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Objective intestinal function in patients with idiopathic REM sleep behavior disorder.

Karoline Knudsen1, Tatyana D Fedorova1, Allan K Hansen1

  • 1Department of Nuclear Medicine and PET Centre, Aarhus University Hospital, Denmark.

Parkinsonism & Related Disorders
|August 26, 2018
PubMed
Summary
This summary is machine-generated.

Gastrointestinal dysfunction, including increased transit time and colonic volume, is common in patients with REM Sleep Behavior Disorder, an early sign of Parkinson's disease (PD). These findings suggest significant gut issues in the prodromal PD phase.

Keywords:
ConstipationGastrointestinalNon-motor symptomRBDTransit time

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Area of Science:

  • Neurology
  • Gastroenterology
  • Pathology

Background:

  • Parkinson's disease (PD) involves alpha-synuclein accumulation and cell death, potentially originating in peripheral nerves.
  • Autonomic dysfunction, such as constipation, is a common early non-motor symptom in PD patients, often preceding diagnosis.

Purpose of the Study:

  • To investigate gastrointestinal (GI) transit time, colonic volume, and peristaltic movements in patients with idiopathic REM Sleep Behavior Disorder (iRBD).
  • To assess iRBD as a prodromal marker for Parkinson's disease or Dementia with Lewy bodies by examining GI function and autonomic involvement.

Main Methods:

  • Twenty-two iRBD patients were studied, comparing their GI function to Parkinson's disease patients and healthy controls.
  • Methods included measuring GI transit time, computed tomography-based colonic volume estimation, and colonic motility.
  • Subjective constipation symptoms were assessed using validated questionnaires.

Main Results:

  • Increased gastrointestinal transit time (33%) and colonic volume (48%) were observed in iRBD patients.
  • Colonic transit time was elevated in 70% of patients, with reduced peristaltic movements.
  • Subjective constipation was reported by 18-41% of patients, with limited correlation to objective GI findings.

Conclusions:

  • Significant GI dysfunction, including increased total GI transit time, colonic volume, and colonic transit time, is present in the early prodromal phase of PD.
  • Findings support the hypothesis of peripheral nerve involvement in early PD, manifesting as gut dysfunction.
  • While objective GI abnormalities are evident, subjective constipation symptoms show limited correlation, highlighting the complexity of early PD diagnosis.