Objective
Increasing evidence has suggested a relationship between post-traumatic stress disorder
(PTSD) and neurodegenerative disorder, such as Alzheimer disease. The association
between PTSD and Parkinson disease (PD), however, remains unclear.
Method
Using the Taiwan National Health Insurance Research Database, 7,280 subjects (1,456
patients aged ≥45 years with PTSD and 5,824 age-/sex-matched individuals without PTSD)
were enrolled between 2002 and 2009 and followed to the end of 2011. Subjects who
developed PD during the follow-up period were identified.
Results
An increased risk of developing PD was found in patients with PTSD (Wald χ2 = 12.061, hazard ratio [HR]: 3.46, 95% confidence interval [CI]: 1.72–6.96) compared
with individuals without PTSD, after adjusting for demographic data and medical and
psychiatric comorbidities. The sensitivity tests after excluding the first year observation
(Wald χ2 = 7.948, HR: 3.01, 95% CI: 1.40–6.46) and the first 3-year observation (Wald χ2 = 5.099, HR: 3.07, 95% CI: 1.16–8.15) were consistent.
Conclusions
Patients with PTSD had an elevated risk of developing PD in later life. Further studies
would be required to clarify the exact pathophysiology between PTSD and PD and to
investigate whether the prompt intervention for PTSD may reduce this risk.
Key Words
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References
- Parkinson's disease.Lancet. 2015; 386: 896-912
- Alzheimer's disease and Parkinson's disease.N Engl J Med. 2003; 348: 1356-1364
- The new definition and diagnostic criteria of Parkinson's disease.Lancet Neurol. 2016; 15: 546-548
- The prevalence of Parkinson's disease: a systematic review and meta-analysis.Mov Disord. 2014; 29: 1583-1590
- Stress, PTSD, and dementia.Alzheimers Dement. 2014; 10: S155-S165
- Military risk factors for Alzheimer's dementia and neurodegenerative disease.Alzheimers Dement. 2014; 10: S90-S91
- Effects of traumatic brain injury and posttraumatic stress disorder on Alzheimer's disease in veterans, using the Alzheimer's Disease Neuroimaging Initiative.Alzheimers Dement. 2014; 10: S226-S235
- Posttraumatic stress disorder and risk of dementia among US veterans.Arch Gen Psychiatry. 2010; 67: 608-613
- Neuropathology of stress.Acta Neuropathol. 2014; 127: 109-135
- Can stress trigger Parkinson's disease?.J Neurol Neurosurg Psychiatry. 2014; 85: 878-881
- Chronic stress and Parkinson's disease.CNS Neurosci Ther. 2014; 20: 1-2
- Stress-induced Parkinson's disease: a working hypothesis.Physiol Behav. 2002; 77: 527-531
- Adjustment disorder and risk of Parkinson's disease.Eur J Neurol. 2016; 23: 751-756
- The epidemiology of Parkinson's disease: risk factors and prevention.Lancet Neurol. 2016; 15: 1257-1272
- The Assessment and Treatment of Individuals with History of Traumatic Brain Injury and Post-Traumatic Stress Disorder: A Systematic Review of the Evidence.Department of Veterans Affairs, Washington, DC2009 (Available from)
- Stress, depression and Parkinson's disease.Exp Neurol. 2012; 233: 79-86
- The stressful life events and Parkinson's disease: a case-control study.Stress Health. 2013; 29: 50-55
- Neurological disease in ex-Far-East prisoners of war.Lancet. 1980; 2: 135-137
- Chronic restraint stress triggers dopaminergic and noradrenergic neurodegeneration: possible role of chronic stress in the onset of Parkinson's disease.Brain Behav Immun. 2016; 51: 39-46
- Loss of dopaminergic neurons occurs in the ventral tegmental area and hypothalamus of rats following chronic stress: possible pathogenic loci for depression involved in Parkinson's disease.Neurosci Res. 2016; 111: 48-55
- Chronic stress enhances microglia activation and exacerbates death of nigral dopaminergic neurons under conditions of inflammation.J Neuroinflammation. 2014; 11: 34
- Involvement of the ventral tegmental area in a rodent model of post-traumatic stress disorder.Neuropsychopharmacology. 2013; 38: 350-363
- Stress and glucocorticoid receptor-dependent mechanisms in long-term memory: from adaptive responses to psychopathologies.Neurobiol Learn Mem. 2014; 112: 17-29
- Peripheral cytokines profile in Parkinson's disease.Brain Behav Immun. 2009; 23: 55-63
- Microglial glucocorticoid receptors play a pivotal role in regulating dopaminergic neurodegeneration in parkinsonism.Proc Natl Acad Sci U S A. 2011; 108: 6632-6637
- Elevated levels of serum interleukin-1 beta in combat-related posttraumatic stress disorder.Biol Psychiatry. 1997; 42: 345-348
- Neuroimmune and cortisol changes in selective serotonin reuptake inhibitor and placebo treatment of chronic posttraumatic stress disorder.Biol Psychiatry. 2004; 56: 121-128
- Assessment of the hypothalamic-pituitary-adrenal axis over a 24-hour diurnal period and in response to neuroendocrine challenges in women with and without childhood sexual abuse and posttraumatic stress disorder.Biol Psychiatry. 2003; 54: 710-718
- Post-traumatic stress disorder: a fast track to premature cardiovascular disease?.Cardiol Rev. 2013; 21: 16-22
- Central and systemic IL-1 exacerbates neurodegeneration and motor symptoms in a model of Parkinson's disease.Brain. 2008; 131: 1880-1894
- Parkinson's disease: less epileptic seizures, more status epilepticus.Epilepsy Res. 2014; 108: 349-354
- The epidemiology of the comorbidity of epilepsy in the general population.Epilepsia. 2004; 45: 1613-1622
Article info
Publication history
Published online: March 23, 2017
Accepted:
March 20,
2017
Received in revised form:
March 8,
2017
Received:
December 19,
2016
Identification
Copyright
© 2017 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.
