Does Head Trauma Cause ALS? Are Professional Athletes at Greater Risk?

September 7, 2010

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By A. Gordon Smith, MD, AAN.com Education Editor

In the past months there has been increasing interest in the role of head trauma, particularly repeated concussion, on risk of developing dementia. These observations have been particularly relevant for former professional football players.

A new paper published in the Journal of Neuropathology and Experimental Neurology suggests head trauma may also lead to a neurodegenerative disorder mimicking ALS. Investigators from the VA Medical Center in Bedford, MA, and Boston University describe three athletes who were diagnosed with Amyotrophic lateral sclerosis (ALS), but were found to have pathologic findings consistent with repeated trauma.

This paper adds to literature suggesting an elevated risk of ALS in veterans and professional soccer players who have suffered head injuries, and is certain to contribute to the controversy regarding the link between head trauma and ALS. A recent article in the New York Times points out that Lou Gehrig himself may have had this entity rather than ALS.

Gehrig, whose nickname was the "Iron Horse," played 2,130 consecutive games, sometimes competing after head injuries.

What are your thoughts regarding the link between head injury and ALS? Do these findings suggest a need to more aggressively gather spinal cord and brain pathology on patients having had ALS?