Connie Marras1,2, Anthony E Lang1, Peter C Austin3,2, Cindy Lau3, David R Urbach3,4,2. 1. Morton and Gloria Shulman Movement Disorders Center, Toronto Western Hospital and The Edmond J. Safra Program in PD, Toronto, Ontario, Canada, University of Toronto, Toronto, Ontario, Canada. 2. Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada. 3. The Institute for Clinical Evaluative Sciences and the University of Toronto, Toronto, Ontario, Canada. 4. Toronto General Research Institute, University Health Network, Department of Surgery, Toronto, Ontario, Canada.
Abstract
INTRODUCTION: Pathogenic movement of alpha-synuclein from the gut to the brain in PD has been proposed. The appendix has a relatively high density of alpha-synuclein deposition in neurologically healthy individuals. We investigated the incidence of PD after appendectomy. METHODS: Using cause-specific hazards regression models, we compared persons over 35 years of age who had undergone appendectomy with two groups of age- and sex-matched individuals having had: (1) a cholecystectomy and (2) neither procedure. Subsequent diagnoses of PD were identified. RESULTS: Among 42,999 individuals undergoing appendectomy, no difference in risk of PD was identified compared to cholecystectomy (hazard ratio = 1.004; 95% confidence interval: 0.740-1.364). Compared with no procedure, individuals with appendectomy had a higher incidence of PD within 5 years, but no significant difference in risk thereafter. CONCLUSION: In our study, appendectomy in mid or late life does not appear to be associated with a reduced risk of PD.
INTRODUCTION: Pathogenic movement of alpha-synuclein from the gut to the brain in PD has been proposed. The appendix has a relatively high density of alpha-synuclein deposition in neurologically healthy individuals. We investigated the incidence of PD after appendectomy. METHODS: Using cause-specific hazards regression models, we compared persons over 35 years of age who had undergone appendectomy with two groups of age- and sex-matched individuals having had: (1) a cholecystectomy and (2) neither procedure. Subsequent diagnoses of PD were identified. RESULTS: Among 42,999 individuals undergoing appendectomy, no difference in risk of PD was identified compared to cholecystectomy (hazard ratio = 1.004; 95% confidence interval: 0.740-1.364). Compared with no procedure, individuals with appendectomy had a higher incidence of PD within 5 years, but no significant difference in risk thereafter. CONCLUSION: In our study, appendectomy in mid or late life does not appear to be associated with a reduced risk of PD.
Authors: Bryan A Killinger; Zachary Madaj; Jacek W Sikora; Nolwen Rey; Alec J Haas; Yamini Vepa; Daniel Lindqvist; Honglei Chen; Paul M Thomas; Patrik Brundin; Lena Brundin; Viviane Labrie Journal: Sci Transl Med Date: 2018-10-31 Impact factor: 17.956