Parkinson's Disease Case Ascertainment in the Sister Study: A Cohort for Environmental Health Research.
Parkinson's Disease Case Ascertainment in the Sister Study: A Cohort for Environmental Health Research.
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DOI：
10.3233/jpd-230053
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Chen H
中科院分区：
文献类型：
--
作者：
Cao Z;Song S;Huang X;Li C;Luo Z;D'Aloisio AA;Suarez L;Hernandez DG;Singleton AB;Sandler DP;Chen H
大型前瞻性研究对于调查帕金森病（PD）的环境原因至关重要，但在此类研究中，通过临床检查进行PD诊断通常是不可行的。介绍美国女性队列的病例确定策略和数据收集。在姐妹研究（n = 50，884，基线年龄55.6±9.0）中，参与者或其代理人首次报告了医生做出的PD诊断。 队列范围内的随访调查收集了后续诊断、药物使用和PD相关运动和非运动症状的数据。我们联系了自我报告的PD病例及其治疗医生，以获得相关的诊断和治疗史。通过专家审查所有可用数据（非运动症状除外）进行诊断裁定。我们使用多变量逻辑回归模型和报告的比值比（OR）和95%置信区间（CI）研究了非运动症状与PD事件的相关性。在确定的371例潜在PD病例中，242例诊断得到确认。与未经证实的病例相比，证实病例更可能在随访期间报告来自多个来源、药物使用以及运动和非运动特征的PD诊断。PD多基因风险评分与确诊PD相关（OR四分位数间距= 1.74，95%CI：1.45-2.10），但与未确诊病例无关（相应OR = 1.05）。 嗅觉减退、做梦行为、便秘、抑郁、不明原因的体重减轻、眼干、口干和疲劳与PD风险显著相关，OR为1.71 - 4.88。8个阴性对照症状中只有1个与PD事件相关。研究结果支持我们在这个大型女性队列中的PD病例确定方法。PD前驱表现可能超出其记录良好的特征。
Large prospective studies are essential for investigating the environmental causes of Parkinson’s disease (PD), but PD diagnosis via clinical exams is often infeasible in such studies. To present case ascertainment strategy and data collection in a US cohort of women. In the Sister Study (n = 50,884, baseline ages 55.6±9.0), physician-made PD diagnoses were first reported by participants or their proxies. Cohort-wide follow-up surveys collected data on subsequent diagnoses, medication usage and PD-relevant motor and nonmotor symptoms. We contacted self-reported PD cases and their treating physicians to obtain relevant diagnostic and treatment history. Diagnostic adjudication was made via expert review of all available data, except nonmotor symptoms. We examined associations of nonmotor symptoms with incident PD, using multivariable logistic regression models and reported odds ratio (OR) and 95% confidence intervals (CI). Of the 371 potential PD cases identified, 242 diagnoses were confirmed. Compared with unconfirmed cases, confirmed cases were more likely to report PD diagnosis from multiple sources, medication usage, and motor and nonmotor features consistently during the follow-up. PD polygenic risk score was associated with confirmed PD (ORinter-quartile range = 1.74, 95% CI: 1.45–2.10), but not with unconfirmed cases (corresponding OR = 1.05). Hyposmia, dream-enacting behaviors, constipation, depression, unexplained weight loss, dry eyes, dry mouth, and fatigue were significantly related to PD risk, with ORs from 1.71 to 4.88. Only one of the eight negative control symptoms was associated with incident PD. Findings support our PD case ascertainment approach in this large cohort of women. PD prodromal presentation is likely beyond its well-documented profile.
影响因子：
3.7
作者：
Shrestha S;Parks CG;Richards-Barber M;Chen H;Sandler DP
通讯作者：
Sandler DP