Constipation and pain in Parkinson’s disease: a clinical analysis

Abstract

Parkinson’s Disease (PD) is a neurodegenerative disorder characterized by both motor and non-motor symptoms (NMS). Among NMS, constipation and pain are both highly prevalent and debilitating affecting up to 80% of PD patients and impairing their quality of life. Here, we investigated the relationship between constipation and pain in PD patients. This is a retrospective study assessing the relationship between pain and constipation in a PD patient population from a clinical database of patients attending the outpatient clinic of the movement disorders division, Neurology Unit of Policlinico Tor Vergata, in Rome. Subjects were assessed with the Unified Parkinson’s Disease Rating Scale (UPDRS) part III, Hoehn and Yahr (H&Y) stage, King’s Parkinson’s Disease Pain Scale (KPPS), Brief Pain Inventory (BPI), Non-Motor Symptoms Scale (NMSS) and Beck Depression Inventory (BDI). Patients were further divided in two groups (Group 1, 32 patients with constipation and Group 2, 35 PD patients without constipation) ANOVA and ANCOVA analysis were used to compare the two groups. PD patients with constipation had significantly higher pain severity and pain interference, as measured by the BPI scale and higher total KPPS score, fluctuation-related pain, nocturnal pain, and radicular pain when compared to PD patients without constipation. This study highlights for the first time a possible interplay between constipation and pain in PD that deserves further investigations.

A comparative analysis of Parkinson’s disease and inflammatory bowel disease gut microbiomes highlights shared depletions in key butyrate-producing bacteria

“…Parkinson's disease (PD) is a neurodegenerative disorder frequently associated with motor symptoms such bradykinesia, resting tremor, rigidity, and postural instability, PD is also associated with a host of non-motor symptoms many of which may possibly appear prior to motor symptom onset 1,2 . Accumulating evidence suggests the gut may play an important role in the pathogenesis of PD, with reports of up to 80% of patients experiencing gastrointestinal (GI) symptoms such as constipation 3 and 20-30% reporting constipation in the prodromal phase 4,5 . Constipation has been associated with an increased risk for PD and continues to be listed among the most prevalent prodromal PD symptoms reported, appearing in some cases 10-20 years before diagnosis 6 .…”

“…Interestingly, substantia nigra which is the compartment with dopamine cells becomes affected later in the process 4,9 . Increased levels of inflammatory markers seem to be asscociated with these changes and have been shown in animal models.…”