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Zhang P, Jin W, Lyu Z, Lyu X, Li L. Study on the mechanism of gut microbiota in the pathogenetic interaction between depression and Parkinson 's disease. Brain Res Bull 2024; 215:111001. [PMID: 38852651 DOI: 10.1016/j.brainresbull.2024.111001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 05/27/2024] [Accepted: 06/06/2024] [Indexed: 06/11/2024]
Abstract
Depression and Parkinson's disease share pathogenetic characteristics, meaning that they can impact each other and exacerbate their respective progression. From a pathogenetic perspective, depression can develop into Parkinson's disease and is a precursor symptom of Parkinson's disease; Parkinson's disease is also often accompanied by depression. From a pharmacological perspective, the use of antidepressants increases the risk of developing Parkinson's disease, and therapeutic medications for Parkinson's disease can exacerbate symptoms of depression. Therefore, identifying how Parkinson's disease and depression impact each other in their development is key to formulating preventive measures and targeted treatment. One commonality in the pathogenesis of depression and Parkinson's disease are alterations in the gut microbiota, with mechanisms interacting in neural, immune inflammatory, and neuroendocrine pathways. This paper reviews the role of gut microbiota in the pathogenesis of depression and Parkinson's disease; conducts a study of the relationship between both conditions and medication; and suggests that dysregulated gut microbiota may be a key factor in explaining the relationship between Parkinson's disease and depression. Finally, on the basis of these findings, this article hopes to provide suggestions that new ideas for the prevention and treatment of depression and Parkinson's disease.
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Affiliation(s)
- Peiyun Zhang
- The Second Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou 310053, China
| | - Wei Jin
- The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou 310053, China
| | - Zhaoshun Lyu
- The Second Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou 310053, China
| | - Xinxuan Lyu
- The Second Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou 310053, China
| | - Lihong Li
- Department of Acupuncture and Moxibustion, the Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310005, China.
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Beydoun HA, Chen JC, Saquib N, Naughton MJ, Beydoun MA, Shadyab AH, Hale L, Zonderman AB. Sleep and affective disorders in relation to Parkinson's disease risk among older women from the Women's Health Initiative. J Affect Disord 2022; 312:177-187. [PMID: 35752216 PMCID: PMC9302785 DOI: 10.1016/j.jad.2022.06.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 06/11/2022] [Accepted: 06/17/2022] [Indexed: 10/17/2022]
Abstract
OBJECTIVES To evaluate sleep and affective (mood/anxiety) disorders as clinical predictors of incident Parkinson's disease (PD) among women ≥65 years of age. METHODS We performed secondary analyses with available data from the Women's Health Initiative Clinical Trials and Observational Study linked to Medicare claims. Sleep, mood and anxiety disorders at baseline were defined using diagnostic codes. Incident PD was defined using self-reported PD, first PD diagnosis, use of PD medications, and/or deaths attributed to PD. Cox regression was applied to estimate hazard ratios (HR) with 95 % confidence intervals (CI), controlling for socio-demographic/lifestyle/health characteristics. Time-to-event was calculated from baseline (1993-1998) to year of PD event, loss to follow-up, death, or December 31, 2018, whichever came first. RESULTS A total of 53,996 study-eligible WHI participants yielded 1756 (3.25 %) PD cases over ~14.39 (±6.18) years of follow-up. The relative risk for PD doubled among women with affective disorders (HR = 2.05, 95 % CI: 1.84, 2.27), mood disorders (HR = 2.18, 95 % CI: 1.97, 2.42) and anxiety disorders (HR = 1.97, 95 % CI: 1.75, 2.22). Sleep disorders alone (without affective) were not significantly associated with PD risk (HR = 0.85, 95 % CI: 0.69, 1.04), whereas affective disorders alone (without sleep) (HR = 1.93, 95 % CI: 1.72, 2.17) or in combination with sleep disorders (HR = 2.18, 95 % CI: 1.85, 2.56) were associated with twice the PD risk relative to no sleep/affective disorders. LIMITATIONS Observational design; Selection bias; Information bias; Generalizability. CONCLUSIONS Among older women, joint sleep/affective disorders and affective disorders alone are strong clinical predictors of incident PD over 14 years.
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Affiliation(s)
- Hind A Beydoun
- Department of Research Programs, Fort Belvoir Community Hospital, Fort Belvoir, VA, USA 22060.
| | - Jiu-Chiuan Chen
- Departments of Population & Public Health Sciences and Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA
| | - Nazmus Saquib
- Department of Research, College of Medicine, Sulaiman AlRajhi University, Al Bukayriah, Saudi Arabia
| | - Michelle J Naughton
- Department of Internal Medicine, College of Medicine, Ohio State University, Columbus, OH 43201, USA
| | - May A Beydoun
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD 21225, USA
| | - Aladdin H Shadyab
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA 92093, USA
| | - Lauren Hale
- Program in Public Health, Department of Family, Population and Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY 11794, USA
| | - Alan B Zonderman
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD 21225, USA
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Beydoun HA, Saquib N, Wallace RB, Chen J, Coday M, Naughton MJ, Beydoun MA, Shadyab AH, Zonderman AB, Brunner RL. Psychotropic medication use and Parkinson's disease risk amongst older women. Ann Clin Transl Neurol 2022; 9:1163-1176. [PMID: 35748105 PMCID: PMC9380147 DOI: 10.1002/acn3.51614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 06/01/2022] [Accepted: 06/09/2022] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE To examine associations of antidepressant, anxiolytic and hypnotic use amongst older women (≥65 years) with incident Parkinson's Disease (PD), using data from Women's Health Initiative linked to Medicare claims. METHODS PD was defined using self-report, first diagnosis, medications and/or death certificates and psychotropic medications were ascertained at baseline and 3-year follow-up. Cox regression models were constructed to calculate adjusted hazard ratios (aHR) with 95% confidence intervals (CI), controlling for socio-demographic, lifestyle and health characteristics, overall and amongst women diagnosed with depression, anxiety and/or sleep disorders (DASD). RESULTS A total of 53,996 WHI participants (1,756 PD cases)-including 27,631 women diagnosed with DASD (1,137 PD cases)-were followed up for ~14 years. Use of hypnotics was not significantly associated with PD risk (aHR = 0.98, 95% CI: 0.82, 1.16), whereas PD risk was increased amongst users of antidepressants (aHR = 1.75, 95% CI: 1.56, 1.96) and anxiolytics (aHR = 1.48, 95% CI: 1.25, 1.73). Compared to non-users of psychotropic medications, those who used 1 type had ~50% higher PD risk, whereas those who used ≥2 types had ~150% higher PD risk. Women who experienced transitions in psychotropic medication use ('use to non-use' or 'non-use to use') between baseline and 3-year follow-up had higher PD risk than those who did not. We obtained similar results with propensity scoring and amongst DASD-diagnosed women. INTERPRETATION The use of antidepressants, anxiolytics or multiple psychotropic medication types and transitions in psychotropic medication use was associated with increased PD risk, whereas the use of hypnotics was not associated with PD risk amongst older women.
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Affiliation(s)
- Hind A. Beydoun
- Department of Research ProgramsFort Belvoir Community HospitalFort BelvoirVirginia22060USA
| | - Nazmus Saquib
- Department of Research, College of MedicineSulaiman AlRajhi UniversityAl BukayriahKingdom of Saudi Arabia
| | - Robert B. Wallace
- Department of Epidemiology and Internal MedicineUniversity of IowaIowa CityIowa52242USA
| | - Jiu‐Chiuan Chen
- Departments of Population & Public Health Sciences and Neurology, Keck School of MedicineUniversity of Southern CaliforniaLos AngelesCaliforniaUSA90089
| | - Mace Coday
- Department of Preventive MedicineUniversity of Tennessee Health Science CenterMemphisTennessee38163USA
| | - Michelle J. Naughton
- Department of Internal Medicine, College of MedicineOhio State UniversityColumbusOhio43201USA
| | - May A. Beydoun
- Laboratory of Epidemiology and Population SciencesNational Institute on Aging, NIA/NIH/IRPBaltimoreMaryland21225USA
| | - Aladdin H. Shadyab
- Herbert Wertheim School of Public Health and Human Longevity ScienceUniversity of California, San DiegoLa JollaCalifornia92093USA
| | - Alan B. Zonderman
- Laboratory of Epidemiology and Population SciencesNational Institute on Aging, NIA/NIH/IRPBaltimoreMaryland21225USA
| | - Robert L. Brunner
- Department of Family and Community Medicine (Emeritus), School of MedicineUniversity of Nevada (Reno)AuburnCalifornia95602USA
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Premotor antidepressants use differs according to Parkinson's disease subtype: A cohort study. Parkinsonism Relat Disord 2021; 87:137-141. [PMID: 34091375 DOI: 10.1016/j.parkreldis.2021.04.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 04/07/2021] [Accepted: 04/20/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Depression is more frequently associated with akinetic-rigid/postural instability gait difficulty subtypes of Parkinson's disease than with tremor-dominant subtype. OBJECTIVES The aim of the study is to investigate the frequency of exposure to antidepressant drugs, as proxy of depression, before motor onset according to Parkinson's disease subtypes. METHOD Based on a historical cohort design, the exposure to antidepressant drugs before Parkinson's disease motor onset was obtained from the drug prescription database and assessed in the resident population of the Local Healthcare Trust of Bologna (443,117 subjects older than 35 years). Diagnosis of Parkinson's disease and subtype (tremor dominant, non-tremor dominant) at onset were recorded by neurologists and obtained from the "ParkLink Bologna" record linkage system. Exposure to antidepressants was compared both to the general population and between the two subtypes. RESULTS From 2006 to 2018, 198 patients had a tremor dominant subtype at onset whereas 450 did not. Comparison with the general population for antidepressant exposure showed an adjusted hazard ratio of 0.86 (95% CI 0.44-1.70) for the tremor dominant subtype and 1.66 (1.16-2.39) for the non-tremor dominant subtype. Comparison of non-tremor dominant with tremor dominant subtypes showed an adjusted odds ratio of 1.86 (1.05-3.95) for antidepressant exposure. CONCLUSIONS In our study, non-tremor dominant Parkinson's disease at onset was significantly associated with exposure to antidepressants in comparison to the general population and in comparison with the tremor dominant subtype. These results support the hypothesis of different biological substrates for different Parkinson's disease subtypes even before motor onset.
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Chan YLE, Chen MH, Bai YM, Li CT, Chen TJ, Su TP. Treatment response and age of onset as risk indicators for parkinson disease in patients with major depressive disorder: A nationwide longitudinal study. J Affect Disord 2021; 283:329-334. [PMID: 33578346 DOI: 10.1016/j.jad.2021.01.056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 12/28/2020] [Accepted: 01/28/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Individuals with major depressive disorder (MDD) have a higher risk of developing Parkinson disease (PD). This study investigated whether response to treatment with antidepressants for MDD can determine patients at risk of developing PD later in life. METHODS We enrolled 3303 patients with newly-diagnosed MDD and 13,212 controls between 2002 and 2004 using Taiwan's Nationwide Health Insurance Research Database. We stratified patients with MDD according to the number of antidepressant regimens prescribed to them and the age at MDD onset and followed all participants until the end of 2013. During follow-up, we evaluated patients for the possibility of developing PD. RESULTS Patients with MDD had a greater likelihood of developing PD than controls. Patients with difficult-to-treat (DTT) MDD had a higher risk of developing PD than the other MDD subgroups (hazard ratio [HR] = 3.44, 95% confidence interval [95% CI]: = 1.99-5.95). When stratified by age (<50, 50-65, >65 years), DTT patients with middle-age or late-onset MDD exhibited elevated risks of developing PD (50-65 years: HR: 7.03, 95% CI: 2.95-16.76; >65 years: HR: 2.89, 95% CI: 1.26-6.65). DISCUSSION Patients with MDD and an onset age of >50 years who responded poorly to antidepressant treatment have an associated higher risk of subsequently developing PD. Therefore, when treating patients with MDD, clinicians should provide intensive antidepressant treatment and evaluations for PD so that risk-prevention measures can be implemented upon MDD diagnosis.
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Affiliation(s)
- Yee-Lam E Chan
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Cheng Ta Li
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Tzeng-Ji Chen
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Hospital and Health Care Administration, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Tung-Ping Su
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan.
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Huang CH, Lin MC, Hsieh CL. Acupuncture Treatment Reduces Incidence of Parkinson's Disease in Patients With Depression: A Population-Based Retrospective Cohort Study in Taiwan. Front Aging Neurosci 2020; 12:591640. [PMID: 33343332 PMCID: PMC7746549 DOI: 10.3389/fnagi.2020.591640] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 11/11/2020] [Indexed: 12/23/2022] Open
Abstract
Depression is a risk factor for subsequent Parkinson's disease (PD). Some patients with depression undergo acupuncture treatment because of other diseases in Taiwan. Therefore, the present study used data from Taiwan's National Health Insurance Research Database (NHIRD) to investigate the incidence of PD in patients having depression with and without acupuncture treatment. We conducted a retrospective study of a matched cohort of 48,981 patients with newly diagnosed depression between 2000 and 2012 who were selected from the NHIRD. The 1:1 propensity score method was utilized to match an equal number of patients (N = 9,189) in the acupuncture and non-acupuncture cohorts. We employed Cox proportional hazard models to evaluate the risk of PD. The cumulative incidence of PD in both cohorts was estimated using the Kaplan–Meier method, and the difference was examined through a log-rank test. Patients with depression who received acupuncture treatment demonstrated a lower risk of PD [adjusted hazard ratio (aHR) = 0.39, 95% confidence interval = 0.31–0.49] than those who did not undergo acupuncture treatment, after adjusting for age, sex, insurance amount, geographic region, urbanization levels, comorbidities, and drugs. The cumulative incidence of PD was significantly lower in the acupuncture cohort than in the non-acupuncture cohort (log-rank test, p < 0.001). The database did not indicate the severity of depression and acupoints. The results suggest that acupuncture treatment significantly reduced the development of PD in patients with depression; however, a future study should be conducted to provide more objective evidence.
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Affiliation(s)
- Cheng-Hao Huang
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan.,Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Mei-Chen Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Ching-Liang Hsieh
- Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan.,Graduate Institute of Acupuncture Science, College of Chinese Medicine, China Medical University, Taichung, Taiwan.,Chinese Medicine Research Center, China Medical University, Taichung, Taiwan
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Vignatelli L, Zenesini C, Belotti LMB, Baldin E, Bonavina G, Calandra-Buonaura G, Cortelli P, Descovich C, Fabbri G, Giannini G, Guarino M, Pantieri R, Samoggia G, Scaglione C, Trombetti S, D'Alessandro R, Nonino F. Risk of Hospitalization and Death for COVID-19 in People with Parkinson's Disease or Parkinsonism. Mov Disord 2020; 36:1-10. [PMID: 33196119 PMCID: PMC7753472 DOI: 10.1002/mds.28408] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 10/27/2020] [Accepted: 11/09/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The risk of COVID-19 and related death in people with Parkinson's disease or parkinsonism is uncertain. The aim of the study was to assess the risk of hospitalization for COVID-19 and death in a cohort of patients with Parkinson's disease or parkinsonism compared with a control population cohort, during the epidemic bout (March-May 2020) in Bologna, northern Italy. METHODS Participants of the ParkLink study with the clinical diagnosis of Parkinson's disease or parkinsonism and people anonymously matched (ratio 1:10) for sex, age, district, and Charlson Index were included. The hospital admission rate for COVID-19 (February 26-May 31, 2020) and the death rate for any cause were the outcomes of interest. RESULTS The ParkLink cohort included 696 subjects with Parkinson's disease and 184 with parkinsonism, and the control cohort had 8590 subjects. The 3-month hospitalization rate for COVID-19 was 0.6% in Parkinson's disease, 3.3% in parkinsonism, and 0.7% in controls. The adjusted hazard ratio (age, sex, district, Charlson Index) was 0.8 (95% CI, 0.3-2.3, P = 0.74) in Parkinson's disease and 3.3 (1.4-7.6, P = 0.006) in parkinsonism compared with controls. Twenty-nine of the infected subjects died; 30-day fatality rate was 35.1%, without difference among the 3 groups. Six of 10 Parkinson's disease/parkinsonism patients had the infection during hospitalization or in a nursing home. CONCLUSIONS Parkinson's disease per se probably is not a risk factor for COVID-19 hospitalization. Conversely, parkinsonism is an independent risk factor probably because of a more severe health status, entailing higher care dependence and placement in high-infection-risk accommodations. © 2020 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Luca Vignatelli
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Corrado Zenesini
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Laura M B Belotti
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Elisa Baldin
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | | | - Giovanna Calandra-Buonaura
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.,Università degli Studi di Bologna, Dipartimento di Scienze Biomediche e NeuroMotorie, Bologna, Italy
| | - Pietro Cortelli
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.,Università degli Studi di Bologna, Dipartimento di Scienze Biomediche e NeuroMotorie, Bologna, Italy
| | | | | | - Giulia Giannini
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.,Università degli Studi di Bologna, Dipartimento di Scienze Biomediche e NeuroMotorie, Bologna, Italy
| | - Maria Guarino
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Roberta Pantieri
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | | | - Cesa Scaglione
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | | | | | - Francesco Nonino
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
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Zenesini C, Baldin E, Vignatelli L, D'Alessandro R. In reply to the letter to the editor regarding “Use of antidepressants and the risk of Parkinson's disease in the Local Health Trust of Bologna: A historical cohort study”. J Neurol Sci 2020; 408:116511. [DOI: 10.1016/j.jns.2019.116511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 09/27/2019] [Indexed: 11/25/2022]
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Kawada T. Antidepressants and Parkinson's disease: a causal association. J Neurol Sci 2020; 408:116512. [DOI: 10.1016/j.jns.2019.116512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 09/27/2019] [Indexed: 10/25/2022]
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