Appendectomy Increases Odds of Developing Parkinson Disease

Individuals who undergo appendectomy have an increased likelihood of developing Parkinson disease (PD) compared with those who do not, according to findings of a retrospective study.¹

Results of the study, led by Mohammed Z. Sheriff, MD, a physician at Case Western Reserve University and University Hospitals Cleveland Medical Center, Ohio, were presented at Digestive Disease Week on Monday, May 20, in San Diego, California.

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Previous research has shown aggregated α-synuclein, a pathologic feature of PD, to be present in enteric neurons. Aggregated α-synuclein can appear in the gastrointestinal (GI) tract in the onset of PD, which has suggested that the GI tract could have a role in the development of PD, according to the study’s abstract. Still, whether appendectomies increase the risk of PD has remained controversial.

For this study, Sheriff and colleagues evaluated health records from an Ohio-based electronic health records company of more than 62.2 million individuals to identify those who had had appendectomies and had been diagnosed with PD a minimum of 6 months later.

A total 488,190 individuals had undergone appendectomies. Among those, 4470 developed PD. Of the remaining individuals who had not undergone an appendectomy, 177,230 developed PD.

The overall relative risk (RR) of developing PD after an appendectomy was 3.19 (95% CI, 3.10-3.28) compared with no procedure. Individuals aged 18 to 64 years (RR, 4.27; 95% CI, 3.99-4.57) and those older than 65 years (RR, 2.20; 95% CI, 2.13-2.27) had an increased risk of PD.

The risk of PD was similar across all age groups regardless of gender or race.

Apart from the 6-month washout period programmed into their initial query of the database, the researchers could not tell from the deidentified records exactly how much time had passed after the appendectomy until PD was diagnosed. 

“This research shows a clear relationship between the appendix, or appendix removal, and Parkinson’s disease, but it is only an association,” Dr Sheriff said in a press release. “Additional research is needed to confirm this connection and to better understand the mechanisms involved.”²

—Melinda Stevens

References:

1. Sheriff MZ, Mansoor E, Cooper GS. Parkinson’s disease is more prevalent in patients with appendectomies: a national population-based study. Presented at: Digestive Disease Week; May 18-21; San Diego, CA. https://www.gastrojournal.org/article/S0016-5085(19)40573-8/pdf. Accessed May 21, 2019.

2. Appendix removal associated with development of Parkinson’s disease [press release]. San Diego, CA: Digestive Disease Week; May 9, 2019. https://ddw.org/news/press-releases/appendix-removal-associated-with-development-of-parkinsons-disease. Accessed May 21, 2019.