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Is There a Higher Risk of Parkinson's for People with Autism?

A recently published research paper in the Journal of the American Medical Association by researchers suggests a possible link between Autism Spectrum Disorder and Parkinson’s Disease by citing shared underlying cause or causes connecting neurodevelopmental disorders like Autism Spectrum Disorder and Parkinson’s Disease. Potential shared underlying factors such as genetics, disrupted brain development, or environmental influences that may link these neurodevelopmental and neurodegenerative conditions. The findings highlight the need for greater awareness of long-term neurological risks in individuals with the Autism Spectrum Disorder.

What Is Autism and Parkinson's Disease

The National Institutes of Mental Health defines Autism Spectrum Disorder (ASD) as a "neurological and developmental disorder that affects how people interact with others, communicate, learn, and behave." According to the Centers for Disease Control 1 in 31 children and 1 in 45 adults have Autism Spectrum Disorder. The Autism Speaks website lists someone with Autism as having experiencing challenges with social skills, challenges with communication, and restrictive or repetitive behaviors and interests that has a direct impact on their quality of life. Other conditions include depression and anxiety, attention-deficit/hyperactivity disorder (ADHD) and other mental and physical conditions that are experienced as a part of the autism spectrum.

Parkinson's Disease (PD) is a neurodegenerative disease that primarily affects movement by causing the gradual loss of dopamine-producing neurons in the brain. It is estimated that by the year 2050, there will be will be 25.2 million people with Parkinson's Disease, 267 per 100,000 people will fall under it's influence experiencing reduced motor function in their body, tremors and see impacts to their lifestyle. Currently, Carbidopa/Levodopa and excercise programs like Rock Steady Boxing offer current patients a close to normal lifestyle. The strongest defense against Parkinson’s disease is the support of the Parkinson’s community. Local programs and medical centers often offer resources and guidance to help individuals navigate their journey.

The Study

The study included 2,278,565 individuals born in Sweden between 1974 and 1999; of those individuals participating in the study who had Autism, 0.05% developed Parkinson’s (1,139 people), while only 0.02% (456 people) of those in the study without ASD developed PD. Taking into account factors like depression, medication use, and family history, researchers found that individuals with ASD were four times more likely to develop Parkinson’s disease.

Two smaller studies for adults over the age of 39 with ASD found higher-than-normal rates of Parkinsonism among individuals in the study. Twenty percent of those not taking any antipsychotic medications as part of their normal daily routine still showed Parkinsonian symptoms, suggesting that motor issues associated with Parkinsonism can develop without complication from medication side effects.

Researchers indicate that diagnosing Parkinson’s Disease in individuals with Autism can be challenging due to the use or ongoing use of neuroleptics by many. They also note that individuals with Autism often exhibit unusual movements, gestures, and coordination issues, and that non-verbal individuals may not consistently follow instructions for standard motor exams. Additionally, there are concerns regarding caregiver turnover in group homes. This complicates the ability to monitor gradual changes in symptoms, which is crucial for confirming whether Parkinson’s Disease is present. 

Missing Links

The study suggests that while there is no definitive reason to directly link Autism Spectrum Disorder (ASD) and Parkinson’s Disease, several overlapping factors point to a possible connection that needs to be further explored. Small sample sizes and non-population-based recruitment (where participants are selected from specific sources like clinics or registries rather than randomly from the general population) inhibit the strength of current findings. Researchers propose that selection bias, long-term use of neuroleptic medications, and shared biological factors could all play a role. For instance, the “unmasking effect” of neuroleptics (antipsychotics) may appear before the social symptoms of Autism in early development of the disorder. These shared features could help bridge the understanding between the two conditions and support more targeted research and clinical approaches.

Along with the effects of some medications and the shared biological connections between ASD and Parkinson’s Disease, research has already shown that impaired motor functions are a core symptom for those who have Autism, both sharing abnormalities in brain regions involved in movement, such as the basal ganglia and cerebellum. Researchers have also identified genetic links, including mutations in a receptor associated with Parkinson’s disease, found in some individuals with autism.

The study also points to individuals with Fragile X Syndrome or carriers of the fragile X premutation, who often develop movement disorders, show high rates of Parkinsonism. 

These findings suggest that autism and Parkinson’s may share an overlapping genetic, molecular landscape and possible changes in brain circuitry.

Limitations

The article does point out limitations to the study itself, citing no control groups for one study, and differing education and IQ of the individuals involved. The differences in medication use between the two studies, limited records on long-term medication and childhood behavior, and small sample sizes with diminishing results.

The study also calls into question the risk of Parkinson’s Disease in people who have autism and are more likely to develop Parkinson’s as they get older. It creates bigger challenges for healthcare, training, and policy changes when it comes to the treatment and care of people with ASD and PD. While research on younger adults with autism is increasing, we still know very little about what happens as they age. This gap could lead to problems in planning their care, especially as the population grows older. The high rates of Parkinson’s in older adults with autism may be just the start of more discoveries. Health systems will need to adjust to better support their needs.

Getting Personal

Three members of my family were born with Autism, the importance of finding a connection to Parkinson's and other neurodegerative diseases could impact them as they get over the age of 50. Advances in research may someday lead to cures, or at least medications, to lessen the impact of the disease if does come to them. If the cause of the disease can someday be determined, it will give my family members or their decendants a chance to have a normal, healthy life.

Source: Is There a Higher Risk of Parkinson's for People with Autism?