Esophageal dysfunction in different stages of Parkinson's disease

Suttrup, Inga; Suttrup, Judith; Suntrup‐Krueger, Sonja; Siemer, M.-L.; Bauer, Jan; Hamacher, Christina; Oelenberg, Stephan; Domagk, Dirk; Dziewas, Rainer; Warnecke, Tobias

doi:10.1111/nmo.12915

Cited by 67 publications

(34 citation statements)

References 36 publications

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“…As the Chicago classification criteria had been developed to identify severe gastrointestinal dysfunction, these criteria might be too strict to detect subtle esophageal alterations in neurological disorders like parkinsonian syndromes. The findings of our study are congruent to those we observed in a large group of PD patients showing comparable values of peristalsis and DCI . Besides, in another current study using HRM, Su et al also found ineffective (55%) and fragmented (48%) esophageal peristalsis using HRM in PD patients without any sign of gastrointestinal disorders, including achalasia, indicating underlying motility disturbances in PD patients as well .…”

Section: Discussionsupporting

confidence: 92%

“…The pathophysiology of esophageal dysfunction in parkinsonian syndromes is a subject of current research as it might give insight into the origins and further development of the disease pathology itself. In a recent study, we described esophageal impairment patterns in a large population of patients with Parkinson's disease (PD) by using high‐resolution manometry (HRM), showing esophageal dysmotility during all stages of the disease . Moreover, these esophageal alterations have been shown to be present even in premotor stages of the disease, indicating an early subclinical involvement of the esophagus and the gastrointestinal tract (GIT) .…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, based on our previous PD esophageal motility study Esophageal Dysfunction in Different Stages of Parkinson's Disease , we performed a data analysis of high resolution manometry (HRM) and fiberoptic endoscopic swallowing (FEES) examination of patients with MSA and PSP. Whereas MSA is an alpha‐synucleinopathy like PD, PSP belongs to the group of tauopathies.…”

Section: Introductionmentioning

confidence: 99%

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Subtle Esophageal Motility Alterations in Parkinsonian Syndromes: Synucleinopathies vs. Tauopathies

Claus

Suttrup

Muhle

et al. 2018

Movement Disord Clin Pract

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Background Esophageal dysfunction is a frequent phenomenon in Parkinson's disease during all disease stages, but data about esophageal involvement in atypical parkinsonian syndromes as well as possible differences between alpha‐synucleinopathies and tauopathies, including causative links to the origin of the dysfunction, are lacking so far. Objective To describe esophageal alternation patterns in different parkinsonian syndromes and to look for differences supporting the hypothesis of alpha‐synuclein aggregation being linked to gastrointestinal impairment in parkinsonian syndromes. Methods We performed an analysis and comparison of esophageal high‐resolution manometry examination parameters in n = 10 patients with Parkinson's disease, n = 10 patients with multiple system atrophy (both alpha‐synucleinopathies), n = 10 patients with progressive supranuclear palsy (tauopathy), and n = 10 age‐matched controls. Additionally, pharyngeal dysphagia was evaluated by an endoscopic examination of swallowing in all three patient groups. Results Statistically significant lower values for esophageal peristalsis and distal contractile integral were found for both groups of alpha‐synucleinopathies (Parkinson's disease and multiple system atrophy) in comparison to the patients with tauopathy (progressive supranuclear palsy group), as well as the age‐matched controls, where pathological pharyngeal findings were similar in all patient groups. Conclusions Subtle esophageal motility alterations in parkinsonian syndromes seem to be limited to alpha‐synucleinopathies, but are not measurable in tauopathies, indicating a causative connection between pathological alpha‐synuclein aggregation in gastrointestinal tissues and esophageal involvement.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Subtle Esophageal Motility Alterations in Parkinsonian Syndromes: Synucleinopathies vs. Tauopathies

Claus

Suttrup

Muhle

et al. 2018

Movement Disord Clin Pract

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“…Upper gastrointestinal symptoms reported in PD patients include: nausea, early satiety, gastric retention, and abdominal distension, caused by incomplete relaxation of esophageal sphincters, diffuse spasms, and reduced peristalsis, gastroparesis and delayed gastric emptying (18,19,20). colonic motility is also reduced because of abnormal intrinsic (enteric nervous system -enswhich normally promotes the peristaltic reflex and extrinsic (vagal) innervations, and also because of early enteric sympathetic denervation (21,22).…”

Section: Methodsmentioning

confidence: 99%

Digestive Symptoms of Autonomic Dysfunction in Parkinson’s Disease Patients

Răşanu¹

2019

Ro J Neurol.

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It is nowadays recognized that Parkinson's disease (PD) involves a variety of non-motor manifestations, which sometimes seriously affect the quality of life in these patients. This study explored the prevalence of digestive symptoms in a group of 86 PD patients from the Southeastern Romania (56% male, mean age 70.6) who had been diagnosed with Parkinson's disease according to the United Kingdom Brain Bank criteria; patient-reported digestive symptoms were assessed using the Scale for Outcomes in Parkinson's Disease for Autonomic Symptoms (SCOPA-AUT). The overall prevalence of digestive symptoms in the studied group was impressive (98,8%). Defecatory dysfunction (75.6%), ranks first followed by swallowing difficulties / choking (68.6%) and constipation (66.3%); 60.4% of study subjects experienced digestive symptoms "regularly" or even "often". The proportion of patients having more than 3 digestive symptoms increased almost progressively with disease duration; nevertheless, there was no statistically significant correlation between disease duration and the number or frequency of digestive symptoms.

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“…Indeed, gastrointestinal symptoms are common in PD, with constipation occurring in up to 66% of patients [36]. Less well known are the esophageal abnormalities, however, up to 95% of people with PD will have a minor disorder of peristalsis [37], which can have a profound impact on their quality of life. For example, dysphagia may lead to drooling, weight loss and potential aspiration.…”

Section: The Gastroenterologistmentioning

confidence: 99%

Multidisciplinary care for people with Parkinson’s disease: the new kids on the block!

Radder

Vries

Riksen

et al. 2019

Expert Review of Neurotherapeutics

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Telephone number: +31-0243615202 Word count for abstract: 200. Word count for text: 7143 words. Number of references: 139. Number of figures: 2. Number of tables: 2. AbstractIntroduction: Parkinson's disease (PD) is a chronic multisystem disorder that causes a wide variety of motor and non-motor symptoms. Over time, the progressive nature of the disease increases the risk of complications such as falls and loss of independence, having a profound impact on quality of life. The complexity and heterogeneity of symptoms therefore warrant a holistic, multidisciplinary approach. Specific healthcare professionals, e.g. the movement disorders neurologist and the PD nurse specialist, are considered essential members of this multidisciplinary team. However, with our increasing knowledge about different aspects of the disease, other disciplines are also being recognized as important contributors to the healthcare team. Areas covered: We describe a selection of these relatively newly-recognized disciplines, including the specialist in vascular medicine, gastroenterologist, pulmonologist, neuroophthalmologist, urologist, geriatrician/elderly care physician, palliative care specialist and the dentist. Furthermore, we share the view of a person with PD on how patients and caregivers should be involved in the multidisciplinary team. Finally, we have included a perspective on the new role of the movement disorder neurologist, with care delivery via "tele-neurology". Expert commentary: Increased awareness about the potential role of these 'new' professionals will further improve disease management and quality of life of PD patients.

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Esophageal dysfunction in different stages of Parkinson's disease

Abstract: Esophageal body impairment in PD is a frequent phenomenon during all disease stages, which possibly reflects α-synucleinopathy in the enteric nervous system.

Cited by 67 publications

References 36 publications

Subtle Esophageal Motility Alterations in Parkinsonian Syndromes: Synucleinopathies vs. Tauopathies

Subtle Esophageal Motility Alterations in Parkinsonian Syndromes: Synucleinopathies vs. Tauopathies

Digestive Symptoms of Autonomic Dysfunction in Parkinson’s Disease Patients

Multidisciplinary care for people with Parkinson’s disease: the new kids on the block!

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