APDA’s Chief Scientific Officer Dr. Rebecca Gilbert weighs in on Traumatic Brian Injury, a small, but important contributor to the overall risk of Parkinson’s

On April 18, 2018, a study was published in the journal Neurology and widely disseminated in the popular press, which demonstrated an increased risk of Parkinson’s disease (PD) after even a mild traumatic brain injury (TBI). The study was conducted using the Veteran’s Heath Administration (VA) databases and identified all patients seen at the VA with a diagnosis of TBI. Age-matched controls without TBI were also selected from the database. The patients’ health information was then followed over time and PD diagnoses in the two groups were tracked:

• Patients who had mild TBI were at 1.5 times the risk of developing PD as compared to the controls.
• Patients with severe TBI, had 1.8 times the risk of developing PD as compared to the controls.
• When the group of patients with the mildest form of TBI – those without any loss of consciousness – was analyzed separately, the increased risk of PD did not reach statistical significance.

To put things in perspective, this study shows that the increased risk of mild, and even severe TBI, is about half the increased risk of having a first degree relative with Parkinson’s. Also, the mildest TBI, without loss of consciousness, may not increase risk of Parkinson’s. TBI is at most, one small contributor to overall risk, but it is a potentially modifiable one and that makes it important. Of course, many TBIs are not preventable, but efforts to prevent those that are (with improved car and sports safety for example) is good public health policy. For older adults, especially those with Parkinson’s disease, falls are a common cause of head injury. Taking steps to prevent falls is a major focus of Parkinson’s care. These steps may involve modifying the home environment to remove unnecessary obstacles or installing grab bars in the bathroom. Physical therapy is also essential to decrease fall risk.

So what are you supposed to do if you have been diagnosed with Parkinson’s disease and had a TBI in the past? You can certainly tell your doctor, but treatment options for your PD remain the same. Once you have PD, preventing future TBIs makes good sense, with focus on fall prevention, although this is the case for the general population as well. If you had a TBI and do not have PD, but are concerned about your future risk of PD, rest assured that TBI is one small contributor to risk of PD, among many risk factors.

To get a more in-depth understanding of Parkinson’s disease, its effect on the lives of those who have it, and how it can be treated, follow the links below: