Objective: To explore the association between constipation and clinical features, imaging and non-imaging biomarkers in early de novo (untreated) Parkinson’s disease (PD) patients.

Background: Constipation is a common non-motor and pre-motor symptom of PD. Deposition of alpha-synuclein inclusions that spread from the gut to the substantia nigra via vagus nerve, has been recently speculated as an early stage in the development of PD. The investigation of associations between constipation and clinical and non-clinical features in early PD patients may provide with important insights in the pathophysiology of the disease.

Methods: In this study we have extracted and analysed data using the Parkinson’s Progression Markers Initiative database for investigating the role of constipation in early de novo PD patients. Data of PD patients were compared to those from a group of age/gender-matched healthy controls (HCs). Constipation has been evaluated using MDS-UPDRS Part-I item1.11 and correlated with clinical features, molecular imaging ([123I]FP-CIT SPECT) and non-imaging (CSF alpha-synuclein, total-tau, p-tau181 and Abeta1-42) biomarkers.

Results: The prevalence of constipation in untreated PD patients (132/398 PD; 33.2%) was higher than HCs (24/189 HC; 12.7%; p<0.0001). Higher severity of constipation correlated with higher burden of motor (MDS-UPDSR Part-III: Pearson’s correlation [r]=0.104, p=0.037) and non-motor symptoms (MDS-UPDSR Part-I: r=0.438, p<0.0001), but no correlation was found with CSF biomarkers and [123I]FP-CIT SPECT. Higher severity of constipation correlated with higher severity of postural instability (r=0.153, p=0.002) but not with rigidity (r=0.029, p=0.560), bradykinesia (r=0.081, p=0.106) and resting tremor (Amplitude: r=0.029, p=0.559; Constancy: r=0.010, p=0.839). With regards to non-motor symptoms, higher severity of constipation correlated with higher severity of cognitive impairment (r=0.150, p=0.027), sleepiness (r=0.150, p=0.027), urinary dysfunction (r=0.225, p<0.0001) and dizziness (r=0.174, p<0.0001).

Conclusions: Constipation is a common feature in early PD and is associated with the presence of postural instability and dizziness, and higher burden of non-motor symptoms such as cognitive impairment, sleepiness and urinary dysfunction. We speculate that our findings may be suggestive of a pre-motor profile in the course of PD.

« Back to 2016 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/constipation-in-early-de-novo-parkinsons-disease-prevalence-and-correlates-with-clinical-features-imaging-and-non-imaging-biomarkers/