Post-Traumatic Stress Disorder is Associated with further Increased Parkinson's Disease Risk in Veterans with Traumatic Brain Injury.
Post-Traumatic Stress Disorder is Associated with further Increased Parkinson's Disease Risk in Veterans with Traumatic Brain Injury.
复制标题
创伤后应激障碍与脑外伤退伍军人帕金森病风险进一步增加有关。
DOI：
10.1002/ana.25726
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发表时间：
2020
影响因子：
11.2
通讯作者：
Jorge,RicardoE
中科院分区：
文献类型：
--
作者：
White,DonnaL;Kunik,MarkE;Yu,Hong;Lin,HelenL;Richardson,PeterA;Moore,Suzanne;Sarwar,AliyaI;Marsh,Laura;Jorge,RicardoE
确定创伤性脑损伤（TBI）和创伤后应激障碍（PTSD）是否是帕金森病（PD）的危险因素。这构成了一个研究的优先事项为退伍军人管理局（VA）与筛选政策和prevention. MethodsPopulation-based，匹配的病例对照研究退伍军人使用VA医疗保健设施，从1999年10月1日至2013年9月30日。我们确定了176，871例PD病例和707，484例随机选择的无PD匹配对照。PD、TBI和PTSD通过经验证的国际疾病分类第9版（ICD）-9代码算法确定。我们使用种族调整的条件logistic regression.ResultsThe总体研究队列TBImild、TBInon-mild和PTSD的患病率分别为0. 65%、0. 69%和5. 5%。在种族调整的单风险因素分析中，TBI和PTSD均与PD显著相关（TBI轻度、TBInon-轻度和PTSD的条件优势比[cOR] = 2.99; 95%置信区间[CI]：2.69-3.32）、3.82（95% CI：3.67-3.97）和2.71（95% CI：2.66-2.77））。在双重风险因素分析中观察到与PTSD/TBI共病的提示性积极相互作用，当PTSD存在时，TBI轻度和TBI非轻度的退伍军人与无TBI的退伍军人相比，PD风险显著增加2.69倍和3.70倍，而当PTSD不存在时，PD风险增加2.17倍和2.80倍。相对PD风险在一个不同的全国队列的退伍军人，并首次提出了一个潜在的适度协同过度风险与共病TBI/PTSD。需要纵向研究来证实这些暗示性的发现。神经网络2020神经网络2020;88：33-41
ObjectiveDetermining if traumatic brain injury (TBI) and post‐traumatic stress disorder (PTSD) are risk factors for Parkinson's disease (PD). This constitutes a research priority for the Veterans Administration (VA) with implications for screening policy and prevention.MethodsPopulation‐based, matched case‐control study among veterans using VA health care facilities from October 1, 1999, to September 30, 2013. We identified 176,871 PD cases and 707,484 randomly selected PD‐free matched controls. PD, TBI, and PTSD were ascertained by validated International Classification of Disease 9th revision (ICD)‐9 code‐based algorithms. We examined the association between both risk factors and PD using race‐adjusted conditional logistic regression.ResultsThe overall study cohort prevalence for TBImild, TBInon‐mild, and PTSD was 0.65%, 0.69%, and 5.5%, respectively. Both TBI and PTSD were significantly associated with PD in single‐risk factor race‐adjusted analyses (conditional odds ratio [cOR] = 2.99; 95% confidence interval [CI]: 2.69–3.32), 3.82 (95% CI: 3.67–3.97), and 2.71 (95% CI: 2.66–2.77) for TBImild, TBInon‐mild, and PTSD, respectively). There was suggestive positive interaction observed with comorbid PTSD/TBI in dual‐risk factor analyses, with significant 2.69‐fold and 3.70‐fold excess relative PD risk in veterans with TBImildand TBInon‐mildversus those without TBI when PTSD was present versus 2.17‐fold and 2.80‐fold excess risk when PTSD was absent.InterpretationOur study was the first to demonstrate that both TBI and PTSD are independently associated with increased relative PD risk in a diverse nationwide cohort of military service veterans, and the first to suggest a potential modest synergistic excess risk in those with comorbid TBI/PTSD. Longitudinal research is needed to confirm these suggestive findings. ANN NEUROL 2020ANN NEUROL 2020;88:33–41