Frontiers in Neurology · Dec 5, 2024

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

By Zhang Y, Liu W, Xu Y

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.

doi.org/10.3389/fneur.2024.1471736Open accessPubMed 39703359Populations