{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T12:52:13Z","timestamp":1788612733030,"version":"build-2803163510"},"reference-count":43,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2019,11,18]],"date-time":"2019-11-18T00:00:00Z","timestamp":1574035200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"The Academy of Finland","award":["295724, 310835"],"award-info":[{"award-number":["295724, 310835"]}]},{"name":"The Finnish Medical Foundation"},{"name":"The Finnish Parkinson Foundation"}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disorders"],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Gut microbiota alterations have been found in prodromal and established Parkinson's disease (PD). Antibiotic exposure can have long\u2010term effects on the composition of human intestinal microbiota, but a potential connection between antibiotic exposure and risk of PD has not been studied previously.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the impact of antibiotic exposure on the risk of PD in a nationwide, register\u2010based, case\u2010control study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We identified all patients who were diagnosed with PD in Finland during the years 1998 to 2014. Information was obtained on individual purchases of orally administered antibiotics during the years 1993 to 2014. We assessed the association between prior antibiotic exposure and PD using conditional logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The study population consisted of 13,976 PD cases and 40,697 controls. The strongest connection with PD risk was found for oral exposure to macrolides and lincosamides (adjusted odds ratio up to 1.416; 95% confidence interval, 1.053\u20131.904). After correction for multiple comparisons, exposure to antianaerobics and tetracyclines 10 to 15\u2009years before the index date, sulfonamides and trimethoprim 1 to 5\u2009years before the index date, and antifungal medications 1 to 5\u2009years before the index date were positively associated with PD risk. In post hoc analyses, further positive associations were found for broad\u2010spectrum antibiotics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Exposure to certain types of oral antibiotics seems to be associated with an elevated risk of PD with a delay that is consistent with the proposed duration of a prodromal period. The pattern of associations supports the hypothesis that effects on gut microbiota could link antibiotics to PD, but further studies are needed to confirm this. \u00a9 2019 International Parkinson and Movement Disorder Society<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mds.27924","type":"journal-article","created":{"date-parts":[[2019,11,18]],"date-time":"2019-11-18T08:28:01Z","timestamp":1574065681000},"page":"431-442","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":87,"title":["Antibiotic Exposure and Risk of Parkinson's Disease in Finland: A Nationwide Case\u2010Control Study"],"prefix":"10.1002","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1005-7812","authenticated-orcid":false,"given":"Tuomas H.","family":"Mertsalmi","sequence":"first","affiliation":[{"name":"Department of Neurology, Helsinki University Hospital and Department of Clinical Neurosciences (Neurology) University of Helsinki  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eero","family":"Pekkonen","sequence":"additional","affiliation":[{"name":"Department of Neurology, Helsinki University Hospital and Department of Clinical Neurosciences (Neurology) University of Helsinki  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9502-7131","authenticated-orcid":false,"given":"Filip","family":"Scheperjans","sequence":"additional","affiliation":[{"name":"Department of Neurology, Helsinki University Hospital and Department of Clinical Neurosciences (Neurology) University of Helsinki  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,11,18]]},"reference":[{"issue":"6","key":"e_1_2_8_2_1","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1002\/ana.23687","article-title":"Meta\u2010analysis of early nonmotor features and risk factors for 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