Potential Mechanisms for Inverse Associations between Caffeine and Parkinson's Disease
Although the results of epidemiological studies suggest that caffeine consumption decreases the risk of Parkinson's disease, other explanations for the inverse association between caffeine consumption and Parkinson's disease risk have been proposed. For example, subtle changes in mood, sleep patterns, and the sense of smell, which have been proposed as symptoms of preclinical Parkinson's disease, could lead to decreased caffeine consumption. 69 , 72 However, this possibility seems unlikely since prospective cohort studies have observed strong inverse associations between Parkinson's disease risk and caffeine consumption more than a decade before diagnosis. Another potential explanation is that a decreased propensity for addictive behavior, e.g., cigarette smoking and caffeine consumption, has the same underlying cause as an increased risk of Parkinson's disease. 3 Recent research supports the idea that chronic caffeine consumption could reduce Parkinson's disease risk. Parkinson's disease is characterized by the degeneration of dopaminergic neurons in the substantia nigra. 73 Studies in animal models suggest that caffeine consumption decreases the risk of Parkinson's disease by protecting against dopaminergic neurotoxicity. 72 The effects of caffeine in the central nervous system are related to its activity as an antagonist of the A1 and A2A subtypes of the adenosine receptor. 74 The expression of A2A-receptors in the brain is restricted almost entirely to the striatum, the target of the dopaminergic neurons that degenerate in Parkinson's disease. Acute toxicity with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) can induce Parkinsonism in humans. 75 A well-established animal model of Parkinson's disease uses MPTP to induce dopaminergic neurotoxicity in mice. Caffeine, at doses comparable to typical human exposures, has been found to attenuate MPTP-induced losses of striatal dopamine and dopamine transporter binding sites in mice. 76 Specific A2A-receptor antagonists mimicked the effect of caffeine as did the absence of functional A2A-receptors in A2A-receptor knockout mice. At present, it is not known exactly how A2A-receptor blockade reduces dopaminergic neurotoxicity. 77 Although the results of epidemiological and animal studies suggest that caffeine may reduce the risk of developing Parkinson's disease, it is premature to recommend increasing caffeine consumption to prevent Parkinson's disease, particularly in women taking exogenous estrogens.
Suicide Risk