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  Vol. 53 No. 3, March 1996 TABLE OF CONTENTS
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Amyotrophic Lateral Sclerosis, Heterogeneous Susceptibility, Trauma, and Epidemiology

Jack E. Riggs, MD

Arch Neurol. 1996;53(3):225-227.


Abstract

Epidemiological studies relating antecedent trauma and amyotrophic lateral sclerosis (ALS) demonstrate a contradiction: positive (but poorly structured) retrospective case-control studies and negative (but uninterpretably small) prospective cohort studies. In this report, the equations for the case-control odds ratio and cohort relative risk in populations with heterogeneous susceptibility to ALS are analyzed. The case-control odds ratio and cohort relative risk converge as the proportion of ALS-nonsusceptible individuals in a population increases and the rate of ALS in nonsusceptible individuals decreases. Cohort studies of antecedent trauma and ALS have no significant advantage over case-control studies in populations in which most individuals are relatively nonsusceptible to ALS. Accordingly, the relationship between antecedent trauma and ALS can be addressed by carefully defined case-control studies.



Author Affiliations

From the Departments of Neurology, Medicine, and Community Medicine, West Virginia University School of Medicine, Morgantown.



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