Increased risk of Parkinson’s disease following tension-type headache: a nationwide population-based cohort study
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Fu-Chi Yang1, Hsuan-Ju Chen2, Jiunn-Tay Lee1, Sy-Jou Chen3,4, Yueh-Feng Sung1, Chia-Hung Kao5,6,7 and Tse-Yen Yang8,9,10
1Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
2Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
3Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
4Graduate Institute of Injury Prevention and Control, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan
5Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
6Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan
7Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan
8Department of Medical Laboratory Science and Biotechnology, China Medical University, Taichung, Taiwan
9Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
10Molecular and Genomic Epidemiology Center, China Medical University Hospital, Taichung, Taiwan
Tse-Yen Yang, email: firstname.lastname@example.org
Keywords: tension-type headache; Parkinson’s disease; retrospective cohort study; National Health Insurance Research Database
Received: July 11, 2017 Accepted: December 04, 2017 Published: December 14, 2017
Purpose: Previous 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.
Methods: Using 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.
Results: The 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.
Conclusions: These 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.
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