Objective: We aimed to study the possible impact of constipation on motor, non-motor, depressive symptoms, cognitive functions and neurosonographic findings in idiopathic Parkinson’s disease (PD) patients.

Background: Constipation is considered  one of the most consistent premotor signs of PD. Constipation not only might be associated with  another autonomic alteration as urological dysfunction but also  linked to up to 4 fold increase in the risk of PD.

Method: We recruited 109 patients fulfilled the criteria for diagnosis of idiopathic PD based on British Brain Bank criteria. We used Unified Parkinson’s disease Rating Scale (UPDRS), Montreal Cognitive Assessment (MOCA) , Non Motor symptom Scale (NMS), Scales for Outcomes in Parkinson’s Disease-Autonomic questionnaire (SCOPA-AUT ) and Hamilton Depression test (HAMD) to assess severity of motor ,cognitive, non-motor, autonomic symptoms and depressive symptoms respectively. According to ROMEⅢ criteria PD patients were subdivided to PD patients with constipation (PD-Cons) and PD patients with no constipation (PD-NoCons) groups. High resolution ultrasound was used to assess Cross Sectional Area (CSA) of cervical part of Vagus Nerves (VN) and transcranial parenchymal ultrasound used to assess echogenicity of Substantia Nigra (SN) and diameter of third ventricle.

Results: PD patients included 65 patients with constipation (59.6 %) and 44 patients without constipation (40.4%)
PD-Cons group was found to have significantly higher H&Y (3.02±1.21 Vs 1.92±0.78 P-value < 0.001), UPDRS (87.64±33.87 Vs 57.97±21.82 P-value < 0.001) total NMSS (105.72±38.38 Vs 71.84± 31.22 P-value < 0.001), SCOPA (24.35±9.37 Vs 15.75 ±7.76 P-value < 0.001) and HAMD (21.15±7.06 Vs 8.68±4.52 P-value < 0.001) than PD-NoCons group.No significant difference between both groups regarding MOCA (20.87 ±4.02 Vs 21.77±5.17,P-value 0.313).
PD-Cons group was found to have significantly lower both VN CSA (mm²) (Right vagus 0.92 ±0.31 Vs 1.28± 0.282 P-value <0.001, Left vagus 0.77±0.23 Vs 1.24±0.32 P-value <0.001 ) and higher both SN echogenicity(cm²) ( Right SN 0.24±0.094 Vs 0.16±0.065 P-value <0.001 , Left SN 0.24±0.096 Vs 0.15±0.061 P-value <0.001) than PD-NoCons
No significant difference between both groups regarding third ventricle diameter P-value 0.07

Conclusion: Constipation could have negative impact on PD patient life through worsening motor, non-motor, autonomic and depressive symptoms.

References: Heinzel, S., Berg, D., Gasser, T., Chen, H., Yao, C., Postuma, R. B., & MDS Task Force on the Definition of Parkinson’s Disease (2019). Update of the MDS research criteria for prodromal Parkinson’s disease. Movement disorders : official journal of the Movement Disorder Society, 34(10), 1464–1470.

« Back to MDS Virtual Congress 2021

MDS Abstracts - https://www.mdsabstracts.org/abstract/constipation-in-parkinsons-disease-clinical-and-neurosonographic-study/