Effects of head trauma and sport participation in young-onset Parkinson\u2019s disease

Tommaso Schirinzi,Nicola Biagio Mercuri,Piergiorgio Grillo,Antonio Pisani,Chiara Salimei,Giulia Di Lazzaro,Kristen Dams-O’Connor,Giulia Maria Sancesario,Henri Zenuni

doi:10.1007/s00702-021-02370-8

Abstract

Head trauma (HT) is emerging as an event anticipating onset of neurodegenerative disorders. However, the potential contribution of HT in young-onset cases (YOPD, age at onset < 50) of Parkinson’s disease (PD) has not been examined yet. Here, we systematically assessed HT history in PD patients to estimate the risk associated, especially in terms of age of onset, and define the correlations with the clinical-biochemical profile. The Brain Injury Screening Questionnaire (BISQ) was administered to 94 PD patients (31 with YOPD, known monogenic forms excluded) and 70 controls. HT history was correlated with motor and non-motor scores in all patients, and to CSF biomarkers of neurodegeneration (α-synuclein, amyloid-β42, total and phosporiled-181 tau, lactate, CSF/serum albumin) into a subgroup. HT increased the risk for both PD and YOPD. In PD patients, but not in those with YOPD, the number of HTs directly correlated with CSF total-tau levels. No other correlations resulted between HT and clinical parameters. Sport-related HT was a specific risk factor for YOPD; conversely, the prolonged sporting life represented a protective factor. HTs can favor PD onset, even as YOPD. Sport-related HT resulted a risk factor for YOPD, although the longer sporting practice delayed PD onset, protecting from YOPD. Tauopathy may underlie the overall association between HT and PD. Additional mechanisms could be instead implicated in HT contribution to YOPD onset.

Highlights

Parkinson’s disease (PD) is a disabling neurodegenerative disorder, with idiopathic and multifactorial origin (Kalia and Lang 2015; Surmeier et al 2017; Petrillo et al 2019)
All participants were screened for HT history using the Brain Injury Screening Questionnaire (BISQ) (DamsO’Connor et al 2014), In brief, BISQ systematically characterizes lifetime exposure to head trauma by providing a list of events that may result in head trauma to facilitate recall of injuries, and for each blow to the head reported, subsequent queries permit estimates of traumatic brain injury (TBI) severity
Individuals Tr + had an increased risk for PD

Summary

Introduction

Parkinson’s disease (PD) is a disabling neurodegenerative disorder, with idiopathic and multifactorial origin (Kalia and Lang 2015; Surmeier et al 2017; Petrillo et al 2019). Common risk factors for the classical presentation of PD in elderly include aging, toxicants exposure, and cardiovascular diseases (Ascherio and Schwarzschild 2016; Imbriani et al 2020). More rarely, PD may appear before the age of 50, as “young onset PD” (YOPD), in the absence of apparently known risk factors (Ylikotila et al 2015; Mehanna and Jankovic 2019; Schirinzi et al 2020b). In animal models of amyotrophic lateral sclerosis (ALS), head injury precipitates genetic susceptibility and anticipates clinical-pathological onset of the disease (Alkaslasi et al 2021). People with head traumas may develop young-onset dementia (Nordstrom et al 2014; LoBue et al 2017; Lobue and Cullum 2019). It might be hypothesized that head trauma (HT) can contribute to accelerate PD onset in those individuals with genetic vulnerability, representing a potential risk factor for YOPD

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Conclusion