Psychosocial risk factors, pre-motor symptoms and first-time hospitalization with Parkinson's disease: a prospective cohort study.
Psychosocial risk factors, pre-motor symptoms and first-time hospitalization with Parkinson's disease: a prospective cohort study.
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DOI：
10.1111/ene.12117
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发表时间：
2013-08
影响因子：
5.1
通讯作者：
Rod NH
中科院分区：
文献类型：
--
作者：
Clark AJ;Ritz B;Prescott E;Rod NH
实验研究支持压力和帕金森症状的发展之间的联系，但缺乏前瞻性的人群研究。本研究的目的是确定几种心理社会因素对帕金森病（PD）风险的影响，并在一项大型前瞻性队列研究中确定PD的潜在运动前症状。在1991-1993年，共有9955名女性和男性从哥本哈根市心脏研究免费PD，被问及主要生活事件，经济困难，社会网络，睡眠受损，和生命衰竭。参与者在全国范围内登记首次住院治疗PD，直到2011年。以暴露依赖性方式，生命力衰竭与PD住院风险较高相关（p趋势=0.001），高与低生命力衰竭相关的风险比为2.50（95% CI：1.28-4.89）。基线时睡眠障碍的参与者的PD住院风险略高（HR=1.49; 95%CI：0.87-2.56）。在目前的研究中，经济困难、重大生活事件或社交网络不足只观察到微弱的关联。总体而言，心理社会风险因素影响PD风险的假设不受支持。然而，结果表明，生命衰竭可能是神经退行性过程的运动前标志物，最终导致运动症状和临床PD。生命衰竭可能有助于筛查，旨在早期发现，并考虑在临床PD高风险人群中进行疾病修饰治疗。
Experimental studies support a link between stress and development of parkinsonian symptoms, but prospective population studies are lacking. The aim of the current study is to determine the effects of several psychosocial factors on risk of Parkinson’s disease (PD) as well as identify potential pre-motor symptoms for PD in a large prospective cohort study. In 1991–1993, a total of 9955 women and men free of PD from the Copenhagen City Heart Study, were asked about major life events, economic hardship, social network, impaired sleep, and vital exhaustion. The participants were followed for first-time hospitalization with PD in nationwide registers until 2011. Vital exhaustion was associated with a higher risk of PD hospitalization in an exposure dependent manner (ptrend=0.001), with high vs. low vital exhaustion being associated with a hazard ratio of 2.50 (95% CI: 1.28–4.89). A slightly higher risk of PD hospitalization (HR=1.49; 95% CI: 0.87–2.56) was suggested in participants with impaired sleep at baseline. No more than weak associations were observed for economic hardship, major life events or inadequate social network in the current study. Overall, the hypothesis that psychosocial risk factors affect the risk of PD is not supported. The results, however, suggests that vital exhaustion may be a pre-motor marker of the neuro-degenerative process eventually leading to motor-symptoms and clinical PD. Vital exhaustion may be useful for screening aimed at early detection and when considering disease-modifying therapies in people at high risk of clinical PD.
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影响因子：
5.6
作者：
McCarter, Stuart J.;St Louis, Erik K.;Boeve, Bradley F.
通讯作者：
Boeve, Bradley F.
影响因子：
2.2
作者：
Ravenek, Michael J.;Schneider, Margaret A.
通讯作者：
Schneider, Margaret A.
影响因子：
4.1
作者：
Jacob EL;Gatto NM;Thompson A;Bordelon Y;Ritz B
通讯作者：
Ritz B
影响因子：
8.6
作者：
Leentjens, AFG;Van den Akker, M;Verhey, FRJ
通讯作者：
Verhey, FRJ
影响因子：
4.7
作者：
HOLMES, TH;RAHE, RH
通讯作者：
RAHE, RH