Constipation is not associated with DAT dopaminergic pathology in early de novo patients with Parkinson's disease.

Constipation is not associated with DAT dopaminergic pathology in early de novo patients with Parkinson's disease.

Eur J Neurol. 2017 Oct 27;:

Authors: Pagano G, Yousaf T, Wilson H, Niccolini F, Polychronis S, Chaudhuri KR, Politis M

Abstract
BACKGROUND: Constipation is a common non-motor symptom of Parkinson's disease. Deposition of α-synuclein inclusions that spread from the gut to the substantia nigra through the vagus nerve has been recently speculated as a pre-motor and early stage of Parkinson's disease.
OBJECTIVE: To investigate whether constipation is associated with dopaminergic pathology at DAT SPECT in early de novo (untreated) Parkinson's disease patients. Our hypothesis is that constipation is associated with other signs of pre-motor Parkinson's disease and independent of DAT dopaminergic pathology. We then investigated for associations with motor and non-motor symptoms, and with cerebrospinal fluid (CSF) biomarkers of Parkinson's disease pathology.
METHODS: Using the Parkinson's Progression Markers Initiative database, we have investigated constipation prevalence and the association between constipation and clinical features, striatal [(123) I]FP-CIT uptake and non-imaging (cerebrospinal fluid and serum) biomarkers. Constipation was evaluated using MDS-UPDRS Part-I item-1.11.
RESULTS: One third (132/398) of de novo Parkinson's patients had constipation. Higher severity of constipation correlated with older age (r=0.728, P<0.001) and higher MDS-UPDRS total score (r=0.285, P<0.001). Higher severity of constipation correlated with worse postural instability (r=0.190, P=0.012), REM sleep behaviour disorder (r=0.228, P<0.0001) and depression (r=0.187, P=0.024). No correlation was found with cerebrospinal fluid, serum and imaging markers of Parkinson's disease pathology.
CONCLUSIONS: Constipation is not associated with DAT dopaminergic pathology but with REM sleep behaviour disorder and depression, speculated pre-motor symptoms of Parkinson's disease. This confirms the hypothesis that constipation may be a pre-motor sign of Parkinson's disease due to an impairment of non-dopaminergic pathways. This article is protected by copyright. All rights reserved.

PMID: 29078029 [PubMed - as supplied by publisher]

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