Upper Gl Mucosal Damage Associated With Parkinson's Disease

Patients with a history of upper gastrointestinal (GI) mucosal damage were found at higher risk of developing a clinical Parkinson's disease (PD) diagnosis, researchers reported in JAMA Network Open.

The investigators sought to evaluate whether upper GI mucosal damage is associated with an increased risk of developing PD. The retrospective cohort study involved patients from the Mass General Brigham system who had undergone upper endoscopy with biopsy between 2000 and 2005 and were followed up until July 2023. Patients with mucosal damage—defined as erosions, esophagitis, ulcers, or peptic injury—were matched 1:3 with patients without mucosal damage, based on factors such as age and sex.

The study analyzed 9,350 patients, with a mean age of 52.3 years; most participants were White (73.7%) and male (55.4%). At baseline, patients with mucosal damage had higher incidences of risk factors such as Helicobacter pylori infection, proton-pump inhibitor use, and gastroesophageal reflux disease. The mean follow-up time was 14.9 years, during which patients with mucosal damage were significantly more likely to develop PD (incident rate ratio [IRR] of 4.15). Even after adjusting for covariates, mucosal damage was associated with a 1.76 times higher risk of PD. Other factors such as constipation, dysphagia, older age, and higher comorbidity were also linked to an increased PD risk.

The findings suggest that a history of upper gastrointestinal MD is associated with an elevated risk of developing PD, highlighting the need for increased monitoring of patients with MD for potential PD development.

Reference
Chang JJ, Kulkarni S, Pasricha TS. Upper Gastrointestinal mucosal damage and subsequent risk of parkinson disease. JAMA Netw Open. Published online ahead of print September 3, 2024. doi:10.1001/jamanetworkopen.2024.31949