancelliere⁴, Sophie Soklaridis⁵, Alvin Li⁶, Jörgen Borg⁷, Jean-Luc af Geijerstam⁷, J David Cassidy⁸

Affiliations

¹ Morton and Gloria Shulman Movement Disorders Centre, and the Edmond J. Safra Program in Parkinson's Research, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada. Electronic address: cmarras@uhnresearch.ca.
² Division of Health Care and Outcomes Research, Toronto Western Research Institute, University Health Network, University of Toronto, Toronto, Ontario, Canada; Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
³ Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Department of Health Sciences, Lakehead University, Thunder Bay, Ontario, Canada; Institute for Work and Health, Toronto, Ontario, Canada; Division of Human Sciences, Northern Ontario School of Medicine, Lakehead University, Thunder Bay, Ontario, Canada.
⁴ Division of Health Care and Outcomes Research, Toronto Western Research Institute, University Health Network, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
⁵ Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
⁶ Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada.
⁷ Department of Clinical Sciences, Rehabilitation Medicine, Karolinska Institutet, Danderyd University Hospital, Stockholm, Sweden.
⁸ Division of Health Care and Outcomes Research, Toronto Western Research Institute, University Health Network, University of Toronto, Toronto, Ontario, Canada; Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Institute of Sports Science and Clinical Biomechanics, Faculty of Health, University of Southern Denmark, Odense, Denmark.

PMID: 24581909
DOI: 10.1016/j.apmr.2013.08.298

Systematic review of the risk of Parkinson's disease after mild traumatic brain injury: results of the International Collaboration on Mild Traumatic Brain Injury Prognosis

Connie Marras et al. Arch Phys Med Rehabil. 2014 Mar.

. 2014 Mar;95(3 Suppl):S238-44.

doi: 10.1016/j.apmr.2013.08.298.

Authors

Connie Marras¹, Cesar A Hincapié², Vicki L Kristman³, Carol Cancelliere⁴, Sophie Soklaridis⁵, Alvin Li⁶, Jörgen Borg⁷, Jean-Luc af Geijerstam⁷, J David Cassidy⁸

Affiliations

¹ Morton and Gloria Shulman Movement Disorders Centre, and the Edmond J. Safra Program in Parkinson's Research, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada. Electronic address: cmarras@uhnresearch.ca.
² Division of Health Care and Outcomes Research, Toronto Western Research Institute, University Health Network, University of Toronto, Toronto, Ontario, Canada; Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
³ Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Department of Health Sciences, Lakehead University, Thunder Bay, Ontario, Canada; Institute for Work and Health, Toronto, Ontario, Canada; Division of Human Sciences, Northern Ontario School of Medicine, Lakehead University, Thunder Bay, Ontario, Canada.
⁴ Division of Health Care and Outcomes Research, Toronto Western Research Institute, University Health Network, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
⁵ Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
⁶ Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada.
⁷ Department of Clinical Sciences, Rehabilitation Medicine, Karolinska Institutet, Danderyd University Hospital, Stockholm, Sweden.
⁸ Division of Health Care and Outcomes Research, Toronto Western Research Institute, University Health Network, University of Toronto, Toronto, Ontario, Canada; Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Institute of Sports Science and Clinical Biomechanics, Faculty of Health, University of Southern Denmark, Odense, Denmark.

PMID: 24581909
DOI: 10.1016/j.apmr.2013.08.298

Abstract

Objective: To synthesize the best available evidence on the risk of Parkinson's disease (PD) after mild traumatic brain injury (MTBI).

Data sources: MEDLINE and other databases were searched (1990-2012) with terms including "craniocerebral trauma" and "parkinsonian disorders." Reference lists of eligible articles and relevant systematic reviews and meta-analyses were also searched.

Study selection: Controlled clinical trials, cohort studies, and case-control studies were selected according to predefined criteria. Studies had to have a minimum of 30 concussion cases.

Data extraction: Eligible studies were critically appraised using a modification of the Scottish Intercollegiate Guidelines Network criteria. Two reviewers independently reviewed and extracted data from accepted studies into evidence tables.

Data synthesis: Evidence was synthesized qualitatively according to modified Scottish Intercollegiate Guidelines Network criteria. Sixty-five studies were eligible and reviewed, and 5 of these with a low risk of bias were accepted as scientifically admissible and form the basis of our findings. Among these admissible studies, the definitions of MTBI were highly heterogeneous. One study found a significant positive association between MTBI and PD (odds ratio, 1.5; 95% confidence interval, 1.4-1.7). The estimated odds ratio decreased with increasing latency between MTBI and PD diagnosis, which suggests reverse causality. The other 4 studies did not find a significant association.

Conclusions: The best available evidence argues against an important causal association between MTBI and PD. There are few high-quality studies on this topic. Prospective studies of long duration would address the limitations of recall of head injury and the possibility of reverse causation.

Keywords: Brain concussion; Parkinson's disease; Rehabilitation; Review, systematic.

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Systematic review of the risk of Parkinson's disease after mild traumatic brain injury: results of the International Collaboration on Mild Traumatic Brain Injury Prognosis

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Systematic review of the risk of Parkinson's disease after mild traumatic brain injury: results of the International Collaboration on Mild Traumatic Brain Injury Prognosis

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