Objective: To examine whether a vagotomy decreases the risk of later Parkinson’s disease (PD).

Background: It has been hypothesized that the α-synuclein pathology of PD may diffuse from the enteric nervous system to the central nervous system via the vagus nerve.

Methods: We conducted a cohort study including 8,279 individuals born in Sweden between 1880 and 1970 who underwent vagotomy between 1964 and 2010 (3,245 truncal and 5,029 selective). For each vagotomized patient, we selected 40 reference individuals matched for sex and year of birth at the date of surgery. The cohort was followed from the index date (date of vagotomy surgery) until PD onset, death, emigration out of Sweden, or December 31, 2010. Incident PD cases were identified using the Swedish Patient Register during 1964-2010. Potential confounding variables that were considered included chronic obstructive pulmonary disease, diabetes, rheumatologic and connective tissue disease, cardiovascular disease, general comorbidity according to Charlson index, and education. Hazard ratios with 95% confidence intervals (CI) were estimated using Cox proportional hazards regression. The temporal relationship between vagotomy and PD was examined.

Results: A total of 4,749 incident PD cases were identified during the follow-up of 6.39 million person-years. The incidence rate (per 100 000 person-years) was 67.8 for vagotomized patients (84.3 for truncal, and 61.2 for selective vagotomy), and 74.4 for reference individuals. Vagotomy was not associated with later PD risk during the entire follow-up (truncal vagotomy: HR= 0.83; 95% CI: 0.59-1.16; and selective vagotomy: HR=1.17; 95% CI: 0.91-1.50). After more than five years from vagotomy, we observed a non-significant trend towards a lower PD risk among individuals with truncal vagotomy (HR, 95% CI: 0.64, 0.41-1.01), while selective vagotomy was not related to PD risk (HR, 95% CI: 1.19, 0.89-1.54).

Conclusions: In this study, vagotomy was not associated with PD risk considering the entire follow-up period. Truncal vagotomy might however be related to a lower PD risk more than five years after the surgery although this finding needs to be verified in larger samples.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/vagotomy-and-parkinsons-disease-risk-a-swedish-register-based-matched-cohort-study/