Lazcano-Ocampo Claudia, Warnecke Tobias, Boura Iro, Urso Daniele, Leta Valentina, Poplawska-Domaszewicz Karolina, Batzu Lucia, Bayram Ece, Raeder Vanessa, Lin Chin-Hsien, Falup-Pecurariu Cristian, Chaudhuri K Ray
Department of Neurology, Institute of Diagnosis INDISA, 1810 Santa Maria Avenue, Santiago, Chile.
Department of Neurology, San Borja Arriarán Hospital, 1234 Santa Rosa Avenue, Santiago, Chile.
J Neural Transm (Vienna). 2025 Jul 17. doi: 10.1007/s00702-025-02924-0.
Although the bidirectional relationship between the central nervous system and the gut has gained increasing attention in neurodegenerative conditions and movement disorders, much of the focus seems to be on constipation and other symptoms related to gastrointestinal hypomotility. However, intestinal hypermotility-related symptoms, such as diarrhoea, are also frequently associated with movement disorders, representing a clinical and research gap that needs to be addressed. This narrative review aims to describe the movement disorders associated with diarrhoea as a gastrointestinal manifestation and provide a useful overview for routine clinical practice. A variety of acquired causes, such as infectious, toxic, metabolic, and autoimmune, as well as inherited conditions may present with diarrhoea; in fact, loosen stool may sometimes precede the onset of movement disorders. Furthermore, the characteristics and volume of diarrhoea may vary depending on the underlying condition, as different pathophysiological mechanisms affecting the central and peripheral nervous system may alter gastrointestinal function. Diarrhoea is a prominent clinical symptom across a wide range of conditions, particularly those manifesting with hyperkinetic movement disorders, such as ataxia, myoclonus and tremor. When occurring in conditions with predominant hypokinetic movement disorders, it is mostly drug-associated or presents as overflow diarrhoea. Further studies exploring the relationship between bowel hypermotility and neurological dysfunction are needed.
尽管中枢神经系统与肠道之间的双向关系在神经退行性疾病和运动障碍中越来越受到关注,但大部分焦点似乎都集中在便秘和其他与胃肠动力不足相关的症状上。然而,与肠道运动亢进相关的症状,如腹泻,也经常与运动障碍相关,这是一个需要解决的临床和研究空白。这篇叙述性综述旨在描述与腹泻相关的运动障碍,将其作为一种胃肠道表现,并为常规临床实践提供有用的概述。多种后天性病因,如感染性、中毒性、代谢性和自身免疫性病因,以及遗传性疾病都可能伴有腹泻;事实上,有时在运动障碍发作之前就会出现大便变稀。此外,腹泻的特征和量可能因潜在疾病而异,因为影响中枢和外周神经系统的不同病理生理机制可能会改变胃肠功能。腹泻是多种疾病中的一个突出临床症状,尤其是那些表现为运动过多性运动障碍的疾病,如共济失调、肌阵挛和震颤。当发生在以运动过少性运动障碍为主的疾病中时,腹泻大多与药物相关或表现为溢出性腹泻。需要进一步研究来探索肠道运动亢进与神经功能障碍之间的关系。