Abstract
PurposePrevious studies have suggested associations between primary headache and neurodegenerative diseases; however, the relationship between tension-type headache (TTH), which is the most common type of primary headache, and Parkinson's disease (PD) remains controversial. Hence, in this nationwide, population-based, retrospective cohort study, we explored the temporal association between TTH and PD.MethodsUsing claims data in the National Health Insurance Research Database of Taiwan, we evaluated 12,309 subjects aged ≥20 years who were newly diagnosed with TTH from 2000 to 2005. The non-TTH group included 49,236 randomly selected sex- and age-matched patients without TTH. Subjects were followed up until the end of 2011, diagnosis of PD, or death. The incidence of PD was compared between the two groups. A Cox multivariable proportional hazards model was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) to estimate the risk of PD.ResultsThe overall incidence of PD (per 1,000 person-years) in the TTH and non-TTH groups was 3.01 and 1.68, respectively. After adjustment for sex, age, and comorbidities, the association between TTH and PD remained statistically significant (adjusted HR = 1.37, 95% CI = 1.19–1.57). The TTH group had a higher risk of PD than the non-TTH group did, regardless of subjects’ sex, age, and comorbidity status.ConclusionsThese findings demonstrate that patients diagnosed with TTH exhibit an increased risk of PD. Additional studies should investigate the potential shared pathophysiological mechanisms of TTH and PD. Clinicians should be aware that TTH is a potential risk factor for PD.
Highlights
Parkinson’s disease (PD) is a progressive neurodegenerative disorder that affects more than 1% of the elderly population worldwide [1]
Compared with the non-tension-type headache (TTH) group, the TTH group had a higher prevalence of comorbidities, including diabetes, hyperlipidemia, hypertension, ischemic heart disease (IHD), depression, migraine, stroke, and head injury (P
We observed that the cumulative incidence of PD was significantly higher in patients with TTH than in subjects without TTH
Summary
Parkinson’s disease (PD) is a progressive neurodegenerative disorder that affects more than 1% of the elderly population worldwide [1]. PD is characterized by motor-related symptoms including bradykinesia, rigidity, and resting tremor, which are caused by the progressive loss of nigrostriatal dopaminergic neurons [2]. The risk for PD increases with age, other risk factors have been reported. These include various medical disorders or comorbidities, such as diabetes, hyperlipidemia, hypertension, ischemic heart disease, dementia, depression, migraine, stroke, chronic kidney disease, and head injury [2,3,4,5,6]. Nonmotor symptoms, including cognitive, psychiatric, sleep, autonomic, sensory, and pain disorders, can develop before the onset of motor symptoms [8]. Pain is one of the most frequent nonmotor symptoms reported by PD patients [9]. The mechanisms of pathological pain in PD are poorly understood
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