Summary: People with a history of upper gastrointestinal ( GI ) damage have a 76 % higher risk of developing Parkinson’s disease. The study demonstrates how underlying conditions like GERD, gastric ulcers, and NSAID usage may raise the risk of this neurological problem.
The findings suggest that people with lower GI damage may require more frequent surveillance of Parkinson’s symptoms. This study supports the “gut-first” assumption, proposing that Parkinson’s does emerge in the colon before affecting the head.
Important Facts:
- Upper GI damage increases Parkinson’s disease risk by 76 %.
- Problems like GERD, lesions, and NSAID usage are linked to this higher risk.
- Parkinson’s perhaps originate in the colon before it impacts the central nervous system.
Origin: BIDMC
A study conducted by Beth Israel Deaconess Medical Center ( BIDMC) researchers found that those with a history of upper gastrointestinal ( GI ) tract damage had a 76 % higher risk of developing Parkinson’s disease than those without.
The study sheds light on the way Parkinson’s may develop in some people and also suggests that increased vigilance among those with a history damage to the upper GI tract—typically ulcerations caused by the H. pylori bacterium,  , gastroesophageal reflux disease , ( GERD ) and/or use of non-steroidal anti-inflammatory drugs ( NSAIDS ) such ibuprofen—for future Parkinson’s disease risk may be warranted.
The results are  , published , in , JAMA Network Open. Co-authors included Jocelyn J. Chang of Tufts University School of Medicine, Subash Kulkarni of BIDMC.
” A growing body of evidence suggests that, at least in a set of people, Parkinson’s disease originates in the colon before affecting the main nerve system”, said related artist Trisha S. Pasricha, MD, MPH, a neurogastroenterologist and director of Clinical Research at the Institute for Gut-Brain Research at BIDMC.
People frequently consider how the mind influences the colon, but the colon has a lot of potential for significant brain-related changes that are still unexplored. Some people with Parkinson’s disease go for years, even decades, before developing engine symptoms like tremors or walking difficulties.
Our laboratory has been working to better understand this “gut-first” Parkinson’s disease pathway because it can provide new avenues for early intervention and treatment techniques.
Parkinson’s disease, a progressive neurological disorder, affects an estimated 8.5 million persons worldwide—a number that has more than doubled over the past three years.
Prasricha and colleagues used patient data from an electronic database that included a picture of industrial educational centers, ambulatory clinics, and neighborhood hospitals in the greater Boston area to investigate this “gut-first hypothesis.”
Between 2000 and 2005, researchers tracked a cohort of patients who had no prior Parkinson’s disease and underwent an upper endoscopy ( EGD ) to image and diagnose issues in the esophagus, stomach, and first portion of the small intestine, which together make up the upper GI tract.
People with mucous injury accidents, or mucous damage, were matched in a 1:1 ratio with those without mucosal damage. Through July 2023, all patients were monitored.
Of 2, 338 patients with mucosal damage, 2.2 % were later diagnosed with Parkinson’s disease, while of the 8, 955 patients without mucosal damage, 0.5 % went on to develop Parkinson’s.
After adjusting for confounders, the risk of developing Parkinson’s disease was 76 % higher among those with a history of mucosal damage than among those without. On average, Parkinson’s disease was detected 14.2 times after mucous destruction was detected on an upper biopsy.
We discovered that having a record of upper gastrointestinal mucous damage was linked to a 76 % higher risk of developing Parkinson’s disease later, which highlights the need for more frequent monitoring of these people, according to Pasricha, who also teaches medicine at Harvard Medical School.
” NSAID use is but widespread—from back pain to headaches—and with , gastric ulcers , worldwide affecting upwards of 8 million people, understanding the path from mucosal damage to Parkinson’s disease pathology may prove important to first recognition of risk as well as prospective intervention.”
About this Parkinson’s disease research news
Author: Jacqueline Mitchell
Source: BIDMC
Contact: Jacqueline Mitchell – BIDMC
Image: The image is credited to Neuroscience News
Original Research: Open access.
By Jocelyn J. Chang et al.,” Upper gastrointestinal mucosal damage and the chance of developing Parkinson’s disease in the future” JAMA Network Open
Abstract
Upper gastrointestinal mucosal damage and the chance of developing Parkinson’s disease in the future
Importance
Although the gut-first hypothesis for Parkinson disease ( PD ) has gained popularity, potential inciting events that could lead to Parkinson pathology as a result of gut-related factors remain a mystery. While , Helicobacter pylori , infection is linked to mucosal damage ( MD) and PD, it is unknown how upper gastrointestinal MD from any source increases PD risk.
Objective
To assess the likelihood of an association between MD findings from an upper endoscopy and a subsequent clinical PD diagnosis.
Design, Setting, and Participants ,  ,
Final follow-up checks were completed on July 31, 2023 for patients who had no prior PD history and had undergone an upper endoscopy with biopsy between January 2000 and December 2005. The study was conducted within the Mass General Brigham system, a multicenter network in the greater Boston, Massachusetts, area. Patients with MD were matched 1: 3 to patients without MD based on age, sex, and date of initial endoscopy.
Exposure
MD, defined as erosions, esophagitis, ulcers, or peptic injury, observed on upper endoscopy or pathology reports.
Main Outcomes and Measures ,  ,
The relative risk of PD, based on a history of MD, is calculated using an IRR and a multivariate Cox proportional hazard ratio ( HR ).
Results
Of 9350 patients, participants had a mean ( SD ) age of 52.3 ( 20.3 ) years, 5177 ( 55.4 % ) were male, and 269 ( 2.9 % ) were Asian, 737 ( 7.9 % ) Black, and 6888 ( 73.7 % ) White. Most participants underwent endoscopy between the ages of 50 and 64 years ( 2842]30.4 % ] ).
At baseline, patients with MD were more likely to have a history of , H pylori , infection, proton-pump inhibitor use, chronic nonsteroidal anti-inflammatory drug use, gastroesophageal reflux disease, smoking, constipation, and dysphagia.
The mean ( SD ) follow-up time was 14.9 ( 6.9 ) years for the whole cohort, during which patients with MD were more likely to develop PD ( IRR, 4.15, 95 % CI, 2.89-5.97,  , P <, .001 ) than those without MD, even after covariate adjustment ( HR, 1.76, 95 % CI 1.11-2.51,  , P = .01 ). Constipation, dysphagia, older age, and higher Charlson-Deyo Comorbidity Index were also associated with higher PD risk.
Conclusions and Relevance ,  ,
A history of upper gastrointestinal MD was linked to a higher risk of developing a clinical PD diagnosis in this cohort study. Patients who have MD may need to be more vigilant to protect themselves from PD risk in the future.
