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Mov Disord. 2018 Mar;33(3):468-472. doi: 10.1002/mds.27336. Epub 2018 Feb 20.

Lifetime exposure to estrogen and progressive supranuclear palsy: Environmental and Genetic PSP study.

Author information

1
Department of Neurology, Inje University Ilsan-Paik Hospital, Goyang, Korea.
2
Movement Disorder Center, Department of Neurosciences, University of California San Diego, San Diego, California, USA.
3
Graduate School of Public Health, San Diego State University, San Diego, California, USA.
4
Department of Family Medicine and Public Health, University of California San Diego, San Diego, California, USA.
5
InMotion, Warrensville Heights, Ohio, USA.
6
Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
7
Department of Neurology, University of California Los Angeles, Los Angeles, California, USA.
8
Banner Sun Health Research Institute, Sun City, Arizona, USA.
9
Department of Neurology, University of Arizona College of Medicine, Phoenix, Arizona, USA.
10
Department of Neurology, University of Utah, Salt Lake City, Utah, USA.
11
Department of Neurology, University of Maryland, Baltimore, Maryland, USA.
12
Department of Neurological Sciences, Rush University, Chicago, Illinois, USA.
13
Department of Neurology, University of Colorado, Denver, Colorado, USA.
14
Morto and Gloria Shulman Movement Disorders Centre and the Edmond J. Saftra Program in Parkinson's Research, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada.
15
Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, Texas, USA.
16
Department of Neurology, University of Kansas, Kansas, Kansas city, USA.
17
Division of Movement Disorders, Department of Neurology, University of Louisville School of Medicine, Louisville, Kentucky, USA.

Abstract

BACKGROUND:

Studies suggesting a protective effect of estrogen in neurodegenerative diseases prompted us to investigate this relationship in progressive supranuclear palsy (PSP).

METHODS:

This case-control study evaluated the self-reported reproductive characteristics and estrogen of 150 women with PSP and 150 age-matched female controls who participated in the Environmental Genetic-PSP study. Conditional logistic regression models were generated to examine associations of PSP with estrogen.

RESULTS:

There was no association between years of estrogen exposure duration and PSP. There was a suggestion of an inverse association between composite estrogen score and PSP that did not reach statistical significance (P = .06). Any exposure to estrogen replacement therapy halved the risk of PSP (odds ratio = 0.52; 95% confidence interval = 0.30-0.92; P = .03). Among PSP cases, earlier age at menarche was associated with better performance on Hoehn and Yahr stage (β = -0.60; SE = 0.26; P = .02) and Unified Parkinson's Disease Rating Scale II score (β = -5.19; SE = 2.48; P = .04) at clinical examination.

CONCLUSIONS:

This case-control study suggests a protective role of lifetime estrogen exposure in PSP. Future studies will be needed to confirm this association. © 2018 International Parkinson and Movement Disorder Society.

KEYWORDS:

case-control study; estrogen; estrogen replacement therapy; parkinsonism; progressive supranuclear palsy

PMID:
29460982
PMCID:
PMC5840026
[Available on 2019-03-01]
DOI:
10.1002/mds.27336

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