Hello,
Thanks for asking this question. I want to first say that I am an
internal medicine physician and not a neurologist. My research
reflects objective, physician-written and peer reviewed data. If you
are looking for more information, please do so via the answer
clarification option and I will be happy to explain or expand any of
my research.
You asked the following question:
“Can head trauma suffered in an automobile accident exasberate (sic)
an
existing condition of Parkinson's disease in the victim?”
The short answer is yes – head trauma can exacerbate (and cause)
Parkinson’s disease. There have been multiple studies linking the
head trauma with Parkinson’s disease.
Tsai et al. (2002) found head trauma may trigger and expedite the
appearance of parkinsonian features:
“While the cause of Parkinson's disease (PD) remains unknown, recent
evidence suggests certain environmental factors, such as well water
drinking, herbicides and pesticides exposure, and neurotoxins, may
trigger the chain of oxidative reactions culminating in the death of
dopaminergic neurons in substantia nigra to cause parkinsonism . . .
Using logistic regression, we found well water drinking and head
injury were risk factors for the development of young-onset
parkinson’s disease (YOPD). When YOPD patients were compared with PD,
we found head injury and exercise were the significant predictors.
Keeping all other variables constant, head injury was a risk factor
and exercise appeared to be a protective factor. We conclude early
exposure to well water drinking and head trauma may trigger and
expedite the appearance of parkinsonian features, but such
acceleration may be prevented through regular exercise.” (1)
Taylor et al. (1999) found head injury to be strongly predictive of
parkinson’s disease:
“Four factors were associated with increased risk for PD: (1) head
injury (OR=6.23, confidence interval [CI]: 2.58-15.07) (i.e. those
with head injuries are 6.23 times more likely to develop parkinson’s);
(2) family history of PD (OR=6.08, CI: 2.35-15. 58); (3) family
history of tremor (OR=3.97, CI: 1.17-13.50); and (4) history of
depression (OR=3.01, CI: 1.32-6.88).” (2)
Veldman et al (1998) found that head trauma both provokes parkinson’s
or influences its natural course:
“This review suggests that pesticides-herbicides, smoking and head
trauma probably represent the most eligible candidates for
environmental factors involved in provoking PD or influencing its
natural course.” (3)
Lees et al. (1997) finds the following:
“Post-traumatic Parkinson's syndrome may occur following cumulative
head trauma in contact sports and exceptionally rarely after single
severe closed head injury.” (4)
Ben-Shlomo (1997) in his epidemiological study states:
“Pesticides and head injuries also show consistently elevated risk.”
(5)
Factor et al. (1991) suggests a relationship between head trauma and
parkinson’s disease:
“The purpose of this study was to evaluate the relationship between
head trauma and Parkinson's disease (PD). A questionnaire was
completed by 97 PD patients (mean age 68.6 years, duration of disease
6.4 years) and 64 spouses acting as controls (mean age 63 years).
Thirty-one PD patients reported head trauma before onset of PD (mean
32.3 years earlier), whereas 11 controls reported head injury before
completing the survey (mean 26 years earlier) (p less than 0.05).
Twenty PD patients and five controls reported head injury associated
with alteration or loss of consciousness (p less than 0.05). Injury
occurred a mean of 37.7 years before onset of PD and 37.2 years before
survey completion in the two groups, respectively. In both of these
comparisons we adjusted the frequencies to eliminate sex differences
between groups . . . a trend toward significance was observed when
examining head trauma with alteration of consciousness. Other
investigators have reported similar results indicating that previous
head trauma may be a risk factor in the etiology of PD.” (6)
Most importantly, Goetz et al (1991) performs a study that asks the
same question you do – do the symptoms in people who have parkinson’s
disease worsen after a motor vehicle accident?:
“During 1 year we monitored changes in clinical disability scores in
10 patients with Parkinson's disease (PD) who sustained head trauma
from motor vehicle accidents. Disability significantly increased
immediately after trauma, but returned to baseline levels in
subsequent weeks. These patients' signs deteriorated over the
subsequent year, but this decline was equivalent to that of a matched
control group with PD who did not have a motor vehicle accident or
trauma. Based on these data, we conclude that trauma or stress caused
by motor vehicle accidents can transiently exacerbate parkinsonian
dysfunction without causing persistent increased disability or an
alteration in disease course.” (7)
Please use any answer clarification before rating this answer. I will
be happy to explain or expand on any issue you may have.
Thanks,
Kevin, M.D.
Internet search strategy:
No internet search engine was used in this research. All sources were
from objective physician-written and peer reviewed sources.
Medline search strategy:
Craniocerebral Trauma AND Parkinson’s disease
Bibliography:
1) Tsai CH. Lo SK. See LC. Chen HZ. Chen RS. Weng YH. Chang FC. Lu CS.
Environmental risk factors of young onset Parkinson's disease: a
case-control study. Clinical Neurology & Neurosurgery. 104(4):328-33,
2002 Sep.
2) Taylor CA. Saint-Hilaire MH. Cupples LA. Thomas CA. Burchard AE.
Feldman RG. Myers RH. Environmental, medical, and family history risk
factors for Parkinson's disease: a New England-based case control
study. American Journal of Medical Genetics. 88(6):742-9, 1999 Dec 15.
3) Veldman BA. Wijn AM. Knoers N. Praamstra P. Horstink MW. Genetic
and environmental risk factors in Parkinson's disease. [Review] [202
refs] Clinical Neurology & Neurosurgery. 100(1):15-26, 1998 Mar.
4) Lees AJ. Trauma and Parkinson disease. [Review] [51 refs] Revue
Neurologique. 153(10):541-6, 1997 Oct.
5) Ben-Shlomo Y. The epidemiology of Parkinson's disease. [Review] [85
refs] Baillieres Clinical Neurology. 6(1):55-68, 1997 Apr.
6) Factor SA. Weiner WJ. Prior history of head trauma in Parkinson's
disease. Movement Disorders. 6(3):225-9, 1991.
7) Goetz CG. Stebbins GT. Effects of head trauma from motor vehicle
accidents on Parkinson's disease. Annals of Neurology. 29(2):191-3,
1991 Feb. |
