Infections or Sepsis Preceding Clinically Diagnosed α-Synucleinopathies: A Case-Control Study

Mov Disord. 2020 Sep;35(9):1684-1689. doi: 10.1002/mds.28111. Epub 2020 Jun 1.

Abstract

Background: Several studies have proposed a role for infections to induce an inflammatory response triggering Parkinson's disease. This remains controversial and the influence of severe infections on other α-synucleinopathies (Dementia with Lewy Bodies, Parkinson's disease dementia, and Multiple System Atrophy) has not been adequately investigated.

Objectives: To assess the association between hospitalization-required infections or sepsis and risk of clinically diagnosed α-synucleinopathies.

Methods: Using the medical records-linkage system (Rochester Epidemiology Project), we identified all α-synucleinopathy cases of in Olmsted County (1991-2010). Cases were matched by symptom-onset age and sex to controls. We reviewed complete medical records to detect hospital-required infections or sepsis preceding clinical-motor onset of α-synucleinopathies. We used conditional logistic regression to calculate the odds ratio of all α-synucleinopathies, adjusting for medications, coffee, and smoking.

Results: There was no association between infection-related hospitalization (odds ratio: 1.05; 95% confidence interval: 0.78-1.40; P = 0.76) or sepsis (odds ratio: 0.86; 95% confidence interval: 0.40-1.85; P = 0.70) and all α-synucleinopathies in multivariable analyses. We did not identify any associations after stratifying for type of α-synucleinopathy, sex, and age at clinical-motor onset. We analyzed sepsis separately with similar results.

Conclusion: We did not observe any associations between infections leading to hospitalization or sepsis and development of any α-synucleinopathies. © 2020 International Parkinson and Movement Disorder Society.

Keywords: case-control; infection; parkinsonism; sepsis; α-synucleinopathies.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Case-Control Studies
  • Humans
  • Lewy Body Disease*
  • Minnesota
  • Sepsis* / diagnosis
  • Sepsis* / epidemiology
  • Synucleinopathies*
  • alpha-Synuclein

Substances

  • alpha-Synuclein