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Preceding pain symptoms and P arkinson's disease: a nationwide population‐based cohort study
Author(s) -
Lin C.H.,
Wu R.M.,
Chang H.Y.,
Chiang Y.T.,
Lin H.H.
Publication year - 2013
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.12197
Subject(s) - medicine , hazard ratio , ibuprofen , incidence (geometry) , cohort , population , cohort study , depression (economics) , disease , proportional hazards model , physical therapy , confidence interval , physics , environmental health , optics , economics , pharmacology , macroeconomics
Background and purpose Painful sensations are recently reported to be a non‐motor feature of P arkinson's disease ( PD ). The non‐steroidal anti‐inflammatory drug ibuprofen is a common painkiller and was reported to be associated with a decreased risk of PD . The aim of the present study was to examine the relationship amongst preceding pain symptoms, use of ibuprofen and risk of PD in a nationwide population‐based cohort. Methods The data of participants who were free of PD at baseline were obtained from two large National Health Interview Surveys ( NHIS ) in T aiwan, conducted in 2001 and 2005. The information regarding pain status included severity and location of pain. Information regarding pain status, use of ibuprofen, comorbidity of depression and PD ‐associated risk/protective behaviors was adjusted using proportional hazards models. Results Amongst 33 388 participants, 32 cases of incident PD were identified after a mean follow‐up of 3 years. After adjusting for the use of ibuprofen and other PD risk factors, subjects with preceding pain symptoms had a higher incidence of PD than those without pain at baseline, and the hazard ratio was 1.79 (95% CI: 0.71–4.51, P = 0.21) for mild pain and 2.88 (95% CI: 1.05–7.86, P = 0.04) for moderate or severe pain. The PD risk increased by 34% with each additional increment in pain score [hazard ratio = 1.34 (1.03–1.75), P = 0.03], showing a dose–response relationship. Conclusions These findings support the hypothesis that pain is associated with PD in the pre‐motor stage of the disease. Further research is needed to clarify the role of sensory system involvement in the pre‐motor phase of PD .