title: Spinal cord injury and Parkinson's disease: a population-based, propensity score-matched, longitudinal follow-up study.
abstract: OBJECTIVE
  To investigate whether patients with spinal cord injury (SCI) are at an increased risk of developing Parkinson's disease (PD).
  
  
  METHODS
  A population-based, propensity score-matched, longitudinal follow-up cohort study.
  
  
  METHODS
  The study was conducted using the National Health Insurance (NHI) Research Database.
  
  
  METHODS
  A total of 10 125 patients with at least 2 ambulatory visits with a diagnosis of SCI in 2001 were enrolled in the SCI group. The non-SCI group comprised 10 125 propensity score-matched patients without SCI. The propensity scores were computed using a logistic regression model that included age, sex, comorbidities and socioeconomic status. The PD-free survival rates of the two groups were estimated using the Kaplan-Meier method. Stratified Cox proportional hazard regression was used to estimate the effect of SCI on subsequent occurrence of PD.
  
  
  RESULTS
  During the 3-year follow-up period, 99 subjects in the SCI group and 59 in the non-SCI group developed PD. The hazard ratio of PD for the SCI group compared with the non-SCI group was 1.65 (95% confidence interval 1.16-2.33, P=0.0049). The PD-free survival rate for the SCI group was lower than that for the non-SCI group (P=0.0017).
  
  
  CONCLUSIONS
  This study shows that SCI is associated with a subsequent increased risk of PD. Further studies are needed to elucidate the mechanism underlying this association.
authors.affiliation: Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital Yun-Lin Branch, Yunlin, Taiwan.
authors.forename: T-S
authors.initials: TS
authors.lastname: Yeh
authors.affiliation: Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital Yun-Lin Branch, Yunlin, Taiwan.
authors.forename: Y-P
authors.initials: YP
authors.lastname: Huang
authors.affiliation: Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: H-I
authors.initials: HI
authors.lastname: Wang
authors.affiliation: Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan.|Department of Physical Medicine and Rehabilitation, National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: S-L
authors.initials: SL
authors.lastname: Pan
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000453:epidemiology* / Q000209:etiology*; D057216:Propensity Score; D012306:Risk; D012737:Sex Factors; D012959:Socioeconomic Factors; D013119:Spinal Cord Injuries / Q000150:complications* / Q000453:epidemiology*; D013997:Time Factors; D055815:Young Adult