Annonaceae Consumption Worsens Disease Severity and Cognitive Deficits in Degenerative Parkinsonism

• Published in: Movement disorders Vol. 37; no. 12; pp. 2355 - 2366
• Main Authors: Cleret de Langavant, Laurent, Roze, Emmanuel, Petit, Aimée, Tressières, Benoit, Gharbi‐Meliani, Amin, Chaumont, Hugo, Michel, Patrick Pierre, Bachoud‐Lévi, Anne‐Catherine, Remy, Philippe, Edragas, Régine, Lannuzel, Annie
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01-12-2022; Wiley Subscription Services, Inc; Wiley
• Subjects: Annonaceae; Annonaceae - adverse effects; Basal ganglia; Brain diseases; Central nervous system diseases; Cognition; Cognitive ability; Cognitive Dysfunction - complications; cognitive impairment; food toxin; Fruits; Life Sciences; Movement disorders; Neurodegenerative diseases; Parkinson; Parkinson's disease; Parkinsonian Disorders - complications; Parkinsonian Disorders - epidemiology; Patient Acuity; Phenotypes; Public health; risk factor; Risk factors; Teas, Herbal; food toxin; cognitive impairment; Annonaceae; risk factor; Parkinson
• ISSN: 0885-3185; 1531-8257
• DOI: 10.1002/mds.29222

Background
High consumption of Annona muricata fruit has been previously identified as a risk factor for atypical parkinsonism in the French Caribbean islands.
Objective
We tested whether consumption of Annonaceae products could worsen the clinical phenotype of patients with any form of degenerative parkinsonism.
Methods
We analyzed neurological data from 180 Caribbean parkinsonian patients and specifically looked for dose effects of lifelong, cumulative Annonaceae consumption on cognitive performance. Using unsupervised clustering, we identified one cluster with mild/moderate symptoms (N = 102) and one with severe symptoms including cognitive impairment (N = 78).
Results
We showed that even low cumulative consumption of fruits/juices (>0.2 fruit‐years) or any consumption of herbal tea from Annonaceae worsen disease severity and cognitive deficits in degenerative parkinsonism including Parkinson's disease (OR fruits‐juices: 3.76 [95% CI: 1.13–15.18]; OR herbal tea: 2.91 [95% CI: 1.34–6.56]).
Conclusion
We suggest that more restrictive public health preventive recommendations should be made regarding the consumption of Annonaceae products. © 2022 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.