Prevalence and severity of symptoms suggestive of gastroparesis in prodromal dementia with Lewy bodies

Durcan, Rory; Donaghy, Paul C.; Barnett, Nicky; Olsen, Kirsty; Yarnall, Alison J.; Taylor, John‐Paul; McKeith, Ian; O’Brien, John; Thomas, Alan

doi:10.1002/gps.5100

Cited by 3 publications

(2 citation statements)

References 28 publications

(61 reference statements)

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“…Gastric dysfunctions are non-motor symptoms of PD that occur prior to the appearance of motor symptoms and persist at all stages of the disease ( 51 , 52 ). It is unclear whether gastric dysfunction in PD is related to the primary central or peripheral neurodegenerative process.…”

Section: Discussionmentioning

confidence: 99%

Gastric-filling ultrasonography to evaluate gastric motility in patients with Parkinson's disease

Zou,

Chen,

Wen

et al. 2024

Front. Neurol.

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BackgroundDelayed gastric emptying is a common non-motor symptom of Parkinson's disease (PD). However, there is currently no objective evaluation and diagnostic method for this condition.ObjectivesThe purpose of this study was to evaluate the feasibility of gastric-filling ultrasonography for gastric motility in patients with PD and the relationship between gastric dynamics and gastrointestinal symptoms and motor symptoms of PD.Design, setting, and patientsWe performed a case-control study with 38 patients with PD and 34 healthy controls.MethodsAll patients underwent a 120-min ultrasonography examination using a 500-ml semi-liquid test meal. We determined the antral contraction amplitude (ACA), the antrum contraction frequency (ACF), the motility index (MI), and the gastric antral cross-sectional area (CSA). We acquired the CSA at six time points: fasting for 12 h (T0), immediately after drinking the semi-liquid test meal (T1); and at 30 (T30), 60 (T60), 90 (T90), and 120 (T120) min. We calculated the gastric emptying rate (GER) at different time points by using the CSA. We compared the GER between the groups and evaluated the correlation between the GER and gastrointestinal symptoms and motor symptoms of PD.ResultsThe MI and ACF were significantly lower in the PD group compared with the control group (P < 0.05). The GER at T30 and the ACA showed no significant difference between the groups (P > 0.05). At different time points, the GER was significantly different between the PD and control groups (P < 0.001). There was no significant association between the GER and gastrointestinal symptoms; none of them were risk factors for impaired gastric emptying (odds ratio > 1). The GER was negatively correlated with the severity of PD motor symptoms (P < 0.05).ConclusionPatients with PD had significantly delayed gastric emptying, which was negatively correlated with the severity of PD motor symptoms. Measuring gastric emptying by gastric-filling ultrasound had good diagnostic value in clinical screening for delayed gastric motility in patients with PD.Clinical Trial Registrationhttps://www.chictr.org.cn/showproj.html?proj=126304.

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Section: Discussionmentioning

confidence: 99%

Gastric-filling ultrasonography to evaluate gastric motility in patients with Parkinson's disease

Zou,

Chen,

Wen

et al. 2024

Front. Neurol.

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“…Motor symptoms of PD became the primary focus of clinicians and researchers over the subsequent 200 years, but recently the topic of PD-associated GI dysfunction has received growing attention [5]. GI symptoms may already be present in prodromal PD [6] and approximately 60-80% of patients with PD eventually experience GI symptoms, as indicated by crosssectional [7,8] and autopsy cohort studies [9], and in an analysis employing a large US claims database in which the incidence of GI disorders reached 65% by 4 years post-PD diagnosis [10].…”

Section: Introductionmentioning

confidence: 99%

Clinical implications of gastric complications on levodopa treatment in Parkinson's disease

Pfeiffer

Isaacson

Pahwa

2020

Parkinsonism & Related Disorders

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Disorders of the gastrointestinal (GI) tract are common and distressing nonmotor symptoms of Parkinson's disease (PD) that can adversely affect levodopa absorption and lead to OFF periods, also known as motor fluctuations. Gastroparesis, which is primarily defined as delayed gastric emptying (DGE), and Helicobacter pylori infection, which is present with increased frequency in PD, are among the most common and important GI disorders reported in PD that may impair oral levodopa absorption and increase OFF time. Symptoms of gastroparesis include nausea, vomiting, postprandial bloating, fullness, early satiety, abdominal pain, and weight loss. DGE has been reported in a substantial fraction of individuals with PD. Symptoms of H. pylori infection include gastritis and peptic ulcers. Studies have found that DGE and H. pylori infection are correlated with delayed peak levodopa plasma levels and increased incidence of motor fluctuations. Therapeutic strategies devised to minimize the potential that gastric complications will impair oral levodopa absorption and efficacy in PD patients include treatments that circumvent the GI tract, such as apomorphine injection, levodopa intestinal gel delivery, levodopa inhalation powder, and deep brain stimulation. Other strategies aim at improving gastric emptying in PD patients, primarily including prokinetic agents.

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The diagnostic performance of functional dopaminergic scintigraphic imaging in the diagnosis of dementia with Lewy bodies: an updated systematic review

Jreige

Kurian

Perriraz

et al. 2023

Eur J Nucl Med Mol Imaging

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Introduction Dopaminergic scintigraphic imaging is a cornerstone to support the diagnosis in dementia with Lewy bodies. To clarify the current state of knowledge on this imaging modality and its impact on clinical diagnosis, we performed an updated systematic review of the literature. Methods This systematic review was carried out according to PRISMA guidelines. A comprehensive computer literature search of PubMed/MEDLINE, EMBASE, and Cochrane Library databases for studies published through June 2022 was performed using the following search algorithm: (a) "Lewy body" [TI] OR "Lewy bodies" [TI] and (b) ("DaTscan" OR "ioflupane" OR "123ip" OR "123?ip" OR "123 ip" OR "123i-FP-CIT" OR "FPCIT" OR "FP-CIT" OR "beta?CIT" OR "beta CIT" OR "CIT?SPECT" OR "CIT SPECT" OR "Dat?scan*" OR "dat scan*" OR "dat?spect*" OR "SPECT"). Risk of bias and applicability concerns of the studies were evaluated using the QUADAS-2 tool. Results We performed a qualitative analysis of 59 studies. Of the 59 studies, 19 (32%) addressed the diagnostic performance of dopamine transporter imaging, 15 (25%) assessed the identification of dementia with Lewy bodies in the spectrum of Lewy body disease and 18 (31%) investigated the role of functional dopaminergic imaging in distinguishing dementia with Lewy bodies from other dementias. Dopamine transporter loss was correlated with clinical outcomes in 19 studies (32%) and with other functional imaging modalities in 15 studies (25%). Heterogeneous technical aspects were found among the studies through the use of various radioligands, the more prevalent being the [123I]N‑ω‑fluoropropyl‑2β‑carbomethoxy‑3β‑(4‑iodophenyl) nortropane (123I-FP-CIT) in 54 studies (91.5%). Image analysis used visual analysis (9 studies, 15%), semi-quantitative analysis (29 studies, 49%), or a combination of both (16 studies, 27%). Conclusion Our systematic review confirms the major role of dopaminergic scintigraphic imaging in the assessment of dementia with Lewy bodies. Early diagnosis could be facilitated by identifying the prodromes of dementia with Lewy bodies using dopaminergic scintigraphic imaging coupled with emphasis on clinical neuropsychiatric symptoms. Most published studies use a semi-quantitative analytical assessment of tracer uptake, while there are no studies using quantitative analytical methods to measure dopamine transporter loss. The superiority of a purely quantitative approach to assess dopaminergic transmission more accurately needs to be further clarified.

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Prevalence and severity of symptoms suggestive of gastroparesis in prodromal dementia with Lewy bodies

Cited by 3 publications

References 28 publications

Gastric-filling ultrasonography to evaluate gastric motility in patients with Parkinson's disease

Gastric-filling ultrasonography to evaluate gastric motility in patients with Parkinson's disease

Clinical implications of gastric complications on levodopa treatment in Parkinson's disease

The diagnostic performance of functional dopaminergic scintigraphic imaging in the diagnosis of dementia with Lewy bodies: an updated systematic review

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