With great interest, we read the article by Konings et al ,1 in which the authors conducted a combined case–control and cohort study and found that dysphagia, gastroparesis, irritable bowel syndrome (IBS) without diarrhoea and constipation specifically predict subsequent newly onset idiopathic Parkinson’s disease (PD) through comparing patients with PD with matched negative controls and patients with Alzheimer’s disease (AD) and cerebrovascular diseases (CVDs). However, several methodological concerns should be carefully addressed before concluding that those gastrointestinal (GI) syndromes can predict the development of PD. First, reverse causation from the diagnostic delay of neurodegenerative diseases is a big concern,2 3 and not considering it in the analysis might lead to spurious associations (eg, the short-term increased PD risk after Clostridium difficile infection4). Given this diagnostic delay, the temporal relationship between GI syndromes and neurodegenerative disease in Konings et al ’s study1 is hard to be determined due to …

中文翻译：

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帕金森病的胃肠道综合征：危险因素还是合并症？


我们怀着极大的兴趣阅读了 Konings 等人的文章，1 其中作者进行了病例对照和队列相结合的研究，发现吞咽困难、胃轻瘫、肠易激综合征 （IBS） 没有腹泻和便秘，通过比较具有匹配阴性对照的 PD 患者和阿尔茨海默病 （AD） 和脑血管疾病 （CVD） 患者，特异性地预测了随后新发的特发性帕金森病 （PD）。然而，在得出这些胃肠道 （GI） 综合征可以预测 PD 发展的结论之前，应仔细解决几个方法学问题。首先，神经退行性疾病诊断延迟的反向因果关系是一个大问题，2 3 在分析中不考虑它可能会导致虚假关联（例如，艰难梭菌感染后短期增加的 PD 风险4）。鉴于这种诊断延迟，Konings 等人的研究1 中胃肠道综合征与神经退行性疾病之间的时间关系很难确定，因为......