EPIDEMIOLOGY AND GENETICS OF PARKINSON'S DISEASE

描述(摘自申请者摘要)：帕金森氏病(PD)是一种 美国不断扩大的老年人口中常见的致残状况 以及世界范围内。其病因尚不清楚，既有遗传因素，也有环境因素。 人们一直在怀疑这些因素。拟议研究的长期目标基于 在不同的采样中是为了弄清帕金森病的病因并找出手段 防止它发生。基于不同抽样的三项独立但相关的研究 并提出了相应的测量策略。被测试的假设直接推导出 从我们目前的工作和初步发现来看。病例对照研究将 包括方圆120英里范围内转诊至梅奥诊所的800例帕金森病患者或 来自5个州的地区和800名对照无PD和帕金森症匹配 年龄(+2岁)、性别和居住地区。来自一般的控制 人口将从医疗保健财务管理名单中确定 65岁或以上及以随机数字拨号方式接听的个案 年龄在65岁以下。曝光将通过直接电话采访获得， 并将包括烟草、咖啡和酒精的使用；寻求新奇的标志 行为；对妇女来说，绝经后使用雌激素替代疗法 以及其他与生殖和雌激素相关的因素。历史上的第一批人 研究将测试单侧和双侧卵巢切除术之间的关系 在已建立的基于人群的队列中，绝经前和帕金森病患者。这项研究 将包括2533名在1950-1987年间在居住期间接受卵巢切除术的妇女 在奥姆斯特德县，明尼苏达州和2533名同龄和居住地的妇女没有 接受卵巢切除术。第二项历史研究将检验这种联系。 明尼苏达多相人格测验测量的人格特征之间 库存(MMPI)和PD在既定的研究队列中。这项研究将 包括在1962-1965年间居住在印度期间接受MMPI测试的8775人 明尼苏达州。拟议的病例对照研究是强有力的，因为它有足够的 统计学力量证实了我们关于雌激素作用的初步发现 并探索药物使用和新奇寻求之间的联系 帕金森病患者的行为特征。所有与病例和控制组的面谈都将是直接的， 建议的卵巢切除术队列研究因其队列设计而很强，其 以人口为基础的抽样，其足够的统计能力，以及由于 预期通过被动和主动策略获得较高的随访率。这个 建议的MMPI队列研究是强有力的，因为它的队列设计，其充分 统计能力和我们在跟踪和跟踪方面的丰富经验 采访个人。这三项研究将大大有助于 通过探索新事物认识帕金森病的原因和可能的预防 并通过使用创新的方法。

DESCRIPTION (Adapted from applicant's abstract): Parkinson's disease (PD) is a common and disabling condition in the expanding elderly population of the US and worldwide. Its etiology remains unknown and both genetic and environmental factors have been suspected. The long-term goal of the proposed studies based in different sampling is to clarify the etiology of PD and to identify means to prevent it. Three independent but related studies based on different sampling and measurement strategies are proposed. The hypotheses tested derive directly from our current work and preliminary findings. A case control study will include 800 cases of PD referred to the Mayo clinic from a 120 mile radius or from a 5 state region and 800 controls free pf PD and parkinsonism matched by age (+ 2 years), sex and region of residence. Controls from the general population will be identified from health care financial administration lists for cases aged 65 years or above and through random digit dialing for cases below 65 years. Exposures will be accessed through direct telephone interview, and will include tobacco, coffee, and alcohol use; markers of novelty seeking behavior; and, for women, use of estrogen replacement therapy after menopause and other reproductive and estrogen related factors. A first historical cohort study will test the association between unilateral and bilateral oophorectomy before menopause and PD in an established population based cohort. The study will include 2,533 women who underwent oophorectomy in 1950-1987 while residing in Olmsted County, MN and 2,533 women of the same age and residence who did not undergo oophorectomy. A second historical study will test the association between personality traits measured by the Minnesota Multiphasic Personality Inventory (MMPI) and PD in an established research cohort. This study will include 8,775 persons who underwent MMPI testing in 1962-1965 while residing in Minnesota. The proposed case-control study is strong because it has adequate statistical power to confirm our preliminary findings on the role of estrogen in PD and to explore the link between substance use and novelty seeking behaviors in PD. All interviews with case and controls will be direct, the proposed oophorectomy cohort study is strong because of its cohort design, its population-based sampling, its adequate statistical power, and because of the expected high rate of follow-up through both passive and active strategies. The proposed MMPI cohort study is strong because of its cohort design, its adequate statistical power and because of our extensive experience with tracing and interviewing individuals. These three studies will contribute greatly to understanding the causes and possible prevention of PD by exploring novel hypotheses and by using innovative methods.