Research Article Outlining a Population (at Risk) of Parkinson’s Disease: Evidence from a Case-Control Study Tommaso Schirinzi, 1 Giuseppina Martella, 1,2 Alessio D’Elia, 1 Giulia Di Lazzaro, 1 Paola Imbriani, 1 Graziella Madeo, 1 Leonardo Monaco, 3 Marta Maltese, 1 and Antonio Pisani 1,2 1 Neurology, Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy 2 IRCCS Fondazione Santa Lucia, Via del Fosso di Fiorano, Rome, Italy 3 Psychiatry, Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy Correspondence should be addressed to Antonio Pisani; pisani@uniroma2.it Received 2 May 2016; Revised 26 June 2016; Accepted 28 July 2016 Academic Editor: Jan Aasly Copyright © 2016 Tommaso Schirinzi et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Te multifactorial pathogenesis of Parkinson’s Disease (PD) requires a careful identifcation of populations “at risk” of developing the disease. In this case-control study we analyzed a large Italian population, in an attempt to outline general criteria to defne a population “at risk” of PD. We enrolled 300 PD patients and 300 controls, gender and age matched, from the same urban geographical area. All subjects were interviewed on demographics, family history of PD, occupational and environmental toxicants exposure, smoking status, and alcohol consumption. A sample of 65 patients and 65 controls also underwent serum dosing of iron, copper, mercury, and manganese by means of Inductively Coupled-Plasma-Mass-Spectrometry (ICP-MS). Positive family history, toxicants exposure, non-current-smoker, and alcohol nonconsumer status occurred as signifcant risk factors in our population. Te number of concurring risk factors overlapping in the same subject impressively increased the overall risk. No signifcant diferences were measured in the metal serum levels. Our fndings indicate that combination of three to four concurrent PD-risk factors defnes a condition “at risk” of PD. A simple stratifcation, based on these questionnaires, might be of help in identifying subjects suitable for neuroprotective strategies. 1. Introduction Parkinson’s Disease (PD) is a common neurodegenerative disorder with progressive disabling motor and nonmotor features. A number of therapeutic interventions allow symp- tomatic relief, but none of them is able to prevent or halt neu- rodegeneration. In the recent past, through a better compre- hension of PD pathogenesis, several molecular pathways have been identifed as potential targets of neuroprotection. Unfor- tunately, clinical trials ofen failed in translating the encour- aging results obtained from in vitro and in vivo experimental fndings. To some extent, the suboptimal selection of enrolled patients and the lack of measurable biomarkers or reliable outcomes account for such failures [1–3]. Genetically defned populations (LRRK2 or GBA mutations) seem to be suitable candidates for neuroprotection [2], but it is well known that less than 10% of PD cases can be ascribed to a monogenic mutation [4]. It is now widely accepted that PD is an idiopathic, multifactorial disease, originating from the inter- action between one or more susceptibility loci of the host and one or several environmental modifers [5–8]. Since numer- ous PD-risk factors, including positive family history, tox- icants exposure, and personal habits, have been identifed [5, 6, 9], specifc eforts should be made to further defne the PD-risk status and, consequently, improve inclusion criteria for neuroprotective treatments. In this case-control study, we screened a large urban population from Italy to outline a population “at risk” of PD. Specifcally, we examined the association between PD and risk factors, measured either as single items or in combination. In addition, in support to Hindawi Publishing Corporation Parkinson’s Disease Volume 2016, Article ID 9646057, 7 pages http://dx.doi.org/10.1155/2016/9646057