Spinal cord injury and Parkinson's disease: a population-based, propensity score-matched, longitudinal follow-up study
Objectives:To investigate whether patients with spinal cord injury (SCI) are at an increased risk of developing Parkinson’s disease (PD).Study design:A population-based, propensity score-matched, longitudinal follow-up cohort study.Setting:The study was conducted using the National Health Insurance (NHI) Research Database.Methods:A total of 10 125 patients with at least 2 ambulatory visits with a diagnosis of SCI in 2001 were enrolled in the SCI group. The non-SCI group comprised 10 125 propensity score-matched patients without SCI. The propensity scores were computed using a logistic regression model that included age, sex, comorbidities and socioeconomic status. The PD-free survival rates of the two groups were estimated using the Kaplan–Meier method. Stratified Cox proportional hazard regression was used to estimate the effect of SCI on subsequent occurrence of PD.Results:During the 3-year follow-up period, 99 subjects in the SCI group and 59 in the non-SCI group developed PD. The hazard ratio of PD for the SCI group compared with the non-SCI group was 1.65 (95% confidence interval 1.16–2.33, P=0.0049). The PD-free survival rate for the SCI group was lower than that for the non-SCI group (P=0.0017).Conclusions:This study shows that SCI is associated with a subsequent increased risk of PD. Further studies are needed to elucidate the mechanism underlying this association.
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