Objective: The aim of this study is to evaluate the patterns of gastroparesis in PD patients with motor fluctuations and dyskinesias.

Background: Gastrointestinal dysfunction is the most common non-motor symptom of Parkinson’s disease (PD), and has been often attributed to gastroparesis. In PD patients, gastroparesis has the potential to affect the absorption of medications and, consequently, motor function. 

Methods: Scintigraphy with radiolabeled sulfur colloid added to acidified orange juice was performed in 85 consecutive advanced PD patients 1 hour after their usual dopaminergic therapy first dose in the morning, to evaluate, among others data, the gastric emptying half time T1/2 (GE). Clinical evaluations at scintigraphy time consisted of collection of demographic, neurological, gastrointestinal and pharmacological data. 

Results: The 85 patients (32 women, mean age: 68 ± 9,2 years, mean disease duration: 10 ± 6,2 years, mean UPDRS III in ON: 17 ± 12,6,median H&Y 3) were divided into 2 groups, using the cut-off point of 40 minutes obtained in normal subjects. The subgroup 1 consisted of 44 patients (69 ± 9.1 years) with GE T1/2 of 26,6 ± 6,9 minutes (normal), the subgroup 2 (65.7 ± 10.2 years) showed a GE of 88.7 ± 58 minutes (delayed). There were no significant differences in demographic or clinical parameters between patients of two groups. Linear regression showed a significant correlation between GE and dosage of peripheral inhibitors, dopamine-agonist dosage and of plasmatic dopamine level (P< 0,05).

Conclusions: This observational study outlines that delayed GE is present in approximately 50% of PD patients with motor fluctuations (delayed-on, wearing off, on-off, no-on) and dyskinesias. The dosage of peripheral inhibitors may concur in GE delay and its consequent effect on drug delivery and efficacy.

References: Bestetti A1, Carola F, Carnevali-Ricci P, Sambataro G, Tarolo GL. 99mTc-sulfur colloid gastroesophageal scintigraphy with late lung imaging to evaluate patients with posterior laryngitis. J Nucl Med. 2000 Oct;41(10):1597-602.

Heetun ZS, Quigley EM. Gastroparesis and Parkinson’s disease: a systematic review. Parkinsonism Relat Disord. 2012 Jun;18(5):433-40. doi: 10.1016/j.parkreldis.2011.12.004. 

« Back to 2017 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/gastroesophageal-dysmotility-in-advanced-parkinsons-disease/