Knudsen Karoline, Haase Anne-Mette, Fedorova Tatyana D, Bekker Anne Charlotte, Østergaard Karen, Krogh Klaus, Borghammer Per
Department of Nuclear Medicine and PET Centre, Aarhus University Hospital, Denmark.
Department of Hepatology and Gastroenterology, Aarhus University Hospital, Denmark.
J Parkinsons Dis. 2017;7(3):471-479. doi: 10.3233/JPD-171131.
Symptoms from the gastrointestinal tract are highly prevalent in Parkinson's disease (PD), but knowledge of the underlying pathology is incomplete and valid objective markers on regional gastrointestinal function are limited.
The aims were to evaluate gastrointestinal transit time and motility in PD patients and controls.
Twenty-two PD patients and 15 controls were included. Gastric-, small intestinal-, and caecum-ascending colonic transit times as well as colonic motility, defined as mass- and fast movements, were performed using the ambulatory 3D-Transit system. Gastrointestinal transit time with radio opaque markers, gastric emptying scintigraphy, and subjective non-motor symptoms were also evaluated.
Using the 3D-Transit system, the patient group displayed significantly longer small intestinal- and caecum-ascending transit times (p = 0.030 and p = 0.0063). No between-group difference was seen in gastric transit time (p = 0.91). Time to first mass- and fast colonic movement were significantly increased in PD (p = 0.023 and p = 0.006). Radio opaque marker gastrointestinal transit time was significantly increased in the patient group (p < 0.0001), whereas no difference was seen in scintigraphic gastric emptying time (p = 0.68). Prevalence of constipation symptoms on the NMSQuest was 41% in PD and 7% in controls.
Significantly increased small intestinal- and caecum-ascending 3D-Transit times were detected in PD patients. Also, time to first propagating colonic movement was increased. Radio opaque marker gastrointestinal transit time was significantly delayed, but no difference was seen in gastric transit time and gastric emptying time. The present findings highlight widespread intestinal involvement in PD increasing throughout the gastrointestinal tract.
胃肠道症状在帕金森病(PD)中极为常见,但对其潜在病理机制的了解尚不完整,且关于区域胃肠功能的有效客观标志物有限。
旨在评估帕金森病患者和对照组的胃肠传输时间及动力。
纳入22例帕金森病患者和15名对照者。使用动态3D传输系统测量胃、小肠、盲肠-升结肠传输时间以及结肠动力,结肠动力定义为集团运动和快速运动。还评估了不透X线标志物的胃肠传输时间、胃排空闪烁扫描以及主观非运动症状。
使用3D传输系统,患者组的小肠和盲肠-升结肠传输时间显著延长(p = 0.030和p = 0.0063)。胃传输时间在两组间未见差异(p = 0.91)。帕金森病患者首次出现结肠集团运动和快速运动的时间显著增加(p = 0.023和p = 0.006)。患者组不透X线标志物的胃肠传输时间显著延长(p < 0.0001),而闪烁扫描胃排空时间未见差异(p = 0.68)。在NMSQuest上便秘症状的发生率在帕金森病患者中为41%,在对照组中为7%。
在帕金森病患者中检测到小肠和盲肠-升结肠的3D传输时间显著增加。此外,首次出现结肠推进运动的时间也增加。不透X线标志物的胃肠传输时间显著延迟,但胃传输时间和胃排空时间未见差异。本研究结果突出了帕金森病中广泛的肠道受累,且这种受累在整个胃肠道中逐渐加重。