Physical Trauma and Demyelinating Diseases: A Systematic Review and Meta-Analysis

Background Although several observational studies investigated the relationship between physical trauma and demyelinating diseases, the relationship is still controversial in the literature. Thus, we decided to conduct a systematic review and meta-analysis to investigate this relationship. Methods On the 22nd of June 2023, PubMed, Scopus, Web of Sciences, and CENTRAL were searched using terms about demyelinating diseases and physical trauma. Studies were included if they investigated the association between physical trauma and the development of a demyelinating disease. Results The total number of the included participants was 2,411,312 from 57 articles. The analysis showed that physical trauma was significantly associated with higher odds of demyelinating disease development (OR=2.51; 95%CI: 1.87-3.37). In addition, both childhood and premorbid traumas were significantly associated with increased risk of demyelinating diseases (OR=2.97; 95%CI: 2.64-3.35, OR=3.51; 95%CI: 2.97-4.14). Fractures (OR=3.17; 95%CI: 2.85-3.52), head (OR=3.61; 95%CI: 2.84-4.59), and spinal traumas (OR=9.06; 95%CI: 1.21-68.01) were significantly associated with increased risk of demyelinating diseases as well. Conclusion In conclusion, we found a significant association between physical trauma and the risk of developing demyelinating diseases. However, several gaps in the literature should be addressed by future studies including the low number of studies investigating demyelinating diseases other than MS.