The Role of Stress as a Risk Factor for Progressive Supranuclear Palsy

Article type: Research Article

Authors: Kelley, Kristen D.^a | Peavy, Guerry^b | Edland, Steven^b | Rogers, Whitney^c | Riley, David E.^d | Bordelon, Yvette^e | Standaert, David^f | Reich, Stephen G.^g | Litvan, Irene^{b; *}

Affiliations: [a] UC San Diego, School of Medicine, La Jolla, CA, USA | [b] Department of Neurosciences, UC San Diego, La Jolla, CA, USA | [c] Department of Neuroscience Training, University of Louisville, Louisville, KY, USA | [d] Department of Neurology, Case Western Reserve University, Cleveland, OH, USA | [e] Department of Neurology, University of California Los Angeles, Los Angeles, CA, USA | [f] Department of Neurology, University of Alabama in Birmingham, Birmingham, AL, USA | [g] Department of Neurology, University of Maryland, Baltimore, MD, USA

Correspondence: [*] Correspondence to: Irene Litvan, M.D., FAAN, FANA, Tasch Endowed Professor in Parkinson Disease Research, Director of the Movement Disorders Center, UC San Diego Department of Neurosciences, 8950 Villa La Jolla Drive, Suite C112, La Jolla, CA 92037, USA. Tel.: +1 858 822 5872; Fax: +1 858 822 5743; E-mail: ilitvan@ucsd.edu.

Abstract: Background: PSP, like Alzheimer’s disease (AD), is a tauopathy. The etiopathogenesis of PSP is not well known and the role of stress has not yet been examined. Recent studies have shown that stress increases the risk for developing AD. This study investigates the role of stress as a risk factor for PSP. Objective: B To examine the association between the development of progressive supranuclear palsy (PSP) and self-reported life stressors. Methods: 76 patients diagnosed with PSP according to the NINDS-SPSP criteria and 68 age-matched unrelated controls were administered a life stressor questionnaire. Stress was quantified as total number of events, number of life changing events, and number of events characterized by self-rated severity. Conditional odds ratio (OR) was calculated for each measure, with participants in the highest quartile of each measure being defined as high-exposure in relation to all other participants. Results: There were no significant differences between the reported number of total events or life-changing events in cases and controls. However, we found 24.4% of cases (N = 11) and 9.1% of controls (N = 5) had a higher exposure to high severity events, yielding an OR of 3.2 (p = 0.04). Conclusions: We found that cases have over a three times greater odds of high exposure to high-severity events than controls prior to the clinical development of PSP, while there were no differences in overall number of reported events. Our findings suggest that high exposure to highly stressful events may be associated with the development of PSP.

Keywords: Progressive supranuclear palsy (PSP), stress, epidemiology, case-control

DOI: 10.3233/JPD-160945

Journal: Journal of Parkinson's Disease, vol. 7, no. 2, pp. 377-383, 2017