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偏头痛与帕金森病的关联:一项全国性队列研究。

The association between migraine and Parkinson's disease: a nationwide cohort study.

机构信息

Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

Department of Neurology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea.

出版信息

Epidemiol Health. 2024;46:e2024010. doi: 10.4178/epih.e2024010. Epub 2023 Dec 18.

Abstract

OBJECTIVES

Clinical studies have suggested an association between migraine and the occurrence of Parkinson's disease (PD). However, it is unknown whether migraine affects PD risk. We aimed to investigate the incidence of PD in patients with migraine and to determine the risk factors affecting the association between migraine and PD incidence.

METHODS

Using the Korean National Health Insurance System database (2002-2019), we enrolled all Koreans aged ≥40 years who participated in the national health screening program in 2009. International Classification of Diseases (10th revision) diagnostic codes and Rare Incurable Diseases System diagnostic codes were used to define patients with migraine (within 12 months of enrollment) and newly diagnosed PD.

RESULTS

We included 214,193 patients with migraine and 5,879,711 individuals without migraine. During 9.1 years of follow-up (55,435,626 person-years), 1,973 (0.92%) and 30,664 (0.52%) individuals with and without migraine, respectively, were newly diagnosed with PD. Following covariate adjustment, patients with migraine showed a 1.35-fold higher PD risk than individuals without migraine. The incidence of PD was not significantly different between patients with migraine with aura and those without aura. In males with migraine, underlying dyslipidemia increased the risk of PD (p=0.012). In contrast, among females with migraine, younger age (<65 years) increased the risk of PD (p=0.038).

CONCLUSIONS

Patients with migraine were more likely to develop PD than individuals without migraine. Preventive management of underlying comorbidities and chronic migraine may affect the incidence of PD in these patients. Future prospective randomized clinical trials are warranted to clarify this association.

摘要

目的

临床研究表明偏头痛与帕金森病(PD)的发生之间存在关联。然而,目前尚不清楚偏头痛是否会影响 PD 的发病风险。我们旨在调查偏头痛患者中 PD 的发病情况,并确定影响偏头痛与 PD 发病之间关联的危险因素。

方法

我们使用韩国国家健康保险系统数据库(2002-2019 年),纳入了所有 2009 年参加国家健康筛查计划的年龄≥40 岁的韩国人。国际疾病分类(第 10 版)诊断代码和罕见不可治愈疾病系统诊断代码用于定义偏头痛(在入组后 12 个月内)和新诊断为 PD 的患者。

结果

我们纳入了 214193 例偏头痛患者和 5879711 例无偏头痛患者。在 9.1 年的随访期间(55435626 人年),分别有 1973 例(0.92%)和 30664 例(0.52%)有偏头痛和无偏头痛的患者被新诊断为 PD。在调整了协变量后,偏头痛患者的 PD 发病风险是无偏头痛患者的 1.35 倍。有先兆偏头痛和无先兆偏头痛患者的 PD 发病率无显著差异。在偏头痛男性患者中,潜在的血脂异常增加了 PD 的发病风险(p=0.012)。相比之下,在偏头痛女性患者中,年龄较小(<65 岁)增加了 PD 的发病风险(p=0.038)。

结论

偏头痛患者比无偏头痛患者更易发生 PD。对潜在合并症和慢性偏头痛的预防性管理可能会影响这些患者 PD 的发病情况。需要进行未来的前瞻性随机临床试验来阐明这种关联。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e92f/10928470/fda16999a7de/epih-46-e2024010f1.jpg

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