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. 2025 Jun 12;11(1):164.
doi: 10.1038/s41531-025-01010-2.

Longitudinal assessment of the association between pesticide exposure and lifestyle with Parkinson's disease motor severity

Theresa Lüth  1 , Amke Caliebe  2 , Carolin Gabbert  1 , Sebastian Sendel  2 , Björn-Hergen Laabs  3 , Inke R König  3 , Christine Klein  1 , Joanne Trinh  4
Affiliations

Longitudinal assessment of the association between pesticide exposure and lifestyle with Parkinson's disease motor severity

Theresa Lüth et al. NPJ Parkinsons Dis. .

Abstract

Longitudinal investigations on the relationship between lifestyle exposures and motor severity are lacking. In this longitudinal study, we included patients with idiopathic Parkinson's disease (iPD) (N = 5139) and LRRK2-related PD (N = 81) from PPMI-Online and Fox Insight. Motor aspects were followed for up to five years. We investigated the association between environmental exposure, lifestyle factors and motor aspect severity over time by applying linear mixed effects models. In LRRK2-PD, black tea consumption was associated with less severe motor aspects (β = -0.51, p = 0.028). In patients with iPD, pesticide exposure was associated with more severe motor aspects over time in PPMI-Online (β = 0.23, p = 3.56 × 10-9). Lastly, caffeinated soda was associated with more severe motor aspects in patients with iPD from PPMI-Online (β = 0.15, p = 3.84 × 10-8) and Fox Insight (β = 0.09, p = 0.031). We suggest that pesticide exposure and lifestyle factors may affect motor severity in patients with LRRK2-PD and iPD, demonstrating the impact on patients even after disease onset.

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Conflict of interest statement

Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1. Study overview.
The diagram illustrates the included longitudinal cohorts and the study design (data quality control, construction of the statistical model and overlaying of environmental/lifestyle data). N number of individuals, iPD Patients with idiopathic Parkinson’s disease, and LRRK2-PD Patients with PD who carry the LRRK2 p.Gly2019Ser variant, f1/f2 polynomial transformation age at onset or disease duration. *If applicable.
Fig. 2
Fig. 2. Motor aspect severity over time.
The plots show the progression of PD motor features along the longitudinal assessments. At each time period, the mean cumulative MDS-UPDRS Part II score is indicated, and the error bars show the corresponding standard deviation. Patients with iPD are shown in blue (PPMI-Online and Fox Insight) and patients with LRRK2-PD are shown in red (Fox Insight). iPD Patients with idiopathic Parkinson’s disease, LRRK2-PD Patients with PD that carry the LRRK2 p.Gly2019Ser variant, TP Time period, N number of individuals.
Fig. 3
Fig. 3. Motor aspect severity over time stratified by pesticide exposure.
The plots show the progression of PD motor features along the longitudinal assessments. The mean cumulative MDS-UPDRS Part II score is indicated at each time period, and the error bars show the corresponding standard deviation. Patients with iPD are shown (PPMI-Online and Fox Insight). The patients are stratified by pesticide exposure. iPD idiopathic Parkinson’s disease, TP Time period, N number of individuals.
Fig. 4
Fig. 4. Motor aspect severity over time stratified by smoking.
The plots show the progression of PD motor features along the longitudinal assessments. The mean cumulative MDS-UPDRS Part II score is indicated at each time period, and the error bars show the corresponding standard deviation. Patients with iPD are shown (PPMI-Online and Fox Insight). The patients are stratified by smoking status. iPD idiopathic Parkinson’s disease, TP Time period, N number of individuals.
Fig. 5
Fig. 5. Motor aspect severity over time stratified by black tea consumption.
The plots show the progression of PD motor features along the longitudinal assessments. The mean cumulative MDS-UPDRS Part II score is indicated at each time period, and the error bars show the corresponding standard deviation. Patients with iPD (PPMI-Online and Fox Insight) and LRRK2-PD (Fox Insight) are shown. The patients are stratified by black tea consumption. iPD idiopathic Parkinson’s disease, LRRK2-PD Patients with PD that carry the LRRK2 p.Gly2019Ser variant, TP Time period, N number of individuals.
Fig. 6
Fig. 6. Motor aspect severity over time stratified by caffeinated soda consumption.
The plots show the progression of PD motor features along the longitudinal assessments. The mean cumulative MDS-UPDRS Part II score is indicated at each time period, and the error bars show the corresponding standard deviation. Patients with iPD (PPMI-Online and Fox Insight) and LRRK2-PD (Fox Insight) are shown. The patients are stratified by caffeinated soda consumption. iPD idiopathic Parkinson’s disease, LRRK2-PD Patients with PD that carry the LRRK2 p.Gly2019Ser variant, TP Time period, N number of individuals.
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