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Neurodegenerative and psychiatric diseases among families with amyotrophic lateral sclerosis
Departments of Medical Epidemiology and Biostatistics, Departments of Clinical Neuroscience, Karolinska Institutet, Solna, Sweden.
Departments of Medical Epidemiology and Biostatistics, Departments of Clinical Neuroscience, Karolinska Institutet, Solna, Sweden.
Örebro University, School of Medical Sciences. Departments of Medical Epidemiology and Biostatistics, Departments of Clinical Neuroscience, Karolinska Institutet, Solna, Sweden.ORCID iD: 0000-0002-6851-3297
Departments of Medical Epidemiology and Biostatistics, Departments of Clinical Neuroscience, Karolinska Institutet, Solna, Sweden.
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2017 (English)In: Neurology, ISSN 0028-3878, E-ISSN 1526-632X, Vol. 89, no 6, 578-585 p.Article in journal (Refereed) Published
Abstract [en]

Objective: To estimate risks of neurodegenerative and psychiatric diseases among patients with amyotrophic lateral sclerosis (ALS) and their families.

Methods: We conducted a register-based nested case-control study during 1990-2013 in Sweden to assess whether patients with ALS had higher risks of other neurodegenerative and psychiatric diseases before diagnosis. We included 3,648 patients with ALS and 36,480 age-, sex-, and county of birth-matched population controls. We further conducted a follow-up study of the cases and controls to assess the risks of other neurodegenerative and psychiatric diseases after ALS diagnosis. To assess the potential contribution of familial factors, we conducted similar studies for the relatives of patients with ALS and their controls.

Results: Individuals with previous neurodegenerative or psychiatric diseases had a 49% increased risk of ALS (odds ratio 1.49, 95% confidence interval 1.35-1.66) compared to individuals without these diseases. After diagnosis, patients with ALS had increased risks of other neurodegenerative or psychiatric diseases (hazard ratio 2.90, 95% confidence interval 2.463.43) compared to individuals without ALS. The strongest associations were noted for frontotemporal dementia, Parkinson disease, other dementia, Alzheimer disease, neurotic disorders, depression, stress-related disorders, and drug abuse/dependence. First-degree relatives of patients with ALS had higher risk of neurodegenerative diseases, whereas only children of patients with ALS had higher risk of psychiatric disorders, compared to relatives of the controls.

Conclusions: Familial aggregation of ALS and other neurodegenerative diseases implies a shared etiopathogenesis among all neurodegenerative diseases. The increased risk of psychiatric disorders among patients with ALS and their children might be attributable to nonmotor symptoms of ALS and severe stress response toward the diagnosis.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2017. Vol. 89, no 6, 578-585 p.
National Category
Neurology
Identifiers
URN: urn:nbn:se:oru:diva-59421DOI: 10.1212/WNL.0000000000004179ISI: 000407048400015Scopus ID: 2-s2.0-85026903648OAI: oai:DiVA.org:oru-59421DiVA: diva2:1137066
Funder
Swedish Research Council, 2015-03170
Note

Funding Agencies:

Swedish Initiative for Research on Microdata in the Social and Medical Sciences (SIMSAM)  340-2013-5867 

Swedish Society of Medical Research  

Karolinska Institutet  

EU Joint Programme-Neurodegenerative Disease Research (JPND) 

Available from: 2017-08-30 Created: 2017-08-30 Last updated: 2017-10-18Bibliographically approved

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