Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK.
Institute for Liver and Digestive Health, University College London, Royal Free Campus, London, UK.
Ann Med. 2021 Dec;53(1):611-625. doi: 10.1080/07853890.2021.1890330.
Gastrointestinal disorders are one of the most significant non-motor problems affecting people with Parkinson disease (PD). Pathogenetically, the gastrointestinal tract has been proposed to be the initial site of pathological changes in PD. Intestinal inflammation and alterations in the gut microbiota may contribute to initiation and progression of pathology in PD. However, the mechanisms underlying this "gut-brain" axis in PD remain unclear. PD patients can display a large variety of gastrointestinal symptoms, leading to reduced quality of life and psychological distress. Gastrointestinal disorders can also limit patients' response to medications, and consequently negatively impact on neurological outcomes. Despite an increasing research focus, gastrointestinal disorders in PD remain poorly understood and their clinical management often suboptimal. This review summarises our understanding of the relevance of the "gut-brain" axis to the pathogenesis of PD, discusses the impact of gastrointestinal disorders in patients with PD, and provides clinicians with practical guidance to their management.
胃肠道疾病是影响帕金森病（PD）患者的最主要非运动问题之一。从发病机制上讲，胃肠道被认为是 PD 病理变化的初始部位。肠道炎症和肠道微生物群的改变可能有助于 PD 病理的发生和进展。然而，PD 中“肠-脑”轴的机制尚不清楚。PD 患者可能会出现多种胃肠道症状，导致生活质量下降和心理困扰。胃肠道疾病也会限制患者对药物的反应，从而对神经学结果产生负面影响。尽管研究关注度不断增加，但 PD 患者的胃肠道疾病仍未得到充分理解，其临床管理往往也不尽人意。本综述总结了我们对“肠-脑”轴与 PD 发病机制相关性的理解，讨论了胃肠道疾病对 PD 患者的影响，并为临床医生提供了管理胃肠道疾病的实用指导。
