ADVERTISEMENT
Four Gastrointestinal Syndromes May Specifically Predict Parkinson Disease
Dysphagia, gastroparesis, constipation, and irritable bowel syndrome (IBS) without diarrhea appear to increase the risk of a subsequent diagnosis of idiopathic Parkinson disease (PD), according to a study published online ahead of print in the journal Gut.
“Early detection of gastrointestinal (GI) syndromes might contribute to the identification of patients at risk of PD during a phase were disease-modifying therapies could prevent the progression of alpha-synuclein pathology,” wrote corresponding author Pankaj Jay Pasricha, MD, of Mayo Clinic Arizona, Scottsdale, Arizona, and coauthors.
>>QUIZ: How much do childhood nightmares increase Parkinson disease risk?
The study tested Braak’s hypothesis, which states PD originates in the GI tract. Because similar GI associations have also been established for Alzheimer disease (AD) and cerebrovascular diseases (CVD), researchers investigated GI syndromes in patients with PD, AD, and CVD, as well as in control subjects without any of the conditions, using data from a US nationwide medical record network. The study included 24,624 patients with idiopathic PD, 19,046 patients with AD, 23,942 patients with CVD, and 24,624 negative controls.
Patients with PD were matched with patients in other groups for factors including age, sex, race/ethnicity, and length of diagnosis to investigate GI syndromes and interventions over an average 6 years preceding PD diagnosis. In a second analysis, researchers categorized participants by GI condition and investigated how many patients within each category developed PD or other neurologic disorders over 5 years.
In both analyses, dysphagia, gastroparesis, constipation, and IBS without diarrhea were associated with an increased risk of a PD diagnosis, according to the study. Dysphagia, gastroparesis, and constipation more than doubled the risk of PD, and IBS without diarrhea was linked with a 17% increased risk. Appendectomy, however, appeared to decrease the risk of PD.
Other gastrointestinal syndromes, such as functional dyspepsia, IBS with diarrhea, and diarrhea plus fecal incontinence, were also more prevalent among people who developed PD — as well as in people who developed AD and CVD, the study found.
“These findings warrant alertness for GI syndromes in patients at higher risk for PD and highlight the need for further investigation of GI precedents in AD and CVD,” researchers wrote. “To establish a stronger body of clinicopathological evidence, we advocate for future studies to assess the sensitivity and specificity of these disorders and their clinicopathological correlates for the early detection of neuropathology.”
References
