Objective: To map and synthesise epidemiological evidence assessing environmental co-exposures and Parkinson’s disease (PD) risk

Background: PD is a multifactorial neurodegenerative disorder attributed to genetic, lifestyle and environmental factors, with the role of the latter in disease development a growing research focus. Several environmental risk factors for PD have been well-established, including pesticide exposure, well-water drinking, traumatic brain injury, exposure to solvents or heavy metals, air pollution and infection. Preclinical studies highlight that these environmental insults can interact synergistically to exacerbate development of the pathological hallmarks of PD, compared to each exposure in isolation. Despite this, population-level studies treat such exposures independently, with limited investigation into the effects of co-exposure. Therefore, this scoping review aims to identify and synthesise epidemiological evidence evaluating environmental co-exposures and their influence on PD risk

Method: This scoping review follows the methodology proposed by Arksey and O’Malley (2005), with reporting in accordance with the PRISMA Extension for Scoping Reviews guidelines. Four databases (MEDLINE via PubMed, Embase, Web of Science, and Scopus) were systematically searched for peer-reviewed observational studies assessing environmental co-exposures in PD. Eligible studies included case-control or cohort studies of human participants with clinically established PD. Studies had to assess at least two environmental exposures and explicitly evaluate co-exposure effects through analyses such as interaction terms or stratification analyses. Two reviewers independently screened titles, abstracts and full texts, with potential conflicts resolved through discussion with a third reviewer

Results: A total of 8,526 studies were screened at the title and abstract stage. Of these, 209 studies were deemed eligible for full-text screening. Data extraction is ongoing and will summarise study characteristics, assessed environmental exposures and how they were operationalised, and statistical approaches used to evaluate co-exposure effects

Conclusion: This scoping review will provide a detailed synthesis of epidemiological evidence exploring environmental co-exposures as drivers of PD. Further, identifying methodological gaps will inform future research investigating cumulative environmental exposures and risk of PD

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MDS Abstracts - https://www.mdsabstracts.org/abstract/environmental-risk-factor-co-exposure-as-drivers-of-parkinsons-disease-development-a-scoping-review/