Risk of Parkinson's disease after anaesthesia and surgery

Jain, Siddharth; Rosenbaum, Paul R.; Reiter, Joseph G; Hill, Alexander S.; Wolk, David A.; Hashemi, Sean; Fleisher, Lee A.; Eckenhoff, Roderic G.; Silber, Jeffrey H.

doi:10.1016/j.bja.2021.12.046

Cited by 3 publications

(2 citation statements)

References 10 publications

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“…COVID-19, have also been described to immediately precede PD [ 25 ]. Similarly, the authors encountered people who developed PD shortly after undergoing surgery or anesthesia, although literature on this phenomenon is currently limited to studies examining the association between anesthesia and the subsequent risk of developing PD later in life, rather than exploring acute onsets of PD [ 26, 27 ]. This hints at mechanisms that occur both during infections and psychological stress, such as increased inflammatory tone [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

The Last Straw: How Stress Can Unmask Parkinson’s Disease

van der Heide,

Trenkwalder,

Bloem

et al. 2024

JPD

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We discuss two people with Parkinson’s disease (PD), in whom tremor manifested directly following a severely stressful event. Both were initially misdiagnosed with a functional neurological disorder. These stories highlight that stress can trigger the onset of clinical manifestations of PD, by unveiling an underlying disease that had been unfolding for many years. Thus, the sudden symptom onset after a stressful event is not unique to functional disorders, and may lead to avoidable feelings of guilt if people wrongly attribute PD to this event. It remains unclear what mechanism explains this phenomenon, and why symptoms persist after the stressful event has passed.

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Section: Discussionmentioning

confidence: 99%

The Last Straw: How Stress Can Unmask Parkinson’s Disease

van der Heide,

Trenkwalder,

Bloem

et al. 2024

JPD

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“…Physical activity ( 2 ), intellectual activity ( 31 ), and cognitive reserve ( 2 , 31 ) are additional important factors that modulate brain plasticity ( 32 – 34 ). Past studies have shown that surgery-related anesthesia is associated with increased risk of neurodegenerative diseases such as Alzheimer’s ( 35 ) and Parkinson’s ( 36 ) diseases. However, the authors suggest that these procedures are not themselves the cause of cognitive impairment or neurodegenerative conditions ( 22 ), but may rather trigger cognitive reserve’s decline ( 37 ) and expose pre-existing neurological damage that was formerly compensated by cognitive reserve.…”

Section: Deliriummentioning

confidence: 99%

Delirium management in perioperative geriatric services: a narrative review of non-pharmaceutical strategies

Travers,

Gagliardi,

Ramseyer

2024

Front. Psychiatry

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Delirium, a common complication in elderly surgical patients, poses significant challenges in perioperative care. Perioperative geriatric services (PGS) aim at managing comorbidities, postoperative complications, and initiating early recovery of mobility to enhance elderly patients’ prognosis in the perioperative period. Studies have shown that patients with preoperative cognitive disorders are at a significantly increased risk of postoperative delirium. While postoperative delirium affects up to 70% of people over 60 and 90% of people with neurodegenerative diseases, it remains underdiagnosed in many cases. Postoperative delirium can lead to functional decline, prolonged hospitalization, increased healthcare costs, cognitive impairment, and psychological malaise. This article briefly summarizes the literature on delirium, its risk factors, and its non-pharmaceutical management strategies within the perioperative period. It highlights the importance of integrating cognitive and psychological assessments into perioperative care protocols to provide baseline data, improve patient outcomes, reduce hospital stays, and minimize complications associated with delirium. By embracing evidence-based delirium management protocols, healthcare professionals can better identify and manage delirium, ultimately improving the quality of care for elderly surgical patients, which would also benefit healthcare staff and healthcare institutions.

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Covariate-adaptive randomization inference in matched designs

Pimentel,

Huang

2024

Journal of the Royal Statistical Society Series B: Statistical Methodology

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It is common to conduct causal inference in matched observational studies by proceeding as though treatment assignments within matched sets are assigned uniformly at random and using this distribution as the basis for inference. This approach ignores observed discrepancies in matched sets that may be consequential for the distribution of treatment, which are succinctly captured by within-set differences in the propensity score. We address this problem via covariate-adaptive randomization inference, which modifies the permutation probabilities to vary with estimated propensity score discrepancies and avoids requirements to exclude matched pairs or model an outcome variable. We show that the test achieves type I error control arbitrarily close to the nominal level when large samples are available for propensity score estimation. We characterize the large-sample behaviour of the new randomization test for a difference-in-means estimator of a constant additive effect. We also show that existing methods of sensitivity analysis generalize effectively to covariate-adaptive randomization inference. Finally, we evaluate the empirical value of combining matching and covariate-adaptive randomization procedures using simulations and analyses of genetic damage among welders and right-heart catheterization in surgical patients.

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Risk of Parkinson's disease after anaesthesia and surgery

Cited by 3 publications

References 10 publications

The Last Straw: How Stress Can Unmask Parkinson’s Disease

The Last Straw: How Stress Can Unmask Parkinson’s Disease

Delirium management in perioperative geriatric services: a narrative review of non-pharmaceutical strategies

Covariate-adaptive randomization inference in matched designs

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