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Neurodegeneration
Short report
Cerebrovascular injury as a risk factor for amyotrophic lateral sclerosis
  1. Martin R Turner1,
  2. Raph Goldacre2,
  3. Kevin Talbot1,
  4. Michael J Goldacre2
  1. 1Nuffield Department of Clinical Neurosciences, Oxford University, John Radcliffe Hospital, Oxford, UK
  2. 2Nuffield Department of Population Health, Oxford University, Oxford, UK
  1. Correspondence to Dr Martin R Turner, Nuffield Department of Clinical Neurosciences, Oxford University, West Wing Level 3, John Radcliffe Hospital, Oxford OX3 9DU, UK; martin.turner{at}ndcn.ox.ac.uk

Abstract

Objective To use an unbiased method to test a previously reported association between cerebral arteriovenous malformation (AVM) embolisation and the subsequent development of amyotrophic lateral sclerosis (ALS).

Methods A hospital record linkage database was used to create cohorts of individuals coded as having cerebral and peripheral vessel AVMs, stroke (separately for haemorrhagic and ischaemic), transient ischaemic attack (TIA) and subarachnoid haemorrhage (SAH). The rate ratio for subsequent ALS was compared to a reference cohort.

Results An increased rate ratio for ALS was found in relation to prior AVM (2.69; p=0.005), all strokes (1.38; p<0.001), and TIA (1.47; p<0.001).

Conclusions Cerebrovascular injury from a variety of causes, rather than the presence of AVM or the associated embolisation procedure per se, may be a risk factor for ALS within the context of a more complex multiple-hit model of pathogenesis.

  • ALS
  • EPIDEMIOLOGY
  • MOTOR NEURON DISEASE
  • CEREBROVASCULAR

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/

https://doi.org/10.1136/jnnp-2015-311157

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