Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland.
Boston Collaborative Drug Surveillance Program, Lexington, MA.
Ann Neurol. 2018 Feb;83(2):363-374. doi: 10.1002/ana.25157. Epub 2018 Feb 10.
To assess the association between incident Parkinson disease (PD) and subsequent incident epileptic seizures.
We conducted a retrospective cohort study with a nested case-control analysis using data from the U.K. Clinical Practice Research Datalink. We identified patients aged ≥40 years with an incident diagnosis of PD between 1995 and 2016 and a matched comparison group of PD-free individuals. We calculated crude incidence rates (IRs) with 95% confidence intervals (CIs) of epileptic seizures in PD patients and the PD-free comparison group, and corresponding crude incidence rate ratios (IRRs). In the nested case-control analysis, we calculated adjusted odds ratios (adj. ORs) of incident PD among cases with incident epileptic seizures and seizure-free controls overall and stratified by various seizure-provoking comorbidities.
Among 23,086 incident PD patients and 92,343 PD-free individuals, we identified 898 patients with incident epileptic seizures. The crude IR of epileptic seizures in PD patients was 266.7/100,000 person-years (95% CI = 235.6-297.7), and in PD-free individuals it was 112.4/100,000 person-years (95% CI = 103.5-121.3; IRR = 2.37, 95% CI = 2.06-2.73). The adj. OR of epileptic seizures was 1.68 (95% CI = 1.43-1.98) in PD patients compared with PD-free individuals. PD patients with comorbid brain disorders (adj. OR = 12.36, 95% CI = 8.74-17.48) or with > 1 seizure-provoking comorbidity (adj. OR = 13.24, 95% CI = 10.15-17.25) were at the highest risk of epileptic seizures compared with PD-free individuals with no seizure-provoking comorbidities.
This study suggests that incident PD is associated with an increased risk of incident epileptic seizures. Ann Neurol 2018;83:363-374.
评估帕金森病（PD）发病与随后癫痫发作发病之间的关联性。
我们开展了一项基于英国临床实践研究数据链的回顾性队列研究，并进行了嵌套病例对照分析。我们纳入了年龄≥40 岁、1995 至 2016 年间首次确诊 PD 的患者，以及与之匹配的无 PD 患者作为对照组。我们计算了 PD 患者和无 PD 对照组的癫痫发作粗发病率（IR）及其 95%置信区间（CI），以及相应的粗发病率比（IRR）。在嵌套病例对照分析中，我们计算了所有病例及各种诱发性合并症病例与无癫痫发作病例之间的 PD 发病比值比（adj. OR）。
在 23086 名 PD 患者和 92343 名无 PD 患者中，我们共发现 898 名患者发生了癫痫发作。PD 患者的癫痫发作粗发病率为 266.7/100000 人年（95%CI=235.6-297.7），无 PD 患者的癫痫发作粗发病率为 112.4/100000 人年（95%CI=103.5-121.3；IRR=2.37，95%CI=2.06-2.73）。与无 PD 患者相比，PD 患者的癫痫发作发病比值比为 1.68（95%CI=1.43-1.98）。与无诱发性合并症的无 PD 患者相比，伴脑部疾病（adj. OR=12.36，95%CI=8.74-17.48）或伴≥1 种诱发性合并症（adj. OR=13.24，95%CI=10.15-17.25）的 PD 患者发生癫痫发作的风险最高。
本研究提示 PD 发病与癫痫发作发病风险增加相关。
