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Instituto Nacional de Neurología y Neurocirugía

2020, Número 2

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Arch Neurocien 2020; 25 (2)


Potenciales fuentes de sesgo en los estudios de factores de riesgo y protección asociados a la Enfermedad de Parkinson

Parra-Medina LE, Álvarez-Cervera FJ, Góngora-Alfaro JL

Idioma: Español
Referencias bibliográficas: 67
Paginas: 6-18
Archivo PDF: 362.06 Kb.


RESUMEN

Introducción: Numerosos estudios epidemiológicos indican que la enfermedad de Parkinson (EP) resulta de una interacción compleja entre diversos factores, algunos de los cuales confieren riesgo y otros protección. Sin embargo, cuando se analiza a fondo el diseño metodológico de cada estudio, se descubre que muchos no controlaron diversos factores de confusión, abriendo la posibilidad de que la asociación encontrada (o ausencia de ella) fuese en realidad un artefacto metodológico.
Objetivo: Destacar algunos de los factores de confusión que deberían ser controlados para minimizar fuentes de sesgo en los estudios epidemiológicos de los factores de riesgo y protección de la EP.
Desarrollo: Se describen posibles sesgos en los estudios de factores que se han asociado a un mayor riesgo de desarrollar la EP (exposición a plaguicidas, traumatismos craneoencefálicos, tener familiares en primer y segundo grado con EP, haber padecido depresión, tener antecedentes de estreñimiento crónico), así como factores que parecen conferir protección (consumo de tabaco, cafeína y analgésicos no esteroideos).
Conclusión: Es necesario llegar a un consenso en cuanto a la metodología de los estudios epidemiológicos de factores de riesgo/protección asociados a la EP. Para reducir los sesgos se recomienda: aplicar criterios que aumenten la certeza de que los familiares con EP fueron diagnosticados correctamente, estimar cuantitativamente la intensidad y duración de los factores bajo estudio, reducir los sesgos de causalidad inversa, excluyendo de los análisis aquellos factores que pudieron ocurrir como consecuencia de los síntomas prodrómicos de la EP, que conservadoramente inician 10 años antes del diagnóstico.


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