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Head trauma preceding PD

A case-control study

From the Departments of Neurology (Drs. Bower, Maraganore, Ahlskog, and Rocca) and Health Sciences Research (Dr. Rocca, B.J. Peterson and S.K. McDonnell), Mayo Foundation, Rochester, MN.

Address correspondence and reprint requests to Dr. J.H. Bower, Department of Neurology, Mayo Clinic, 200 First St. SW, Rochester, MN 55905; e-mail: bower.james{at}mayo.edu

Objective: To investigate the association of PD with preceding head trauma using a case-control study design.

Methods: The medical records-linkage system of the Rochester Epidemiology Project was used to identify 196 subjects who developed PD in Olmsted County, MN, from 1976 through 1995. Each incident case was matched by age (±1 year) and sex to a general population control. The complete medical records of cases and controls in the system were reviewed to detect preceding episodes of head trauma.

Results: The frequency of head trauma overall was significantly higher in cases than in controls (odds ratio [OR] = 4.3; 95% CI = 1.2 to 15.2). Compared with subjects who never experienced a trauma, subjects who experienced a mild head trauma with only amnesia had no increased risk; however, subjects who experienced a mild head trauma with loss of consciousness or a more severe trauma had an OR of 11.0 (95% CI = 1.4 to 85.2). Although not significant, head trauma resulting in hospitalization was more frequent in cases than in control subjects (OR = 8.0; 95% CI = 1.0 to 64.0). Whereas the OR was higher for men than women and for patients with later onset of PD than for patients with earlier onset, these differences were not significant.

Conclusions: These results suggest an association between head trauma and the later development of PD that varies with severity. Although the OR is high (4.3), the population attributable risk is only 5% because head trauma is a relatively rare event.

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