Original Article

Constipation is not associated with dopamine transporter pathology in early drug-naïve patients with Parkinson's disease

G. Pagano

orcid.org/0000-0002-6247-8988

Neurodegeneration Imaging Group, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK

National Parkinson Foundation International Centre of Excellence, Department of Basic & Clinical Neuroscience, King's College London and Kings College Hospital, London, UK

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T. Yousaf,

T. Yousaf

Neurodegeneration Imaging Group, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK

National Parkinson Foundation International Centre of Excellence, Department of Basic & Clinical Neuroscience, King's College London and Kings College Hospital, London, UK

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H. Wilson,

H. Wilson

Neurodegeneration Imaging Group, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK

National Parkinson Foundation International Centre of Excellence, Department of Basic & Clinical Neuroscience, King's College London and Kings College Hospital, London, UK

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F. Niccolini,

F. Niccolini

Neurodegeneration Imaging Group, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK

National Parkinson Foundation International Centre of Excellence, Department of Basic & Clinical Neuroscience, King's College London and Kings College Hospital, London, UK

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S. Polychronis,

S. Polychronis

Neurodegeneration Imaging Group, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK

National Parkinson Foundation International Centre of Excellence, Department of Basic & Clinical Neuroscience, King's College London and Kings College Hospital, London, UK

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K. R. Chaudhuri,

K. R. Chaudhuri

National Parkinson Foundation International Centre of Excellence, Department of Basic & Clinical Neuroscience, King's College London and Kings College Hospital, London, UK

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M. Politis,

Corresponding Author

M. Politis

[email protected]

Neurodegeneration Imaging Group, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK

National Parkinson Foundation International Centre of Excellence, Department of Basic & Clinical Neuroscience, King's College London and Kings College Hospital, London, UK

Correspondence: M. Politis, Neurodegeneration Imaging Group, Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology & Neuroscience, 125 Coldharbour Lane, Camberwell, London SE5 9NU, UK (tel.: + 44 207 8485682; fax: +44 020 7848 59114; e-mail: [email protected]).Search for more papers by this author

G. Pagano,

G. Pagano

orcid.org/0000-0002-6247-8988

Neurodegeneration Imaging Group, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK

National Parkinson Foundation International Centre of Excellence, Department of Basic & Clinical Neuroscience, King's College London and Kings College Hospital, London, UK

Search for more papers by this author

T. Yousaf,

T. Yousaf

Neurodegeneration Imaging Group, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK

National Parkinson Foundation International Centre of Excellence, Department of Basic & Clinical Neuroscience, King's College London and Kings College Hospital, London, UK

Search for more papers by this author

H. Wilson,

H. Wilson

Neurodegeneration Imaging Group, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK

National Parkinson Foundation International Centre of Excellence, Department of Basic & Clinical Neuroscience, King's College London and Kings College Hospital, London, UK

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F. Niccolini,

F. Niccolini

Neurodegeneration Imaging Group, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK

National Parkinson Foundation International Centre of Excellence, Department of Basic & Clinical Neuroscience, King's College London and Kings College Hospital, London, UK

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S. Polychronis,

S. Polychronis

Neurodegeneration Imaging Group, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK

National Parkinson Foundation International Centre of Excellence, Department of Basic & Clinical Neuroscience, King's College London and Kings College Hospital, London, UK

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K. R. Chaudhuri,

K. R. Chaudhuri

National Parkinson Foundation International Centre of Excellence, Department of Basic & Clinical Neuroscience, King's College London and Kings College Hospital, London, UK

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M. Politis,

Corresponding Author

M. Politis

[email protected]

Neurodegeneration Imaging Group, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK

National Parkinson Foundation International Centre of Excellence, Department of Basic & Clinical Neuroscience, King's College London and Kings College Hospital, London, UK

First published: 27 October 2017

https://doi.org/10.1111/ene.13503

Citations: 22

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Abstract

Background and purpose

Constipation is a common non-motor symptom of Parkinson's disease (PD). Deposition of α-synuclein inclusions that spread from the gut to the substantia nigra through the vagus nerve has recently been speculated to be a pre-motor and early stage of PD. The aim of the study was to investigate whether constipation is associated with dopaminergic pathology on dopamine transporter (DAT) single-photon emission computed tomography in early drug-naïve patients with PD. Our hypothesis was that constipation is associated with other signs of pre-motor PD and is independent of DAT pathology. We then investigated for associations with motor and non-motor symptoms, and with cerebrospinal fluid biomarkers of PD pathology.

Methods

Using the Parkinson's Progression Markers Initiative database, we investigated the prevalence of constipation and the association between constipation and clinical features, striatal [¹²³I]Ioflupane uptake and non-imaging (cerebrospinal fluid and serum) biomarkers. Constipation was evaluated using Movement Disorder Society-Sponsored Revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Part I item 1.11.

Results

One third (132/398) of de-novo patients with PD had constipation. Higher severity of constipation correlated with older age (r = 0.728, P < 0.001), higher MDS-UPDRS total score (r = 0.285, P < 0.001), worse postural instability (r = 0.190, P = 0.012), rapid eye movement sleep behaviour disorder (r = 0.228, P < 0.0001) and depression (r = 0.187, P = 0.024). No correlation was found with cerebrospinal fluid, serum and imaging markers of PD pathology.

Conclusions

Constipation was not associated with DAT pathology but with rapid eye movement sleep behaviour disorder and depression, which are speculated to be pre-motor symptoms of PD. This confirms the hypothesis that constipation may be a pre-motor sign of PD due to an impairment of non-dopaminergic pathways.

Supporting Information

References

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Volume25, Issue2

February 2018

Pages 307-312

Constipation is not associated with dopamine transporter pathology in early drug-naïve patients with Parkinson's disease

Abstract

Background and purpose

Methods

Results

Conclusions

Supporting Information

References

Citing Literature

References

Information

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Constipation is not associated with dopamine transporter pathology in early drug-naïve patients with Parkinson's disease

Abstract

Background and purpose

Methods

Results

Conclusions

Supporting Information

References

Citing Literature

References

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