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Published online before print September 23, 2009, doi:10.1212/WNL.0b013e3181c06635)
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Received February 26, 2009
Accepted August 5, 2009

Autoimmune disease and risk for Parkinson disease. A population-based case-control study

K. Rugbjerg MSc*, S. Friis MD, B. Ritz MD, PhD, E. S. Schernhammer MD, DrPH, L. Korbo MD, DMSc, and J. H. Olsen MD, DMSc

From the Institute of Cancer Epidemiology (K.R., S.F., J.H.O.), Danish Cancer Society, Copenhagen, Denmark; Department of Epidemiology and Environmental Sciences (B.R.), School of Public Health, University of California, Los Angeles; Channing Laboratory (E.S.S.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Department of Epidemiology (E.S.S.), Harvard School of Public Health, Boston; and Department of Neurology (L.K.), Bispebjerg Hospital, Copenhagen.


* To whom correspondence should be addressed. E-mail: rugbjerg{at}cancer.dk.

Objective: Inflammatory mediators are increased in autoimmune diseases and may activate microglia and might cause an inflammatory state and degeneration of dopaminergic neurons in the brain. Thus, we evaluated whether having an autoimmune disease increases the risk for developing Parkinson disease (PD).

Methods: A population based case-control study was conducted in Denmark of 13,695 patients with a primary diagnosis of PD recorded in the Danish National Hospital Register during the period 1986–2006. Each case was matched on year of birth and sex to 5 population controls selected at random from among inhabitants of Denmark who were alive at the date of the patient's diagnosis. The main exposure measure was a hospital diagnosis of 1 of 32 selected autoimmune diseases recorded 5 or more years before the index date in the files of the Danish Hospital Register.

Results: We observed no overall association between a diagnosis of autoimmune disease and risk for subsequent PD (odds ratio 0.96, 95% confidence interval 0.85–1.08). In a subgroup of patients with autoimmune diseases with systemic involvement, primarily rheumatoid arthritis, we saw a decrease in risk for PD of 30%.

Conclusions: Our results do not support the hypothesis that autoimmune diseases increase the risk for Parkinson disease. The decreased risk observed among patients with rheumatoid arthritis might be explained by underdiagnosis of movement disorders such as Parkinson disease in this patient group or by a protective effect of the treatment with anti-inflammatory drugs over prolonged periods.


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Neuroinflammation and Parkinson disease: The silent battleground
Ronald F. Pfeiffer
Neurology 2009 73: 1434-1435. [Full Text] [PDF]



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R. F. Pfeiffer
Neuroinflammation and Parkinson disease: The silent battleground
Neurology, November 3, 2009; 73(18): 1434 - 1435.
[Full Text] [PDF]




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