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Original research
Risk of Parkinson’s disease in multiple sclerosis and neuromyelitis optica spectrum disorder: a nationwide cohort study in South Korea
  1. Soonwook Kwon1,
  2. Se Young Jung2,3,
  3. Kyung-do Han4,
  4. Jin Hyung Jung5,
  5. Yohwan Yeo6,
  6. Eun Bin Cho7,8,
  7. Jong Hyeon Ahn9,
  8. Dong Wook Shin10,11,12,
  9. Ju-Hong Min9,13,14
  1. 1Neurology, Inha University Hospital, Incheon, South Korea
  2. 2Family Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
  3. 3Digital Healthcare, Seoul National University Bundang Hospital, Seongnam, South Korea
  4. 4Statistics and Actuarial Science, Soongsil University, Seoul, South Korea
  5. 5Biostatistics, The Catholic University of Korea, Seoul, South Korea
  6. 6Family Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, South Korea
  7. 7Neurology, Gyeongsang Institute of Health Sciences, Jinju, South Korea
  8. 8Neurology, Gyeongsang National University Changwon Hospital, Changwon, South Korea
  9. 9Neurology, Samsung Medical Center, Seoul, South Korea
  10. 10Family Medicine, Samsung Medical Center, Gangnam-gu, South Korea
  11. 11Clinical Research Design and Evaluation/Department of Digital Health, SAIHST, Seoul, South Korea
  12. 12Center for Wireless and Population Health Systems, University of California, San Diego, California, USA
  13. 13Neuroscience Center, Samsung Medical Center, Gangnam-gu, South Korea
  14. 14Health Sciences and Technology, SAIHST, Seoul, South Korea
  1. Correspondence to Dr Ju-Hong Min, Department of Neurology, Samsung Medical Center Sungkyunkwan University School of Medicine, Seoul, 06351, Republic of Korea; juhongm{at}skku.edu; Dr Dong Wook Shin, Department of Family Medicine & Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06351, Republic of Korea; dwshin.md{at}gmail.com

Abstract

Background Neurodegeneration is associated with pathogenesis of both multiple sclerosis (MS) and neuromyelitis optica (NMOSD). Parkinson’s disease (PD) is a representative neurodegenerative disease, however, whether MS or NMOSD is associated with risk of PD is not known.

Methods MS and NMOSD cohorts were collected from the Korean National Health Insurance Service between 1 January 2010 and 31 December 2017, using International Classification of Diseases 10th revision diagnosis codes and information in the Rare Intractable Disease management programme. The PD incidence rate that occurred after a 1-year lag period was calculated and compared with that of a control cohort matched for age, sex, hypertension, diabetes and dyslipidaemia in a 1:5 ratio.

Results The incidence rates of PD in patients with MS and NMOSD were 3.38 and 1.27 per 1000 person-years, respectively, and were higher than that of their matched control groups. The adjusted HR of PD was 7.73 (95% CI, 3.87 to 15.47) in patients with MS and 2.61 (95% CI, 1.13 to 6.02) in patients with NMOSD compared with matched controls. In both patients with MS and NMOSD, there were no significant differences in relative risk when stratified by sex, age, diabetes, hypertension and dyslipidaemia.

Conclusion The PD risk was higher in patients with MS and NMOSD compared with healthy controls and was particularly high in patients with MS. Further investigations should be performed to determine the pathophysiology and occurrence of PD in patients with MS and NMOSD.

  • MULTIPLE SCLEROSIS
  • PARKINSON'S DISEASE
  • EPIDEMIOLOGY

Data availability statement

Data are available upon reasonable request. The data set analyzed in this study is not publicly available because of restricted access, but further information about the data set is available from the corresponding author on reasonable request.

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Data availability statement

Data are available upon reasonable request. The data set analyzed in this study is not publicly available because of restricted access, but further information about the data set is available from the corresponding author on reasonable request.

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Footnotes

  • SK and SYJ contributed equally.

  • Contributors SK and SYJ contributed to formal analysis, investigation, writing–original draft. K-dH, JHJ and YY contributed to data curation and analysis. EBC and JHA contributed to investigation, review and editing. DWS and J-HM contributed to study concept and design, validation, supervision, manuscript correction and are guarantors for the overall contents.

  • Funding This research was partially supported by a grant from the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HI20C1073).

  • Competing interests J-HM has lectured, consulted and received Honoria from Bayer Schering Pharma, Merck Serono, Biogen Idec, Sanofi Genzyme, Teva-Handok, UCB, Samsung Bioepis and Mitsubishi Tanabe Pharma and Roche and received a National Research Foundation of Korea grant and an SMC Research and Development Grant. The other authors report no competing interest.

  • Provenance and peer review Not commissioned; externally peer reviewed.