Risk of Parkinson's disease after colectomy: longitudinal follow-up study using a national sample cohort

Background and purpose Parkinson's disease (PD) is a neurodegenerative disorder characterized by deposition of intraneural inclusion bodies in the brain as well as the enteric nervous system. Emerging concepts regarding the brain-gut axis have been proposed for neurological disorders. Thus, the present study investigated the associations between colectomy and developing PD. Methods We conducted a retrospective cohort study using National Health Insurance Service-National Sample Cohort of Korea. This study included patients who underwent colectomy during 2003-2009, and up to 10 individuals per patient, matched in terms of age and sex, who did not undergo colectomy. The colectomy group was subdivided by the causes and surgical methods of colectomy. The risk of PD occurrence was evaluated over a follow-up period of at least 6 years using Cox regression analyses. Results Colectomy was associated with a higher risk of developing PD (adjusted hazard ratio [HR]: 1.962; 95% confidence interval [CI] 1.002-3.840). There was no significant difference in the occurrence of PD among the subgroups classified by the causes or surgical methods of colectomy. Conclusions Colectomy was associated with the development of PD, suggesting that colon issues play an important role in the pathophysiological mechanisms of PD.