[Lower gastrointestinal dysfunction in patients with Parkinson's disease].

Autor:	Pilipovich AA; Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia., Vorob'eva OV; Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia., Makarov SA; Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia., Kuchuk AV; Peoples' Friendship University of Russia, Moscow, Russia.
Jazyk:	ruština
Zdroj:	Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova [Zh Nevrol Psikhiatr Im S S Korsakova] 2023; Vol. 123 (12), pp. 42-49.
DOI:	10.17116/jnevro202312312142
Abstrakt:	Objective: To assess the lower gastrointestinal tract dysfunction in patients with Parkinson's disease (PD) and to reveal its relationships with motor and non-motor symptoms. Material and Methods: One hundred and eighteen patients with PD of I-III Hoehn and Yahr (H&Y) stages were studied using UPDRSI-IV, Sch&En, PDQ-39, MMSE, BDI, STAI-S and STAI-T, PFS-16, NMSQ, GSRS, BSFS, AUA. Body mass index and saliva amount and lacrimation (Schirmer's test) were assessed. Results: Constipation from mild to moderate intensity was present in 71.2% of the patients; predominantly mild diarrhea occurred in 27.9%; alternations of diarrhea with the difficulty in intestine emptying were observed in 25.4%. We found significant correlations of constipation with the following parameters: Sch&En scales ( rS =-0.291) and PDQ-39 ( rS =0.478), patient's age ( rS =0.275), H&Y stage ( rS =0.2604), UPDRS ( rS =0.254), axial motor symptoms of parkinsonism, and a number of affective and autonomic disorders, most of which were partly dopamine-resistant. Diarrhea did not affect the quality of patient's life, or depend on age, PD stage, main digital and non-motor symptoms, but directly correlated with the severity of constipation ( rS =0.263) and other gastrointestinal disorders. There were no effects of dopaminergic therapy, including levodopa, dopamine-receptor-agonists, and amantadine, on the lower gastrointestinal tract dysfunction. Conclusion: Dysfunction of the lower gastrointestinal tract (predominantly from mild to moderate intensity) was detected in most PD patients of I-III stages. Our data indicate a complex pathogenesis of the PD impaired bowel emptying, involving degeneration of non-dopaminergic structures, and the predominant influence of concomitant diseases and inadequate laxative therapy on the formation of diarrhea syndrome in PD.
Databáze:	MEDLINE
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