Predictors of gastric emptying in Parkinson's disease

Abstract

Predictors of gastric emptying (GE) in patients with idiopathic Parkinson's disease (PD) of a solid and liquid meal are not well defined. For measurement of GE 80 patients with PD were randomly assigned to receive either a solid meal (250 kcal) containing 13C-octanoate (n = 40) or a liquid meal (315 kcal) with 13C-acetate (n = 40). All patient groups were off medication affecting motility and were matched for age, gender, body mass index, disease duration and severity, using Unified Parkinson's Disease Rating Scale (UPDRS). Gastric emptying was compared with a healthy control group (n = 40). Multiple regression analysis was used to determine predictors of gastric emptying. Exactly 88% and 38% of PD patients had delayed GE of solids and liquids respectively. Solid and liquid emptying was similar in women and men. There were no differences in GE in PD patients < 65 years of age when compared with patients > or = 65 years. Multiple regression analysis showed that motor handicaps such as rigour and action tremor are independent predictors of solid GE (r = 0.68, P < 0.001). The severity of motor impairment, but not any other neurological symptom, as assessed by UPDRS is associated with gastroparesis in PD and solid emptying is more likely to be delayed.

Loss of enteric dopaminergic neurons and associated changes in colon motility in an MPTP mouse model of Parkinson's disease

“…This dysmotility contributes directly to the morbidity of PD and complicates the disease's clinical management. For example, in the stomach, delayed emptying leads to nausea, contributes to weight loss because of decreased food intake, and adds to fluctuations in motor impairment from variable absorption of medication (Djaldetti, et al, 1996, Goetze, et al, 2006, Goetze, et al, 2005, Kurlan, et al, 1988. In the colon, longer transit time due to poor motility causes harder stools and constipation by increasing the absorption of water , Edwards, et al, 1992, Ueki and Otsuka, 2004.…”

Is Levodopa Pharmacokinetics in Patients with Parkinson’s Disease Depending on Gastric Emptying?

“…Some studies have shown that delayed GE in PD patients is associated with disease severity [4] [29] while other studies cannot find any association of GE and disease duration or Hoehn and Yahr clinical scale [5] [6] [8]. Abnormalities in gastric motility have also been shown with electrogastrography in PD patients both in early and advanced stages of the disease [40] [41].…”

“…Another factor is the gastric emptying (GE) [3]. It has been shown that more than 70% of PD patients suffer from impaired gastric motility [4] [5] with symptoms like early satiety, postprandial bloating and nausea and it has been suggested that this is caused by the delay in GE that has been shown in PD patients [5]- [13]. Delayed GE has also been shown to impair the levodopa uptake and is therefore suggested to worsen motor fluctuations [4] [11] [14] [15] [16].…”

Trastornos autonómicos en enfermedad de Parkinson

“…El compromiso se manifi esta principalmente como gastroparesia (36-88%) con náuseas, saciedad precoz y disconfort abdominal 35,36 . El retraso del vaciamiento se ha implicado en casos de fl uctuaciones motoras ("on" retardado y no "on"), siendo de utilidad el manejo con prokinéticos (domperidona) 37,38 .…”