Objective: To describe the occurrence of three cases of conjugal Parkinson´s disease (PD) in a data set of 160 PD patients with a follow up of 10 years or more.

Background: PD is a neurodegenerative disease characterised by alpha-synuclein aggregation and accumulation with a prevalence rate in the UK of 12.1/1000 for those > 65 years. With regard its pathogenesis, current interest focuses on environmental factors and the gut-brain axis as well as on the so-called prion-hypothesis of alpha-synuclein propagation.

Methods: Case series.

Results: Case #1: This 79 year old gentleman has been taking care of his wife who has been diagnosed with PD five years earlier. 6 months ago, she noted a tremor of his jaw and his leg. On examination, he had hypomimia, a resting tremor of arm and leg on the left, and asymmetric bradykinesia (left>right), and cogwheel rigidity. His gait was slow and Parkinsonian, there was no postural instability. The clinical diagnosis of PD was made and a DAT scan was abnormal. Case #2: This 78 year old gentleman has been carer of his 77 year old wife, who had been diagnosed with PD (asymmetric, tremulous, responsive to L-dopa with development of dyskinesias) 15 years earlier. When he accompanied her to our clinic, he mentioned having slowed down lately, and we noted in him hypomimia and asymmetric bradykinesia. Case #3: Historical case with similar history to the above.

Conclusions: Based on above prevalence rates, the chance of two spouses having PD would be 0.014%. Thus, despite its limitations, the observation of conjugal PD in 1.8% of the cases seems remarkable inasmuch it excels the expected prevalence by far. It could be a chance finding, or the result of shared environmental risk factors. An infective hypothesis is more difficult to conceive, but body fluids like saliva are considered to be of low infective risk in prion disease. Proper surveillance and larger population studies would be required to conclusively investigate this matter.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/conjugal-parkinsons-disease-real-or-chance/