Categories
Parkinson's disease

Is bipolar disorder a risk factor for Parkinson’s disease?

Bipolar disorder and risk of Parkinson disease: a nationwide longitudinal study

Huang MH, Cheng CM, Huang KL, et al.

Neurology 2019; 92:e2735-e2742.

Abstract

OBJECTIVE:

To evaluate the risk of Parkinson disease (PD) among patients with bipolar disorder (BD).

METHODS:

Using the Taiwan National Health Insurance Research Database, we examined 56,340 patients with BD and 225,360 age- and sex-matched controls between 2001 and 2009 and followed them to the end of 2011. Individuals who developed PD during the follow-up period were identified.

RESULTS:

Patients with BD had a higher incidence of PD (0.7% vs 0.1%, p < 0.001) during the follow-up period than the controls. A Cox regression analysis with adjustments for demographic data and medical comorbid conditions revealed that patients with BD were more likely to develop PD (hazard ratio [HR] 6.78, 95% confidence interval [CI] 5.74-8.02) than the control group. Sensitivity analyses after exclusion of the first year (HR 5.82, 95% CI 4.89-6.93) or first 3 years (HR 4.42; 95% CI 3.63-5.37) of observation showed consistent findings. Moreover, a high frequency of psychiatric admission for manic/mixed and depressive episodes was associated with an increased risk of developing PD.

CONCLUSION:

Patients with bipolar disorder had a higher incidence of Parkinson’s disease during the follow-up period than the control group. Manic/mixed and depressive episodes were associated with an elevated likelihood of developing PD. Further studies are necessary to investigate the underlying pathophysiology between BD and PD.

See also

Faustino PR, Duarte GS, Chendo I, et al. Risk of developing Parkinson disease in bipolar disorder: a systematic review and meta-analysis. JAMA Neurol 2019; doi: 10.1001/jamaneurol.2019.3446 (Epub ahead of print).

Both papers are cited in the neurochecklist:

Parkinson’s disease (PD): risk factors

Abstract link 1

Abstract link 2

By National Institute of Mental Health (NIMH), National Institute of Health (NIH), U.S. Department of Health and Human Services. – https://www.nimh.nih.gov/health/publications/bipolar-disorder/index.shtml#pub1, Public Domain, Link
Categories
Parkinson's disease

Is bipolar disorder a risk factor for Parkinson’s disease?

Risk of developing Parkinson disease in bipolar disorder: a systematic review and meta-analysis

Faustino PR, Duarte GS, Chendo I, et al

JAMA Neurol 2019 (Epub ahead of print)

Abstract

BACKGROUND:

Parkinson disease (PD) manifests by motor and non-motor symptoms, which may be preceded by mood disorders by more than a decade. Bipolar disorder (BD) is characterized by cyclic episodes of depression and mania. It is also suggested that dopamine might be relevant in the pathophysiology of BD.

METHODS:

To assess the association of BD with a later diagnosis of idiopathic PD. An electronic literature search was performed of Cochrane Controlled Register of Trials, MEDLINE, Embase, and PsycINFO from database inception to May 2019 using the terms Parkinson disease, bipolar disorder, and mania, with no constraints applied. Studies that reported data on the likelihood of developing PD in BD vs non-BD populations were included. Two review authors independently conducted the study selection. Two review authors independently extracted study data. Data were pooled using a random-effects model, results were abstracted as odds ratios and 95% CIs, and heterogeneity was reported as I2.

RESULTS:

Seven studies were eligible for inclusion and included 4 374 211 participants overall. A previous diagnosis of BD increased the likelihood of a subsequent diagnosis of idiopathic PD (odds ratio, 3.35; 95% CI, 2.00-5.60; I2 = 92%). A sensitivity analysis was performed by removing the studies that had a high risk of bias and also showed an increased risk of PD in people with BD (odds ratio, 3.21; 95% CI, 1.89-5.45; I2 = 94%). Preplanned subgroup analyses according to study design and diagnostic certainty failed to show a significant effect.

CONCLUSIONS:

This review suggests that patients with BD have a significantly increased risk of developing PD compared with the general population. Subgroup analyses suggested a possible overestimation in the magnitude of the associations. These findings highlight the probability that BD may be associated with a later development of PD and the importance of the differential diagnosis of parkinsonism features in people with BD.

This paper is cited in the neurochecklist:

Parkinson’s disease (PD): risk factors

Abstract link

By National Institute of Mental Health (NIMH), National Institute of Health (NIH), U.S. Department of Health and Human Services. – https://www.nimh.nih.gov/health/publications/bipolar-disorder/index.shtml#pub1, Public Domain, Link