Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Executive Deputy EditorIndividualAuthor
In Reply: We agree with Dr Honig that "association
does not prove causation," and we clearly stated that the observational nature
of our study does not support the conclusion that coffee or caffeine are protective
against PD. How others report or interpret our results is beyond our control.
We also agree that very early PD may affect the development of habits
such as coffee drinking, cigarette smoking, and alcohol consumption that characteristically
begin in late adolescence or early adulthood. As Honig points out, we noted
that individuals with a constitutional propensity to develop PD could have
a physiological intolerance to caffeine. Honig states that individuals with
preclinical PD may have a "neurophysiologically based disinclination" to caffeine
use. The distinction between "physiological intolerance" and "neurophysiologically
based disinclination" is not clear to us. We also disagree with Honig's statement
that patients destined to develop PD are symptomatic for 5 to 20 years preceding
diagnosis, as there is no evidence for this assertion.
Ross GW, Abbott RD, Petrovitch H, White LR, Tanner CM. Relationship Between Caffeine Intake and Parkinson Disease—Reply. JAMA. 2000;284(11):1378-1379. doi:10.1001/jama.284.11.1378