Spinal Cord Injury Is Related to an Increased Risk of Multiple Sclerosis: A Population-Based, Propensity Score-Matched, Longitudinal Follow-Up Study

JOURNAL OF NEUROTRAUMA, 2015 · DOI: 10.1089/neu.2014.3723 · Published: May 1, 2015

Spinal Cord Injury Neurology Public Health

Simple Explanation

This study investigated the relationship between spinal cord injury (SCI) and the risk of developing multiple sclerosis (MS). It used a large population-based dataset from Taiwan to compare individuals with and without SCI. The researchers matched the two groups based on factors like age, sex, and socioeconomic status to ensure a fair comparison. They then tracked who developed MS in each group over time. The study found that people with SCI had a significantly higher risk of developing MS compared to those without SCI, suggesting a potential link between the two conditions.

Study Duration

2001-2003 (Follow up until end of 2003)

Participants

11,913 subjects with SCI and 59,565 propensity score–matched subjects without SCI

Evidence Level

Not specified

Key Findings

1
Patients with SCI had an 8.33-fold higher risk of MS, compared with non-SCI subjects.
2
The incidence rate of MS in the SCI group was 17.60 per 100,000 person-years, compared to 2.82 in the non-SCI group.
3
This study is the ﬁrst to show an increased risk of developing MS in SCI patients.

Research Summary

This study investigated the association between spinal cord injury (SCI) and the subsequent development of multiple sclerosis (MS) using a population-based, propensity score-matched, longitudinal follow-up design. The study found that individuals with SCI had a significantly higher risk of developing MS compared to those without SCI, suggesting a potential link between the two conditions. The researchers propose that SCI might compromise the blood–spinal cord barrier, promote systemic autoimmunity, and increase psychological stress, all of which could contribute to the increased risk of MS.

Practical Implications

Clinical Vigilance

Clinicians should be aware of the increased risk of MS in patients with SCI.

Further Research

Further research is needed to validate these findings and investigate the underlying mechanisms linking SCI and MS.

Preventative Strategies

Explore potential preventative strategies for MS in individuals with SCI, such as stress management or immune modulation.

Study Limitations

1
Diagnoses of SCI, MS, and medical comorbidities in our study were entirely determined from the ICD codes from the NHI claim database and there may be concern about the diagnostic accuracy of the database.
2
information was lacking regarding several lifestyle factors that may have an impact on the risk of MS, such as smoking, sunlight exposure, and vitamin D consumption
3
most inhabitants of Taiwan are of Chinese ethnicity and it is uncertain whether our ﬁndings can be generalized to other ethnic groups.

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