Association of gout with brain reserve and vulnerability to neurodegenerative disease

Anya Topiwala (), Kulveer Mankia, Steven Bell, Alastair Webb, Klaus P. Ebmeier, Isobel Howard, Chaoyue Wang, Fidel Alfaro-Almagro, Karla Miller, Stephen Burgess, Stephen Smith and Thomas E. Nichols
Additional contact information
Anya Topiwala: University of Oxford
Kulveer Mankia: Chapel Allerton Hospital
Steven Bell: University of Cambridge
Alastair Webb: University of Oxford
Klaus P. Ebmeier: University of Oxford, Warneford Hospital
Isobel Howard: University of Oxford
Chaoyue Wang: University of Oxford
Fidel Alfaro-Almagro: University of Oxford
Karla Miller: University of Oxford
Stephen Burgess: University of Cambridge
Stephen Smith: University of Oxford
Thomas E. Nichols: University of Oxford

Nature Communications, 2023, vol. 14, issue 1, 1-9

Abstract: Abstract Studies of neurodegenerative disease risk in gout are contradictory. Relationships with neuroimaging markers of brain structure, which may offer insights, are uncertain. Here we investigated associations between gout, brain structure, and neurodegenerative disease incidence. Gout patients had smaller global and regional brain volumes and markers of higher brain iron, using both observational and genetic approaches. Participants with gout also had higher incidence of all-cause dementia, Parkinson’s disease, and probable essential tremor. Risks were strongly time dependent, whereby associations with incident dementia were highest in the first 3 years after gout diagnosis. These findings suggest gout is causally related to several measures of brain structure. Lower brain reserve amongst gout patients may explain their higher vulnerability to multiple neurodegenerative diseases. Motor and cognitive impairments may affect gout patients, particularly in early years after diagnosis.

Date: 2023
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DOI: 10.1038/s41467-023-38602-6

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