Antibiotic exposure and risk of Parkinson's disease in finland : A nationwide case-control study

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Mertsalmi , T H , Pekkonen , E & Scheperjans , F 2020 , ' Antibiotic exposure and risk of Parkinson's disease in finland : A nationwide case-control study ' , Movement Disorders , vol. 35 , no. 3 , pp. 431-442 .

Title: Antibiotic exposure and risk of Parkinson's disease in finland : A nationwide case-control study
Author: Mertsalmi, Tuomas H.; Pekkonen, Eero; Scheperjans, Filip
Contributor organization: HUS Neurocenter
Neurologian yksikkö
University of Helsinki
BioMag Laboratory
Department of Neurosciences
Date: 2020-03
Language: eng
Number of pages: 12
Belongs to series: Movement Disorders
ISSN: 0885-3185
Abstract: Background Gut microbiota alterations have been found in prodromal and established Parkinson's disease (PD). Antibiotic exposure can have long-term effects on the composition of human intestinal microbiota, but a potential connection between antibiotic exposure and risk of PD has not been studied previously. Objective To evaluate the impact of antibiotic exposure on the risk of PD in a nationwide, register-based, case-control study. Methods We identified all patients who were diagnosed with PD in Finland during the years 1998 to 2014. Information was obtained on individual purchases of orally administered antibiotics during the years 1993 to 2014. We assessed the association between prior antibiotic exposure and PD using conditional logistic regression. Results The study population consisted of 13,976 PD cases and 40,697 controls. The strongest connection with PD risk was found for oral exposure to macrolides and lincosamides (adjusted odds ratio up to 1.416; 95% confidence interval, 1.053-1.904). After correction for multiple comparisons, exposure to antianaerobics and tetracyclines 10 to 15 years before the index date, sulfonamides and trimethoprim 1 to 5 years before the index date, and antifungal medications 1 to 5 years before the index date were positively associated with PD risk. In post hoc analyses, further positive associations were found for broad-spectrum antibiotics. Conclusions Exposure to certain types of oral antibiotics seems to be associated with an elevated risk of PD with a delay that is consistent with the proposed duration of a prodromal period. The pattern of associations supports the hypothesis that effects on gut microbiota could link antibiotics to PD, but further studies are needed to confirm this. (c) 2019 International Parkinson and Movement Disorder Society
Subject: antibiotic exposure
Parkinson's disease
risk factors
3112 Neurosciences
3124 Neurology and psychiatry
Peer reviewed: Yes
Rights: cc_by_nc
Usage restriction: openAccess
Self-archived version: publishedVersion

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