Skjærbæk Casper, Knudsen Karoline, Kinnerup Martin, Hansen Kim Vang, Borghammer Per
Department of Nuclear Medicine and PET, Aarhus University Hospital, Palle Juul-Jensens Boulevard 165, DK-8200 Aarhus N, Aarhus, Denmark.
Department of Neurology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 165, DK-8200 Aarhus N, Aarhus, Denmark.
Parkinsons Dis. 2022 Jul 15;2022:4108401. doi: 10.1155/2022/4108401. eCollection 2022.
Nonmotor symptoms, including constipation and dysphagia, are very common in Parkinson's disease (PD) and Lewy pathology is widespread in the gastrointestinal tract, particularly in the lower esophagus. Constipation and REM sleep behavior disorder (RBD) may present prior to clinical diagnosis. Yet, little is known about esophageal dysfunction and its connection to constipation in early PD.
This study aimed to investigate esophageal and colonic transit in early moderate PD and to study correlations between symptoms and objective measures.
Thirty early moderate PD patients and 28 healthy controls (HC) were included in this cross-sectional study. Esophageal transit times were determined by esophageal scintigraphy and colonic transit times by CT after radio-opaque marker ingestion. Olfaction tests, clinical evaluation, and nonmotor questionnaires were also performed.
Distal esophageal transit times and colonic transit times were both significantly prolonged in the PD group compared to HC ( < 0.05 and < 0.01, respectively) and a moderate-strong positive correlation was found between colonic transit time (CTT) and RBDSQ score ( = 0.61, < 0.001). Significant correlations were also found between CTT and SCOPA-AUT scores as well as between CTT and ROME III functional constipation scores.
Colonic transit correlates with probable RBD and is more severely prolonged in early moderate PD than is the distal esophageal transit time.
非运动症状，包括便秘和吞咽困难，在帕金森病（PD）中非常常见，路易小体病理改变在胃肠道广泛存在，尤其是在食管下段。便秘和快速眼动睡眠行为障碍（RBD）可能在临床诊断之前就已出现。然而，早期帕金森病中食管功能障碍及其与便秘的关系鲜为人知。
本研究旨在调查早期中度帕金森病患者的食管和结肠转运情况，并研究症状与客观测量指标之间的相关性。
本横断面研究纳入了30例早期中度帕金森病患者和28名健康对照者（HC）。通过食管闪烁显像测定食管转运时间，在摄入不透X线标记物后通过CT测定结肠转运时间。还进行了嗅觉测试、临床评估和非运动问卷调查。
与健康对照者相比，帕金森病组的食管远端转运时间和结肠转运时间均显著延长（分别为<0.05和<0.01），并且结肠转运时间（CTT）与RBDSQ评分之间存在中度至强的正相关（r = 0.61，P<0.001）。CTT与SCOPA-AUT评分之间以及CTT与ROME III功能性便秘评分之间也存在显著相关性。
结肠转运与可能的RBD相关，并且在早期中度帕金森病中比食管远端转运时间延长得更严重。
