REM sleep behavior disorder correlates with constipation in de novo Chinese Parkinson’s disease patients

Chen, Yajing; Xu, Qian; Wu, Langping; Zhou, Mengxi; Lin, Yin; Jiang, Yuhan; He, Qing; Zhao, Lei; Liu, Jian-Ren; Chen, Wei

doi:10.1007/s10072-022-06381-5

Cited by 8 publications

(4 citation statements)

References 32 publications

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“…Recent histopathological evidence indicates that enteric α-Syn D deposition is more prevalent in RBD-positive than RBD-negative subjects [42]. Moreover, subjects with premotor RBD and constipation fit the criteria of "body first" phenotype [8,43]. In our cohort about half of the patients (52.2%) presented both premotor RBD and GI symptoms of constipation.…”

Section: Plos Pathogensmentioning

confidence: 49%

α-Synuclein seeding activity in duodenum biopsies from Parkinson’s disease patients

et al. 2023

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Abnormal deposition of α-synuclein is a key feature and biomarker of Parkinson’s disease. α-Synuclein aggregates can propagate themselves by a prion-like seeding-based mechanism within and between tissues and are hypothesized to move between the intestine and brain. α-Synuclein RT-QuIC seed amplification assays have detected Parkinson’s-associated α-synuclein in multiple biospecimens including post-mortem colon samples. Here we show intra vitam detection of seeds in duodenum biopsies from 22/23 Parkinson’s patients, but not in 6 healthy controls by RT-QuICR. In contrast, no tau seeding activity was detected in any of the biopsies. Our seed amplifications provide evidence that the upper intestine contains a form(s) of α-synuclein with self-propagating activity. The diagnostic sensitivity and specificity for PD in this biopsy panel were 95.7% and 100% respectively. End-point dilution analysis indicated up to 106 SD50 seeding units per mg of tissue with positivity in two contemporaneous biopsies from individual patients suggesting widespread distribution within the superior and descending parts of duodenum. Our detection of α-synuclein seeding activity in duodenum biopsies of Parkinson’s disease patients suggests not only that such analyses may be useful in ante-mortem diagnosis, but also that the duodenum may be a source or a destination for pathological, self-propagating α-synuclein assemblies.

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Section: Plos Pathogensmentioning

confidence: 49%

α-Synuclein seeding activity in duodenum biopsies from Parkinson’s disease patients

et al. 2023

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“…ex Balf. ( da huang ), a herb specific for constipation, while RBD has been reported to be correlated with constipation (Kong et al, 2020 ; Chen et al, 2023 ). This finding indicated that PD-induced RBD may be treated via anti-constipation herbs like Rheum tanguticum Maxim .…”

Section: Discussionmentioning

confidence: 99%

Real-world Chinese herbal medicine for Parkinson's disease: a hospital-based retrospective analysis of electronic medical records

Lyu,

Zhang,

Mao

et al. 2024

Front. Aging Neurosci.

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BackgroundParkinson's disease (PD) is a progressive neurodegenerative condition. Chinese medicine therapies have demonstrated effectiveness for PD in controlled settings. However, the utilization of Chinese medicine therapies for PD in real-world clinical practice and the characteristics of patients seeking these therapies have not been thoroughly summarized.MethodThe study retrospectively analyzed initial patient encounters (PEs) with a first-listed diagnosis of PD, based on electronic medical records from Guangdong Provincial Hospital of Chinese Medicine between July 2018 and July 2023.ResultsA total of 3,206 PEs, each corresponding to an individual patient, were eligible for analyses. Approximately 60% of patients made initial visits to the Chinese medicine hospital after receiving a PD diagnosis, around 4.59 years after the onset of motor symptoms. Over 75% of the patients visited the Internal Medicine Outpatient Clinic at their initial visits, while a mere 13.85% visited PD Chronic Care Clinic. Rest tremor (61.98%) and bradykinesia (52.34%) are the most commonly reported motor symptoms, followed by rigidity (40.70%). The most commonly recorded non-motor symptoms included constipation (31.88%) and sleep disturbance (25.27%). Integration of Chinese medicine and conventional medicine therapies was the most common treatment method (39.15%), followed by single use of Chinese herbal medicine (27.14%). The most frequently prescribed herbs for PD included Glycyrrhiza uralensis Fisch. (gan cao), Astragalus mongholicus Bunge (huang qi), Atractylodes macrocephala Koidz. (bai zhu), Angelica sinensis (Oliv.) Diels (dang gui), Rehmannia glutinosa (Gaertn.) DC. (di huang), Paeonia lactiflora Pall. (bai shao), Bupleurum chinense DC. (chai hu), Citrus aurantium L. (zhi qiao/zhi shi/chen pi), Panax ginseng C. A. Mey. (ren shen), and Poria cocos (Schw.) Wolf (fu ling). These herbs contribute to formulation of Bu zhong yi qi tang (BZYQT).ConclusionPatients typically initiated Chinese medical care after the establishment of PD diagnosis, ~4.59 years post-onset of motor symptoms. The prevalent utilization of CHM decoctions and patented Chinese herbal medicine products, underscores its potential in addressing both motor and non-motor symptoms. Despite available evidence, rigorous clinical trials are needed to validate and optimize the integration of CHM, particularly BZYQT, into therapeutic strategies for PD.

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“…61,62 RBD has been considered as a prodromal PD due to its high likelihood to convert into neurodegenerative synucleinopathies, such as PD and dementia with Lewy bodies. 63 Additionally, RBD in PD was also associated with worse non-motor symptoms, such as cognitive impairment, 64,65 constipation, 66,67 hallucination, 66 and depression. 66 In current study, striatum SBR was negatively associated with RBDSQ scores, indicating striatal dopamine depletion may contribute to the occurrence of RBD in PD.…”

Section: Discussionmentioning

confidence: 99%

Striatal dopamine depletion drives disease progression and network topology aberrations specifically by impairing left M1 network

Chen,

Li,

Zhou

et al. 2023

Preprint

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Background Stratal dopamine depletion contributes to both motor and non-motor symptoms of patients with Parkinson's disease (PD). The objective of current study is to explore whether stratal dopamine depletion shapes clinical heterogeneity by impairing brain networks of PD patients. Methods In this cross-sectional study, PD participants undergoing functional magnetic resonance imaging from Parkinson's Progression Markers Initiative (PPMI) database were investigated. According to the levels of striatal binding ratio (SBR) in bilateral striatum, PD patients were classified into lower quartile group (SBR level rank: 0%~25%), interquartile group (SBR level rank: 26%~75%), and upper quartile group (SBR level rank: 76%~100%) based on their SBR level quartiles to examine how stratal dopamine depletion affects clinical manifestations and brain networks. Findings PD patients in the lower quartile group showed more severe motor and non-motor symptoms compared to upper quartile group. Additionally, topological metrics in both structural and functional network were significantly different between upper quartile group and lower quartile group. Furthermore, the functional network of left primary motor cortex (M1) was specifically impaired in lower quartile group, which resulted in topological disruptions in functional network. Importantly, impaired left M1 network in PD patients mediated the effects of striatal dopamine depletion on both motor and non-motor symptoms. Interpretation Striatal dopamine depletion specifically impaired left M1 network, which contributed to aberrant functional network topology and dopamine-dependent motor and non-motor symptoms. Funding National Natural Science Foundation of China (Grant No. 81873778, 82071415) and National Research Center for Translational Medicine at Shanghai (Grant No. NRCTM(SH)-2021-03).

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REM sleep behavior disorder correlates with constipation in de novo Chinese Parkinson’s disease patients

Cited by 8 publications

References 32 publications

α-Synuclein seeding activity in duodenum biopsies from Parkinson’s disease patients

α-Synuclein seeding activity in duodenum biopsies from Parkinson’s disease patients

Real-world Chinese herbal medicine for Parkinson's disease: a hospital-based retrospective analysis of electronic medical records

Striatal dopamine depletion drives disease progression and network topology aberrations specifically by impairing left M1 network

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