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Are patients with Parkinson's disease at a lower risk of catching the common cold? Propensity score matching

  • Shuichiro Neshige
    Correspondence
    Corresponding author. Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Graduate School of Biomedical and Health Sciences, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
    Affiliations
    Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Graduate School of Biomedical and Health Sciences, Japan

    Epilepsy Center, Hiroshima University Hospital, Japan
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  • Shiro Aoki
    Affiliations
    Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Graduate School of Biomedical and Health Sciences, Japan
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  • Tomohisa Nezu
    Affiliations
    Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Graduate School of Biomedical and Health Sciences, Japan
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  • Masahiro Nakamori
    Affiliations
    Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Graduate School of Biomedical and Health Sciences, Japan
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  • Yu Yamazaki
    Affiliations
    Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Graduate School of Biomedical and Health Sciences, Japan
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  • Tomohiko Ohshita
    Affiliations
    Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Graduate School of Biomedical and Health Sciences, Japan
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  • Hirofumi Maruyama
    Affiliations
    Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Graduate School of Biomedical and Health Sciences, Japan

    Epilepsy Center, Hiroshima University Hospital, Japan
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      Highlights

      • We evaluated the association between PD and risk of common colds.
      • We used a propensity score to compare patients with PD with those with common brain diseases.
      • A diagnosis of PD had a significant negative association with colds.
      • The incidence of colds was lower in PD than in the other common brain diseases.
      • Physiological alpha-synuclein may contribute to inflammatory responses against infections.

      Abstract

      Introduction

      Accumulating evidence indicating that inflammatory responses play crucial roles in Parkinson's disease (PD) development provided a hypothesis that physiological alpha-synuclein may contribute to inflammatory responses against infections during non-advanced stages of PD. Thus, we examined the risk of catching a common cold in patients with PD as compared to other common brain diseases.

      Methods

      We extracted PD (non-advanced; without dementia) and control (AD: Alzheimer's disease, migraine, epilepsy, and ischemic stroke) patient data from insurance claim data available between 2010 and 2021. After confirming the clinical PD diagnosis, we investigated factors associated with cold diagnoses and used propensity score matching to identify differences in the incidence of colds between PD and control patients.

      Results

      Diagnosis of colds in PD patients (n = 726) and controls (AD = 377, migraine = 1019, epilepsy = 3414, ischemic stroke = 6943) was found in 1186 (9.5%) patients, which was independently associated with being female (odds ratio: OR 1.59; 95%CI 1.41–1.79; P < 0.0001), follow-up by neurologists (OR 1.30; 95%CI 1.15–1.48; P < 0.0001), diagnosis of PD (OR 0.30; 95%CI 0.20–0.45; P < 0.0001) and COVID-19 pandemic period (OR 0.58; 95%CI 0.47–0.72; P < 0.0001). After propensity score matching, the incidence of colds was significantly lower in PD (3.4%) versus in controls; AD (9.8%; P < 0.0001), migraine (13.3%; P < 0.0001), epilepsy (11.0%; P < 0.0001), ischemic stroke (8.8%; P < 0.0001).

      Conclusions

      Patients with PD were less likely to be diagnosed with colds. However, several confounding factors will need to be examined. Moreover, alpha-synuclein may provide protective resistance to viral infections by activating the immune system due to chronic inflammation in non-advanced PD patients.

      Keywords

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