Head trauma preceding PD - A case-control study
Head trauma preceding PD - A case-control study
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DOI：
10.1212/01.wnl.0000068008.78394.2c
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发表时间：
2003-05-27
期刊：
影响因子：
9.9
通讯作者：
Rocca, WA
中科院分区：
文献类型：
--
作者：
Bower, JH;Maraganore, DM;Rocca, WA
目的：采用病例对照研究设计，探讨帕金森病与既往头部外伤的关系。研究方法：罗切斯特流行病学项目的医疗记录链接系统被用来确定196 PD在奥姆斯特德县，明尼苏达州，从1976年至1995年的主题。每个事件病例的年龄（+/-1岁）和性别与一般人群对照相匹配。对系统中病例和对照的完整医疗记录进行了审查，以检测先前的头部创伤事件。结果：总体而言，病例组的头部创伤发生率显著高于对照组（比值比[OR] = 4.3; 95%CI = 1.2 - 15.2）。与从未经历创伤的受试者相比，经历轻度头部创伤仅伴有健忘症的受试者的风险未增加;然而，经历轻度头部创伤伴意识丧失或更严重创伤的受试者的OR为11.0（95% CI = 1.4 - 85.2）。虽然不显著，但病例中导致住院的头部创伤比对照受试者更常见（OR = 8.0; 95%CI = 1.0至64.0）。尽管男性的OR高于女性，晚发PD患者的OR高于早发PD患者，但这些差异并不显著。结论：这些结果表明，头部创伤和PD的后期发展之间的关联，随着严重程度的不同而不同。虽然OR很高（4.3），但人群归因风险仅为5%，因为头部创伤是相对罕见的事件。
Objective: To investigate the association of PD with preceding head trauma using a case-control study design. Methods: The medical records-linkage system of the Rochester Epidemiology Project was used to identify 196 subjects who developed PD in Olmsted County, MN, from 1976 through 1995. Each incident case was matched by age ( +/-1 year) and sex to a general population control. The complete medical records of cases and controls in the system were reviewed to detect preceding episodes of head trauma. Results: The frequency of head trauma overall was significantly higher in cases than in controls (odds ratio [OR] = 4.3; 95% CI = 1.2 to 15.2). Compared with subjects who never experienced a trauma, subjects who experienced a mild head trauma with only amnesia had no increased risk; however, subjects who experienced a mild head trauma with loss of consciousness or a more severe trauma had an OR of 11.0 (95% CI = 1.4 to 85.2). Although not significant, head trauma resulting in hospitalization was more frequent in cases than in control subjects (OR = 8.0; 95% CI = 1.0 to 64.0). Whereas the OR was higher for men than women and for patients with later onset of PD than for patients with earlier onset, these differences were not significant. Conclusions: These results suggest an association between head trauma and the later development of PD that varies with severity. Although the OR is high (4.3), the population attributable risk is only 5% because head trauma is a relatively rare event.