Gastrointestinal manifestations in Parkinson’s disease: prevalence and occurrence before motor symptoms

To assess the prevalence of gastrointestinal symptoms (GIS) in Parkinson’s disease (PD) compared to control subjects and their timing of appearance in relationship to the onset of motor symptoms. There is a rostrocaudal gradient of alpha-synuclein (α-SYN) neuropathology in the enteric nervous system...

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Bibliographic Details
Published in:Journal of neurology 2013-05, Vol.260 (5), p.1332-1338
Main Authors: Cersosimo, Maria G., Raina, Gabriela B., Pecci, Cristina, Pellene, Alejandro, Calandra, Cristian R., Gutiérrez, Cristiam, Micheli, Federico E., Benarroch, Eduardo E.
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Constipation
Female
Gastrointestinal Diseases - epidemiology
Gastrointestinal Diseases - etiology
Humans
Male
Medicine
Medicine & Public Health
Middle Aged
Motor Activity - physiology
Neurology
Neuroradiology
Neurosciences
Original Communication
Parkinson Disease - complications
Parkinson Disease - epidemiology
Parkinson's disease
Prevalence
Severity of Illness Index
Statistics, Nonparametric
Surveys and Questionnaires
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Summary:To assess the prevalence of gastrointestinal symptoms (GIS) in Parkinson’s disease (PD) compared to control subjects and their timing of appearance in relationship to the onset of motor symptoms. There is a rostrocaudal gradient of alpha-synuclein (α-SYN) neuropathology in the enteric nervous system at early stages of PD with higher burden in the upper than the lower gut. However, only constipation has been recognized as a premotor gastrointestinal manifestation of PD. 129 PD patients and 120 controls underwent a structured questionnaire to assess the presence of GIS and, in PD patients, the time of their appearance respect to the onset of motor manifestations. GIS significantly more prevalent in PD patients were dry mouth, drooling, dysphagia, constipation and defecatory dysfunction. Constipation and defecatory dysfunction preceded motor manifestations. Whereas gastroparesis symptoms preceded motor manifestations, their prevalence was not significantly different from controls. Despite evidence of a higher α-SYN burden in the upper gut, only constipation and defecatory dysfunction were prominent premotor GIS of PD.
ISSN:0340-5354
1432-1459
DOI:10.1007/s00415-012-6801-2