{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T23:29:40Z","timestamp":1777937380820,"version":"3.51.4"},"reference-count":28,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2020,2,24]],"date-time":"2020-02-24T00:00:00Z","timestamp":1582502400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100021981","name":"Roche Canada","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100021981","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100000226","name":"ontario ministry of health and long-term care","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000226","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100012665","name":"institute for clinical evaluative sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012665","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Mult Scler"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Physical trauma, specifically concussions sustained during adolescence, has been hypothesized to be a risk factor for multiple sclerosis (MS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To examine the association between adolescent concussions and future MS diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This retrospective study using linked administrative databases from Ontario, Canada, identified 97,965 adolescents (age 11\u201318\u2009years) who sustained \u2a7e1 concussion and presented to an emergency department between 1992 and 2011. Cases were matched 1:3 with individuals who had not sustained a concussion based on age, sex, address, and index date. The primary outcome was MS diagnosis, using a validated MS diagnosis definition: \u2a7e1 hospitalization or \u2a7e5 physician billings within 2\u2009years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A concussion during adolescence was associated with a significantly increased risk of MS (hazard ratio (HR)\u2009=\u20091.29, p\u2009=\u20090.03). Sex-specific analysis revealed that only males who sustained a concussion in adolescence had a raised risk of MS (HR\u2009=\u20091.41, p\u2009=\u20090.04).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This study supports an association between concussions in adolescence and future MS diagnoses, highlighting the potentially serious long-term effects of concussions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1352458520908037","type":"journal-article","created":{"date-parts":[[2020,2,24]],"date-time":"2020-02-24T09:03:01Z","timestamp":1582534981000},"page":"180-187","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":17,"title":["Concussion in adolescence and the risk of multiple sclerosis: A retrospective cohort study"],"prefix":"10.1177","volume":"27","author":[{"given":"Christopher A","family":"Povolo","sequence":"first","affiliation":[{"name":"Department of Clinical Neurological Sciences, London Health Sciences Center, London, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer N","family":"Reid","sequence":"additional","affiliation":[{"name":"Institute for Clinical Evaluative Sciences, London, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salimah Z","family":"Shariff","sequence":"additional","affiliation":[{"name":"Institute for Clinical Evaluative Sciences Western, Lawson Heath Research Institute and Arthur Labatt School of Nursing, Western University, London, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Blayne","family":"Welk","sequence":"additional","affiliation":[{"name":"Institute for Clinical Evaluative Sciences and Department of Surgery and Epidemiology & Biostatistics, Western University, London, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah A","family":"Morrow","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurological Sciences, University Hospital, London Health Sciences Centre (LHSC), Western University, London, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2020,2,24]]},"reference":[{"key":"bibr1-1352458520908037","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2009.11.010"},{"key":"bibr2-1352458520908037","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2013.08.011"},{"key":"bibr3-1352458520908037","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1964.21.4.0249"},{"key":"bibr4-1352458520908037","doi-asserted-by":"publisher","DOI":"10.1111\/j.1750-3639.1991.tb00646.x"},{"key":"bibr5-1352458520908037","doi-asserted-by":"publisher","DOI":"10.1002\/ana.25036"},{"key":"bibr6-1352458520908037","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.150790"},{"key":"bibr7-1352458520908037","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2017.09.018"},{"key":"bibr8-1352458520908037","doi-asserted-by":"publisher","DOI":"10.1177\/1352458514556303"},{"key":"bibr9-1352458520908037","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000006395"},{"key":"bibr10-1352458520908037","doi-asserted-by":"publisher","DOI":"10.1002\/pds.1674"},{"key":"bibr11-1352458520908037","first-page":"343","volume-title":"Handbook of clinical neurology","author":"Confavreux C","year":"2014"},{"key":"bibr12-1352458520908037","unstructured":"Canchola AJ, Stewart SL, Bernstein L, et al. 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