Abstract
The possibility that alcohol consumption should be considered as a “protective factor” for Parkinson’s disease (PD) has been suggested by several case–control studies. However, other case–control studies and data from prospective longitudinal cohort studies have been inconclusive. We carried out a systematic review which included all the eligible studies published on PD risk related with alcohol consumption, and conducted a meta-analysis according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. The systematic review was performed using two databases, and the meta-analysis of the eligible studies with the software Meta-Disc1.1.1. Heterogeneity between studies was tested with the Q-statistic. The meta-analysis included 26 eligible retrospective case–control studies (8798 PD patients, 15,699 controls) and 5 prospective longitudinal cohort studies (2404 PD patients, 600,592 controls) on alcohol consumption and PD. In retrospective case–control studies the frequency of PD patients never drinkers was higher and the frequency of heavy + moderate drinkers was lower [diagnostic OR (95% CI) 1.33(1.20–1.48) and 0.74(0.64–0.85)], respectively, when compared to healthy controls. In contrast, in prospective studies, the differences were not significant with the exception of a trend towards a higher frequency of non-drinkers in PD women and a significantly lower frequency of moderate + heavy drinkers in PD men in those studies which stratified data by gender. The present meta-analysis suggests an inverse association between alcohol consumption and PD, which is supported by the results of case–control studies but not clearly by prospective ones.
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Baumann RJ, Jameson HD, McKean HG, Haack DG, Weisberg LM (1980) Cigarette smoking and Parkinson disease: 1. Comparison of cases with matched neighbours. Neurology 30:839–843
Wang WZ, Fang XH, Chen XM, Jiang DH, Lin ZJ (1993) A case–control study on the environmental risk factors of Parkinson disease in Tianjin, China. Neuroepidemiology 12:209–218
Watanabe K (1994) A case–control study of Parkinson’s disease. Nihon Koshu Eisei Zasshi 41:22–33
Liou HH, Tsai MC, Chen CJ, Jeng JS, Chang YC, Chen SY, Chen RC (1997) Environmental risk factors and Parkinson’s disease: a case–control study in Taiwan. Neurology 48:1583–1588
Fujii C, Harada S, Ohkoshi N, Hayashi A, Yoshizawa K (1998) Study on Parkinson’s disease and alcohol drinking. Nihon Arukoru Yakubutsu Igakkai Zasshi 33:683–691
Fall PA, Fredrikson M, Axelson O, Granérus AK (1999) Nutritional and occupational factors influencing the risk of parkinson’s disease: a case–control study in Southeastern Sweden. Mov Disord 14:28–37
Ragonese P, Salemi G, Morgante L, Aridon P, Epifanio A, Buffa D, Scoppa F, Savettieri G (2003) A case–control study on cigarette, alcohol, and coffee consumption preceding Parkinson’s disease. Neuroepidemiology 22:297–304
Tan EK, Tan C, Fook-Chong SM, Lum SY, Chai A, Chung H, Shen H, Zhao Y, Teoh ML, Yih Y, Pavanni R, Chandran VR, Wong MC (2003) Dose-dependent protective effect of coffee, tea, and smoking in Parkinson’s disease: a study in ethnic Chinese. J Neurol Sci 216:163–167
Wirdefeldt K, Gatz M, Pawitan Y, Pedersen NL (2005) Risk and protective factors for Parkinson’s disease: a study in Swedish twins. Ann Neurol 57:27–33
Evans AH, Lawrence AD, Potts J, MacGregor L, Katzenschlager R, Shaw K, Zijlmans J, Lees AJ (2006) Relationship between impulsive sensation seeking traits, smoking, alcohol and caffeine intake, and Parkinson’s disease. J Neurol Neurosurg Psychiatry 77:317–321
Dhillon AS. Tarbutton GL, Levin JL, Plotkin GM, Lowry LK, Nalvone JT (2008) Pesticide/environmental exposures and Parkinson’s disease in East Texas. J Agromed 13:37–48
Brighina L, Schneider NK, Lesnick TG, de Andrade M, Cunningham JM, Mrazek D, Rocca WA, Maraganore DM (2009) Alpha-synuclein, alcohol use disorders, and Parkinson disease: a case–control study. Parkinsonism Relat Disord 15:430–434
Kenborg L, Lassen CF, Ritz B, Andersen KK, Christensen J, Schernhammer ES, Hansen J, Wermuth L, Rod NH, Olsen JH (2015) Lifestyle, family history, and risk of idiopathic Parkinson disease: a large Danish case–control study. Am J Epidemiol 181:808–816
Schernhammer ES, Lassen CF, Kenborg L, Ritz B, Olsen JH, Hansen J (2015) Occupational history of night shift work and Parkinson’s disease in Denmark. Scand J Work Environ Health 41:377–383
Lang AE, Marsden CD, Obeso JA, Parkes JD (1982) Alcohol and Parkinson disease. Ann Neurol 12:254–256
Jiménez-Jiménez FJ, Mateo D, Giménez-Roldan S (1992) Premorbid smoking, alcohol consumption, and coffee drinking habits in Parkinson’s disease: a case–control study. Mov Disord 7:339–344
Hellenbrand W, Seidler A, Boeing H, Robra BP, Vieregge P, Nischan P, Joerg J, Oertel WH, Schneider E, Ulm G (1996) Diet and Parkinson’s disease. I: a possible role for the past intake of specific foods and food groups. Results from a self-administered food-frequency questionnaire in a case–control study. Neurology 47:636–643
Paganini-Hill A (2001) Risk factors for Parkinson’s disease: the Leisure world cohort study. Neuroepidemiology 20:118–124
Cassani E, Barichella M, Ferri V, Pinelli G, Iorio L, Bolliri C, Caronni S, Faierman SA, Mottolese A, Pusani C, Monajemi F, Pasqua M, Lubisco A, Cereda E, Frazzitta G, Petroni ML, Pezzoli G (2017) Dietary habits in Parkinson’s disease: adherence to Mediterranean diet. Parkinsonism Relat Disord 42:40–46
Haack DG, Baumann RJ, McKean HE, Jameson HD, Turbek JA (1981) Nicotine exposure and Parkinson disease. Am J Epidemiol 114:191–199
Ho S, Woo J, Lee CM (1989) Epidemiologic study of Parkinson’s disease in Hong Kong. Neurology 39:1314–1318
Wechsler LS, Checkoway H, Franklin GM, Costa LG (1991) A pilot study of occupational and environmental risk factors for Parkinson’s disease. Neurotoxicology 12:387–392
Morano A, Jiménez-Jiménez FJ, Molina JA, Antolín MA (1994) Risk-factors for Parkinson’s disease: case–control study in the province of Cáceres, Spain. Acta Neurol Scand 89:164–170
Mayeux R, Tang MX, Marder K, Côté LJ, Stern Y (1994) Smoking and Parkinson’s disease. Mov Disord 9:207–212
Gorell JM, Rybicki BA, Johnson CC, Peterson EL (1999) Smoking and Parkinson’s disease: a dose–response relationship. Neurology 52:115–119
Benedetti MD, Bower JH, Maraganore DM, McDonnell SK, Peterson BJ, Ahlskog JE, Schaid DJ, Rocca WA (2000) Smoking, alcohol, and coffee consumption preceding Parkinson’s disease: a case–control study. Neurology 55:1350–1358
Behari M, Srivastava AK, Das RR, Pandey RM (2001) Risk factors of Parkinson’s disease in Indian patients. J Neurol Sci 190:49–55
Checkoway H, Powers K, Smith-Weller T, Franklin GM, Longstreth WT Jr, Swanson PD (2002) Parkinson’s disease risks associated with cigarette smoking, alcohol consumption, and caffeine intake. Am J Epidemiol 155:732–738
Tsai C, Lo SK, See LC, Chen HZ, Chen RS, Weng YH, Chang FC, Lu CS (2002) Environmental risk factors of young onset Parkinson’s disease: a case–control study. Clin Neurol Neurosurg 104:328–333
Dong JQ, Zhang ZX, Zhang KL (2003) Parkinson’s disease and smoking: an integral part of PD’s etiological study. Biomed Environ Sci 16:173–179
Galanaud JP, Elbaz A, Clavel J, Vidal JS, Corrèze JR, Alpérovitch A, Tzourio C (2005) Cigarette smoking and Parkinson’s Disease: a case–control study in a population characterized by a high prevalence of pesticide exposure. Mov Disord 20:181–189
Dick FD, De Palma G, Ahmadi A, Scott NW, Prescott GJ, Bennett J, Semple S, Dick S, Counsell C, Mozzoni P, Haites N, Bezzina Wettinger S, Mutti A, Otelea M, Seaton A, Söderkvist P (2007) Felice A, on behalf of the Geoparkinson study group. Environmental risk factors for Parkinson’s disease and parkinsonism: the Geoparkinson study. Occup Environ Med 64:666–672
Fukushima W, Miyake Y, Tanaka K, Sasaki S, Kiyohara C, Tsuboi Y, Yamada T, Oeda T, Miki T, Kawamura N, Sakae N, Fukuyama H, Hirota Y, Nagai M, Fukuoka Kinki Parkinson’s Disease Study Group (2010) Alcohol drinking and risk of Parkinson’s disease: a case–control study in Japan. BMC Neurol 10:111
Nicoletti A, Pugliese P, Nicoletti G, Arabia G, Annesi G, De Mari M, Lamberti P, Grasso L, Marconi R, Epifanio A, Morgante L, Cozzolino A, Vasta R, Barone P, Torchia G, Quattrone A, Zappia M (2010) Voluptuary habits and clinical subtypes of Parkinson’s disease: the FRAGAMP case–control study. Mov Disord 25:2387–2394
van der Mark M, Nijssen PC, Vlaanderen J, Huss A, Mulleners WM, Sas AM, van Laar T, Kromhout H, Vermeulen R (2014) A case–control study of the protective effect of alcohol, coffee, and cigarette consumption on Parkinson disease risk: time-since-cessation modifies the effect of tobacco smoking. PLoS One 9:e95297
Nicoletti A, Vasta R, Mostile G, Nicoletti G, Arabia G, Iliceto G, Lamberti P, Marconi R, Morgante L, Barone P, Quattrone A, Zappia M (2017) Head trauma and Parkinson’s disease: results from an Italian case–control study. Neurol Sci 38:1835–1839
Grandinetti A, Morens DM, Reed D, MacEachern D (1994) Prospective study of cigarette smoking and the risk of developing idiopathic Parkinson’s disease. Am J Epidemiol 139:1129–1138
Hernán MA, Chen H, Schwarzschild MA, Ascherio A (2003) Alcohol consumption and the incidence of Parkinson’s disease. Ann Neurol 54:170–175
Ishihara-Paul L, Wainwright NW, Khaw KT, Luben RN, Welch AA, Day NE, Brayne C, Surtees PG (2008) Prospective association between emotional health and clinical evidence of Parkinson’s disease. Eur J Neurol 15:1148–1154
Palacios N, Gao X, O’Reilly E, Schwarzschild M, McCullough ML, Mayo T, Gapstur SM, Ascherio AA (2012) Alcohol and risk of Parkinson’s disease in a large, prospective cohort of men and women. Mov Disord 27:980–987
Liu R, Guo X, Park Y, Wang J, Huang X, Hollenbeck A, Blair A, Chen H (2013) Alcohol consumption, types of alcohol, and Parkinson’s disease. PLoS One 8:e66452
Sääksjärvi K, Knekt P, Männistö S, Lyytinen J, Jääskeläinen T, Kanerva N, Heliövaara M (2014) Reduced risk of Parkinson’s disease associated with lower body mass index and heavy leisure-time physical activity. Eur J Epidemiol 29:285–292
Ishihara L, Brayne C (2005) A systematic review of nutritional risk factors of Parkinson’s disease. Nutr Res Rev 18:259–282
Noyce AJ, Bestwick JP, Silveira-Moriyama L, Hawkes CH, Giovannoni G, Lees AJ, Schrag A (2012) Meta-analysis of early nonmotor features and risk factors for Parkinson disease. Ann Neurol 72:893–901
Zhang D, Jiang H, Xie J (2014) Alcohol intake and risk of Parkinson’s disease: a meta-analysis of observational studies. Mov Disord 29:819–822
Bettiol SS, Rose TC, Hughes CJ, Smith LA (2015) Alcohol consumption and Parkinson’s disease risk: a review of recent findings. J Parkinsons Dis 5:425–442
Hubble JP, Cao T, Hassanein RE, Neuberger JS, Koller WC (1993) Risk factors for Parkinson’s disease. Neurology 43:1693–1697
Tan XH, Wang SM, Xue NQ, Teng WT, Feng YQ (2004) Study on the risk factors and its interaction on Parkinson disease. Zhonghua Liu Xing Bing Xue Za Zhi 25:527–530
Eriksson AK, Löfving S, Callaghan RC, Allebeck P (2013) Alcohol use disorders and risk of Parkinson’s disease: findings from a Swedish national cohort study 1972–2008. BMC Neurol 13:190
Kuopio AM, Marttila RJ, Helenius H, Rinne UK (1999) Environmental risk factors in Parkinson’s disease. Mov Disord 14:928–939
Maher NE, Golbe LI, Lazzarini AM, Mark MH, Currie LJ, Wooten GF, Saint-Hilaire M, Wilk JB, Volcjak J, Maher JE, Feldman RG, Guttman M, Lew M, Waters CH, Schuman S, Suchowersky O, Lafontaine AL, Labelle N, Vieregge P, Pramstaller PP, Klein C, Hubble J, Reider C, Growdon J, Watts R, Montgomery E, Baker K, Singer C, Stacy M, Myers RH (2002) Epidemiologic study of 203 sibling pairs with Parkinson’s disease: the GenePD study. Neurology 58:79–84
Konitsiotis S, Bostantjopoulou S, Chondrogiorgi M, Katsarou Z, Tagaris G, Mavromatis I, Ntzani EE, Mentenopoulos G, Greek Parkinson Study Group (2014) Clinical characteristics of Parkinson’s disease patients in Greece: a multicenter, nation-wide, cross-sectional study. J Neurol Sci 343:36–40
Zamora J, Abraira V, Muriel A, Khan KS, Coomarasamy A (2006) Meta-DiSc: a software for meta-analysis of test accuracy data. BMC Med Res Methodol 6:31
Mantel N, Haenszel W (1959) Statistical aspects of the analysis of data from retrospective studies. J Natl Cancer Inst 22:719–748
DerSimonian R, Laird N (1986) Meta-analysis in clinical trials. Control Clin Trials 7:177–188
Cochran WG (1954) The combination of estimates from different experiments. Biometrics 10:101–129
Higgins JP, Thompson SG, Deeks JJ, Altman DG (2003) Measuring inconsistency in meta-analyses. Br Med J 327:557–560
Moher D, Liberati A, Tetzlaff J, Altman DG, Group P (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 6:e1000097
Ishihara L, Brayne C (2006) What is the evidence for a premorbid parkinsonian personality: a systematic review. Mov Disord 21:1066–1072
Ma H, Zhu G (2014) The dopamine system and alcohol dependence. Shanghai Arch Psychiatry 26:61–68
Kilcoyne B, Shmulewitz D, Meyers JL, Aharonovich E, Greenstein E, Frisch A, Weizman A, Spivak B, Edenberg HJ, Gelernter J, Hasin DS (2014) Alcohol consumption mediates the relationship between ADH1B and DSM-IV alcohol use disorder and criteria. J Stud Alcohol Drugs 75:635–642
Buervenich S, Carmine A, Galter D, Shahabi HN, Johnels B, Holmberg B, Ahlberg J, Nissbrandt H, Eerola J, Hellström O, Tienari PJ, Matsuura T, Ashizawa T, Wüllner U, Klockgether T, Zimprich A, Gasser T, Hanson M, Waseem S, Singleton A, McMahon FJ, Anvret M, Sydow O, Olson L (2005) A rare truncating mutation in ADH1C (G78Stop) shows significant association with Parkinson disease in a large international sample. Arch Neurol 62:74–78
Tan EK, Nagamitsu S, Matsuura T, Khajavi M, Jankovic J, Ondo W, Ashizawa T (2001) Alcohol dehydrogenase polymorphism and Parkinson’s disease. Neurosci Lett 305:70–72
Buervenich S, Sydow O, Carmine A, Zhang Z, Anvret M, Olson L (2000) Alcoholdehydrogenase alleles in Parkinson’s disease. Mov Disord 15:813–818
Zhao CC, Cai HB, Wang H, Pan SY (2016) Role of ADH2 and ALDH2 gene polymorphisms in the development of Parkinson’s disease in a Chinese population. Genet Mol Res 15(3):1–8
Belin AC, Westerlund M, Anvret A, Lindqvist E, Pernold K, Ogren SO, Duester G, Galter D (2011) Modeling Parkinson’s disease genetics: altered function of the dopamine system in Adh4 knockout mice. Behav Brain Res 217:439–445
Anvret A, Ran C, Westerlund M, Gellhaar S, Lindqvist E, Pernold K, Lundströmer K, Duester G, Felder MR, Galter D, Belin AC (2012) Adh1 and Adh1/4 knockout mice as possible rodent models for presymptomatic Parkinson’s disease. Behav Brain Res 227:252–257
Galter D, Buervenich S, Carmine A, Anvret M, Olson L (2003) ALDH1 mRNA: presence in human dopamine neurons and decreases in substantia nigra in Parkinson’s disease and in the ventral tegmental area in schizophrenia. Neurobiol Dis 14:637–647
Mandel S, Grunblatt E, Riederer P, Amariglio N, Jacob-Hirsch J, Rechavi G, Youdim MB (2005) Gene expression profiling of sporadic Parkinson’s disease substantia nigra pars compacta reveals impairment of ubiquitin-proteasome subunits, SKP1A, aldehyde dehydrogenase, and chaperone HSC-70. Ann N Y Acad Sci 1053:356–375
Liu G, Yu J, Ding J, Xie C, Sun L, Rudenko I, Zheng W, Sastry N, Luo J, Rudow G, Troncoso JC, Cai H (2014) Aldehyde dehydrogenase 1 defines and protects a nigrostriatal dopaminergic neuron subpopulation. J Clin Investig 124:3032–3046
Zhang X, Ye YL, Wang YN, Liu FF, Liu XX, Hu BL, Zou M, Zhu JH (2015) Aldehyde dehydrogenase 2 genetic variations may increase susceptibility to Parkinson’s disease in Han Chinese population. Neurobiol Aging 36:2660
Molochnikov L, Rabey JM, Dobronevsky E, Bonucelli U, Ceravolo R, Frosini D, Grünblatt E, Riederer P, Jacob C, Aharon-Peretz J, Bashenko Y, Youdim MB, Mandel SA (2012) A molecular signature in blood identifies early Parkinson’s disease. Mol Neurodegener 7:26
Madadi F, Khaniani MS, Shandiz EE, Ayromlou H, Najmi S, Emamalizadeh B, Taghavi S, Jamshidi J, Tafakhori A, Shahidi GA, Darvish H (2016) Genetic analysis of the ZNF512B, SLC41A1, and ALDH2 polymorphisms in Parkinson’s disease in the Iranian population. Genet Test Mol Biomarkers 20:629–632
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We recognize the effort of the personnel of the Library of Hospital Universitario “Príncipe de Asturias”, Alcalá de Henares (Madrid, Spain), who achieved an important number of papers for us. Professor James McCue revised in detail the quality of the English language. The work of the authors was supported in part by Fondo de Investigación Sanitaria, Instituto de Salud Carlos III, Madrid, Spain (Grant PI15/00303), and Junta de Extremadura, Mérida, Spain (Grants GR15026 and IB16170). Partially funded with FEDER funds.
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Jiménez-Jiménez, F.J., Alonso-Navarro, H., García-Martín, E. et al. Alcohol consumption and risk for Parkinson’s disease: a systematic review and meta-analysis. J Neurol 266, 1821–1834 (2019). https://doi.org/10.1007/s00415-018-9032-3
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DOI: https://doi.org/10.1007/s00415-018-9032-3