Gastric Motility in Parkinson's Disease is Altered Depending on the Digestive Phase and Does Not Correlate with Patient-Reported Motor Fluctuations.
Parkinson’s disease
gastrointestinal motility
real-time magnetic resonance imaging
stomach
Journal
Journal of Parkinson's disease
ISSN: 1877-718X
Titre abrégé: J Parkinsons Dis
Pays: Netherlands
ID NLM: 101567362
Informations de publication
Date de publication:
2020
2020
Historique:
pubmed:
18
8
2020
medline:
18
9
2021
entrez:
18
8
2020
Statut:
ppublish
Résumé
Altered gastric motility is a frequent non-motor symptom of Parkinson's disease (PD). It has been hypothesized that disturbed gastric motility contributes to motor fluctuations in PD due to an erratic gastro-duodenal transport and an unpredictable absorption of drugs. We investigated whether patient-reported fluctuations are associated with parameters of gastric motility visualized by real-time magnetic resonance imaging (MRI) of the stomach. We analyzed real-time MRI-scans of the stomach after an overnight fasting period in 16 PD patients and 20 controls. MRI was performed 1) in the fasting state, 2) directly after a test meal, and 3) 4 hours postprandially. Gastric motility indices were calculated and compared between groups. MRI showed an attenuated gastric motility in PD patients compared to controls. The difference was most obvious in the early postprandial phase. Gastric motility was not associated with patient-reported motor fluctuations. Using an iron-containing capsule we were able to retrace retention of drugs in the stomach. The results of this study stress the importance of considering the phase of digestion when investigating gastric motility in PD. Despite theoretical considerations, we did not find robust evidence for an association between MRI parameters of gastric motility and patient-reported motor fluctuations. For future studies that aim to investigate gastric motility in PD by MRI, we suggest multiple short-time MRIs to better track the whole gastro-duodenal phase in PD. Such an approach would also allow to retrace the retention of drugs in the stomach as shown by our approach using an iron-containing capsule.
Sections du résumé
BACKGROUND
Altered gastric motility is a frequent non-motor symptom of Parkinson's disease (PD). It has been hypothesized that disturbed gastric motility contributes to motor fluctuations in PD due to an erratic gastro-duodenal transport and an unpredictable absorption of drugs.
OBJECTIVE
We investigated whether patient-reported fluctuations are associated with parameters of gastric motility visualized by real-time magnetic resonance imaging (MRI) of the stomach.
METHODS
We analyzed real-time MRI-scans of the stomach after an overnight fasting period in 16 PD patients and 20 controls. MRI was performed 1) in the fasting state, 2) directly after a test meal, and 3) 4 hours postprandially. Gastric motility indices were calculated and compared between groups.
RESULTS
MRI showed an attenuated gastric motility in PD patients compared to controls. The difference was most obvious in the early postprandial phase. Gastric motility was not associated with patient-reported motor fluctuations. Using an iron-containing capsule we were able to retrace retention of drugs in the stomach.
CONCLUSION
The results of this study stress the importance of considering the phase of digestion when investigating gastric motility in PD. Despite theoretical considerations, we did not find robust evidence for an association between MRI parameters of gastric motility and patient-reported motor fluctuations. For future studies that aim to investigate gastric motility in PD by MRI, we suggest multiple short-time MRIs to better track the whole gastro-duodenal phase in PD. Such an approach would also allow to retrace the retention of drugs in the stomach as shown by our approach using an iron-containing capsule.
Identifiants
pubmed: 32804102
pii: JPD202144
doi: 10.3233/JPD-202144
pmc: PMC7683086
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1699-1707Références
J Gastroenterol Hepatol. 2009 Aug;24(8):1401-6
pubmed: 19702908
Am J Gastroenterol. 1999 Oct;94(10):2866-73
pubmed: 10520835
Parkinsonism Relat Disord. 2018 Oct;55:18-25
pubmed: 29891432
Clin Nucl Med. 2017 Feb;42(2):83-87
pubmed: 27941374
Neurosci Lett. 2005 Mar 3;375(3):170-3
pubmed: 15694254
Neurology. 1996 Apr;46(4):1051-4
pubmed: 8780089
Parkinsonism Relat Disord. 2019 Jan;58:28-34
pubmed: 30143390
Lancet Neurol. 2015 Jun;14(6):625-39
pubmed: 25987282
Mov Disord. 2001 Nov;16(6):1041-7
pubmed: 11748735
J Magn Reson Imaging. 2004 Apr;19(4):453-8
pubmed: 15065169
Gut. 2004 Sep;53(9):1256-61
pubmed: 15306580
Mov Disord Clin Pract. 2020 Mar 16;7(3):343-345
pubmed: 32258239
Gut. 1999 Jan;44(1):106-11
pubmed: 9862835
J Parkinsons Dis. 2017;7(3):471-479
pubmed: 28759975
Mov Disord. 2010 Apr 15;25(5):623-8
pubmed: 20213819
Neurogastroenterol Motil. 2006 May;18(5):369-75
pubmed: 16629864
PLoS One. 2019 May 3;14(5):e0216396
pubmed: 31050679