Abstract
Introduction Parkinson's disease (PD) is an age-related neurodegenerative disease likely caused by complex interactions between genetic and environmental risk factors. Exposure to pesticides, toxic metals, solvents, and history of traumatic brain injury have been implicated as environmental risk factors for PD, underscoring the importance of identifying risk factors associated with PD across different communities. Methods We conducted a questionnaire-based case-control study in a rural area on the New Hampshire/Vermont border, enrolling PD patients and age- and sex-matched controls from the general population between 2017 and 2020. We assessed frequent participation in a variety of recreational and occupational activities and surveyed potential chemical exposures. Results Suffering from “head trauma or a concussion” prior to diagnosis was associated with a fourfold increased risk of PD. Adjustment for head trauma negated any risk of participation in “strenuous athletic activities.” We observed a 2.7-fold increased risk of PD associated with activities involving lead (adjusted p=0.038). Conclusion Implicating these factors in PD risk favors public health efforts in exposure mitigation while also motivating future work mechanisms and intervention opportunities.
Highlights
Parkinson’s disease (PD) is an age-related neurodegenerative disease likely caused by complex interactions between genetic and environmental risk factors
A higher proportion of PD patients reported participation in “strenuous athletic activities, such as running, swimming, or other competitive sports” (57.9% of cases vs. 43.2% of controls, p 0.020); adjusting for head trauma as a confounding factor mitigates this association (Table 2)
Reports of suffering “head trauma or a concussion that caused you to black out or lose consciousness” prior to the diagnosis date were much more frequent among PD patients (42.7%) compared to controls (18.4%). e risk remained significantly increased in a model adjusted for age, sex, smoking, family history, and athletic activity (Table 2)
Summary
Parkinson’s disease (PD) is an age-related neurodegenerative disease likely caused by complex interactions between genetic and environmental risk factors. Implicating these factors in PD risk favors public health efforts in exposure mitigation while motivating future work mechanisms and intervention opportunities. Gene mapping in subjects with rare familial forms of PD [4] and large scale GWAS studies [5] have implicated numerous genetic variants associated with PD risk. Despite these discoveries, PD resulting from a causal genetic mutation is infrequent, suggesting the potential that lifestyle factors play a role in the development of the disease. Identifying environmental factors that increase PD risk would allow exposure mitigation and disease prevention efforts while facilitating the experimental investigation of mechanisms and intervention opportunities
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