Vagotomy and subsequent risk of Parkinson's disease

Elisabeth Svensson, Erzsébet Horváth-Puhó, Reimar W. Thomsen, Jens Christian Djurhuus, Lars Pedersen, Per Borghammer, Henrik Toft Sørensen

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Abstract

Objective 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, whereas superselective 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 superselective vagotomy. Risk of PD was also decreased after 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 superselective 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). Statistical precision of 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.

Original languageEnglish
Pages (from-to)522-529
Number of pages8
JournalAnnals of Neurology
Volume78
Issue number4
DOIs
Publication statusPublished - Oct 1 2015

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Vagotomy
Parkinson Disease
Confidence Intervals
Truncal Vagotomy
Population
Denmark
Registries
Smoking
Brain

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Svensson, E., Horváth-Puhó, E., Thomsen, R. W., Djurhuus, J. C., Pedersen, L., Borghammer, P., & Sørensen, H. T. (2015). Vagotomy and subsequent risk of Parkinson's disease. Annals of Neurology, 78(4), 522-529. https://doi.org/10.1002/ana.24448

Vagotomy and subsequent risk of Parkinson's disease. / Svensson, Elisabeth; Horváth-Puhó, Erzsébet; Thomsen, Reimar W.; Djurhuus, Jens Christian; Pedersen, Lars; Borghammer, Per; Sørensen, Henrik Toft.

In: Annals of Neurology, Vol. 78, No. 4, 01.10.2015, p. 522-529.

Research output: Contribution to journalArticle

Svensson, E, Horváth-Puhó, E, Thomsen, RW, Djurhuus, JC, Pedersen, L, Borghammer, P & Sørensen, HT 2015, 'Vagotomy and subsequent risk of Parkinson's disease', Annals of Neurology, vol. 78, no. 4, pp. 522-529. https://doi.org/10.1002/ana.24448
Svensson E, Horváth-Puhó E, Thomsen RW, Djurhuus JC, Pedersen L, Borghammer P et al. Vagotomy and subsequent risk of Parkinson's disease. Annals of Neurology. 2015 Oct 1;78(4):522-529. https://doi.org/10.1002/ana.24448
Svensson, Elisabeth ; Horváth-Puhó, Erzsébet ; Thomsen, Reimar W. ; Djurhuus, Jens Christian ; Pedersen, Lars ; Borghammer, Per ; Sørensen, Henrik Toft. / Vagotomy and subsequent risk of Parkinson's disease. In: Annals of Neurology. 2015 ; Vol. 78, No. 4. pp. 522-529.
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