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@ARTICLE{Holtz:1032081,
      author       = {Holtz, Anna-Victoria and Fink, Anne and Tamgüney,
                      Gültekin and Doblhammer, Gabriele},
      title        = {{C}olonoscopy and {S}ubsequent {R}isk of {P}arkinson’s
                      {D}isease},
      journal      = {Journal of Parkinson's Disease},
      volume       = {14},
      number       = {4},
      issn         = {1877-7171},
      address      = {Amsterdam},
      publisher    = {IOS Press},
      reportid     = {FZJ-2024-05984},
      pages        = {747 - 760},
      year         = {2024},
      abstract     = {Background: Parkinson’s disease (PD) is caused by the
                      misfolding and aggregation of α-synuclein in neurons into
                      toxic oligomers and fibrils that have prion-like properties
                      allowing them to infect healthy neurons and to be
                      transmitted to animal models of PD by injection or oral
                      exposure. Given α-synuclein fibrils’ potential
                      transmission on the gut-brain axis, α-synuclein may be
                      transmitted through colonoscopy procedures.Objective: This
                      study examines a possible association between colonoscopy
                      and PD.Methods: Longitudinal health insurance data of
                      250,000 individuals aged 50+ from 2004–2019 was analyzed.
                      Cox proportional hazard and competing risk models with death
                      as a competing event were estimated to calculate the risk of
                      PD. Colonoscopy was categorized as never receiving
                      colonoscopy, colorectal cancer (CRC) screening without or
                      with biopsy, destruction or excision (BDE), and diagnostic
                      colonoscopy without or with BDE.Results:We identified 6,422
                      new cases of PD among 221,582 individuals. The Cox model
                      revealed a significantly increased risk of PD for patients
                      who ever had a diagnostic colonoscopy without or with BDE
                      (HR = 1.31; $95\%$ CI: [1.23–1.40]; HR= 1.32
                      [1.22–1.42]) after adjustment for age and sex. After
                      controlling for covariates and death, persons who ever
                      underwentCRCscreening had a $40\%$ reduced risk ofPD(CRHR =
                      0.60 [0.54–0.67]), while persons who underwent diagnostic
                      colonoscopy had a $20\%$ reduced risk of PD (CRHR = 0.81
                      [0.75–0.88]).Conclusions: Colonoscopy does not increase
                      the risk of PD, after adjusting for death and covariates.
                      Individuals who underwent only CRC screening had the lowest
                      risk of PD, which may be a result of a more health-conscious
                      lifestyle.},
      cin          = {IBI-7},
      ddc          = {610},
      cid          = {I:(DE-Juel1)IBI-7-20200312},
      pnm          = {5244 - Information Processing in Neuronal Networks
                      (POF4-524)},
      pid          = {G:(DE-HGF)POF4-5244},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {38669559},
      UT           = {WOS:001255361500011},
      doi          = {10.3233/JPD-240017},
      url          = {https://juser.fz-juelich.de/record/1032081},
}