Daniel M. Keller, PhDJune 28, 2016
BERLIN — Truncal vagotomy is associated with a reduced risk of developing Parkinson's disease (PD) at more than 5 years after the procedure, a study reports.
The finding supports the hypothesis that PD may begin as an α-synuclein pathology in the enteric nervous system that propagates via the vagus nerve into the central nervous system. Selective vagotomy showed no such association.
In a presentation here at the 20th International Congress of Parkinson's Disease and Movement Disorders, researchers led by PhD student Bojing Liu of the Department of Medical Epidemiology and Biostatistics at the Karolinska Institute in Stockholm drew upon the Swedish National Patient Register to conduct a matched cohort study comparing 9840 patients who underwent vagotomy between 1970 and 2010 with reference patients who did not have vagotomy (n = 378,840).
The reference patients were randomly selected on the basis of the date of surgery and matched by sex and year of birth. Patients were followed from the date of vagotomy to PD diagnosis, death, emigration, or the end of 2010, whichever occurred first.
At more than 5 years after vagotomy, truncal vagotomy was associated with a lower risk of developing PD, but selective vagotomy was not. At greater than 10 years, the association of truncal vagotomy and lower PD risk showed the same trend but was not significant.
Table. Vagotomy and Risk of Developing Parkinson's Disease
| Follow-up Point | Adjusted HR (95% CI) for Truncal Vagotomya | Adjusted HR (95% CI) for Selective Vagotomya |
| Entire | 0.77 (0.55 - 1.08) | 1.11 (0.87 - 1.42) |
| >5 y | 0.58 (0.37 - 0.91) | 1.15 (0.89 - 1.49) |
| >10 y | 0.58 (0.33 - 1.01) | 1.11 (0.83 - 1.48) |
| >20 y | 0.76 (0.31 - 1.87) | 0.76 (0.44 - 1.32) |
CI = confidence interval; HR = hazard ratio.
aAdjusted for chronic obstructive pulmonary disease (as a proxy for smoking), comorbidity index, and country of birth.
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