Vagotomy and subsequent risk of Parkinson’s disease

-
Abstract
Vagotomy and subsequent risk of Parkinson’s disease
Objectives: Parkinson’s disease (PD) may be caused by an enteric neurotropic pathogen entering the brain through the vagal nerve, a process that may take over 20 years. We investigated the risk of PD in patients who underwent vagotomy, and hypothesized that truncal vagotomy is associated with a protective effect, while super-selective vagotomy has a minor effect.

Methods: We constructed cohorts of all patients in Denmark who underwent vagotomy during 1977-1995 and a matched general population cohort, by linking Danish registries. We used Cox regression to compute hazard ratios (HRs) for PD and corresponding 95% confidence intervals [CIs], adjusting for potential confounders.
Results: Risk of PD was decreased in patients who underwent truncal [HR = 0.85, 95% CI= 0.56–1.27; follow-up of >20 years: HR = 0.58, 95% CI: 0.28–1.20] compared to super-selective vagotomy. Risk of PD was also decreased following truncal vagotomy when compared to the general population cohort [overall adjusted HR = 0.85, 95% CI 0.63–1.14; follow-up >20 years, adjusted HR = 0.53 [95% CI: 0.28–0.99]. In patients who underwent super-selective vagotomy, risk of PD was similar to the general population [HR = 1.09, 95% CI: 0.84–1.43; follow-up of >20 years: HR = 1.16, 95% CI: 0.80–1.70]. The statistical precision of the risk estimates was limited. Results were consistent after external adjustment for unmeasured confounding by smoking.
Interpretation: Full truncal vagotomy is associated with a decreased risk for subsequent PD, suggesting that the vagal nerve may be critically involved in the pathogenesis of PD.

Comments

Post a Comment

Popular posts from this blog

Cell Reproduction

-
Image
Genetic Control of Protein Synthei s s, Cell Function, and Cell Reproduction    Virtually everyone knows that the genes, located in the nuclei of all cells of the body, control heredity from parents to children, but most people do not realize that these same genes also control day-today function of all the body’s cells. The genes control cell function by determining which substances are synthesized within the cell which structures, which enzymes, which chemicals. The general schema of genetic control : Each gene, which is a nucleic acid called deoxyribonucleic acid (DNA), automatically controls the formation of another nucleic acid, ribonucleic acid (RNA); this RNA then spreads throughout the cell to control the formation of a specific protein. Because there are more than 30,000 different genes in each cell, it is theoretically possible to form a very large number of different cellular proteins. Some of the cellular proteins are structural proteins, which, in associati...
Read more

The Anterior Pituitary and Hypothalamus

-
Image
The anterior pituitary is often referred to as the “master gland” because, together with the hypothalamus, it orchestrates the complex regulatory functions of multiple other endocrine glands. The anterior pituitary gland produces six major hormones: (1) prolactin (PRL), (2) growth hormone (GH), (3) adrenocorticotropin hormone (ACTH), (4) luteinizing hormone (LH), (5) follicle-stimulating hormone (FSH), and (6) thyroid-stimulating hormone (TSH). Pituitary hormones are secreted in a pulsatile manner, reflecting stimulation by an array of specific hypothalamic releasing factors. Each of these pituitary hormones elicits specific responses in peripheral target tissues.  The Disorders of the Anterior  Pituitary and Hypothalamus  Hormonal products of these peripheral glands, in turn, exert feedback control at the level of the hypothalamus and pituitary to modulate pituitary function. Pituitary tumors cause characteristic hormone excess syndromes. Hormone deficiency m...
Read more

Hypothalamic Tumor

-
Image
HYPOTHALAMIC, PITUITARY, AND OTHER SELLAR MASSES PITUITARY TUMORS    Pituitary adenomas are the most common cause of pituitary hormone hypersecretion and hyposecretion syndromes in adults. They account for ~15% of all intracranial neoplasms. At autopsy, up to one-quarter of all pituitary glands harbor an unsuspected microadenoma. Pathogenesis    Pituitary adenomas are benign neoplasms that arise from one of the five anterior pituitary cell types. The clinical and biochemical phenotype of pituitary adenomas depend on the cell type from which they are derived. Thus, tumors arising from lactotrope (PRL), somatotrope (GH), corticotrope (ACTH), thyrotrope (TSH), or gonadotrope (LH, FSH) cells hypersecrete their respective hormones. . Plurihormonal tumors that express combinations of GH, PRL, TSH, ACTH, and the glycoprotein hormone α subunit may be diagnosed by careful immunocytochemistry or may manifest as clinical syndromes that combine features of these hor...
Read more