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. 2024 Dec 5:15:1471736.
doi: 10.3389/fneur.2024.1471736. eCollection 2024.

Association between herpes zoster and Parkinson's disease and dementia: a systematic review and meta-analysis

Yanfeng Zhang #  1 , Weiping Liu  1 , Yang Xu #  2   3
Affiliations

Association between herpes zoster and Parkinson's disease and dementia: a systematic review and meta-analysis

Yanfeng Zhang et al. Front Neurol. .

Abstract

Objectives: This meta-analysis investigated the relationship between herpes zoster and the risk of dementia or Parkinson's disease by analyzing published clinical studies.

Methods: We systematically searched PubMed, Cochrane, Embase, and Web of Science Core Collection databases on April 25, 2024. Hazard ratios (HR) were used for statistical analyses. Random-effects models were applied, and heterogeneity was assessed using the I2 statistic.

Results: Herpes zoster was associated with a non-significant trend toward increased dementia risk (HR = 1.11, 95% CI 0.99-1.24, p = 0.07) but significantly increased Parkinson's disease risk (HR = 1.15, 95% CI 1.03-1.30, p = 0.02). Subgroup analyses revealed that herpes zoster significantly elevated the risk of the prospective study subgroup (HR = 1.08, 95% CI 1.02-1.13, p = 0.004) and vascular dementia subgroup (HR = 1.17, 95% CI 1.00-1.37, p = 0.05). Significant heterogeneity was observed for both outcomes (dementia: I 2 = 98%, p < 0.00001; Parkinson's disease: I 2 = 94%, p < 0.00001).

Conclusion: Herpes zoster raises the risk of Parkinson's disease and vascular dementia, with a potential causal link to dementia. Early vaccination against herpes zoster is recommended over post-infection antiviral treatment to mitigate risks.

Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/ and our registration number is CRD42024555620.

Keywords: Parkinson’s disease; dementia; herpes zoster; meta-analysis; systematic review; vascular dementia.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of literature screening process.
Figure 2
Figure 2
Forest plot of overall analysis results. (A) Forest plots for overall dementia-related analyses; (B) Forest plots for overall analyses related to Parkinson’s disease.
Figure 3
Figure 3
Sensitivity analysis results. (A) Overall analysis of herpes zoster and dementia and 95% CI calculations from Stata software. (B) Overall analysis of herpes zoster and Parkinson’s disease and 95% CI calculations from Stata software.
See this image and copyright information in PMC

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