Distinctive pathophysiology underlying constipation in Parkinson’s disease: implication for cognitive inefficiency

TY - JOUR

T1 - Distinctive pathophysiology underlying constipation in Parkinson’s disease: implication for cognitive inefficiency

AU - Tucker, Rosalind M.

AU - Ryan, Suzanne

AU - Hayee, Bu' Hussain

AU - Bjarnason, Ingvar

AU - Augustin, Aisha D.

AU - Umamahesan, Chianna

AU - Taylor, David

AU - Weller, Clive

AU - Dobbs, Sylvia M.

AU - Dobbs, John

AU - Charlett, André

PY - 2020/6/19

Y1 - 2020/6/19

N2 - Depression is associated with constipation within and outside Parkinson’s disease (PD). Since impaired cognitive-processing (bradyphrenia) features in PD and an enterokinetic agent improved cognitive performance in healthy individuals, bradyphrenia may be associated with constipation. We aim to define the archetypical bowel function of PD, and its association with cognition, mood and motor-features within and outside PD. We assessed colonic transit-time (oral radio-opaque markers over 6 days), bowel function and psychometric questionnaires and measures of PD-facets, including bradyphrenia, in 58 participants with diagnosed-PD and 71 without (controls). Best abdominal x-ray (day-7) predictors of PD-status were total retained marker count and transverse colon segmental-delay. However, Rome functional constipation-status complemented segmental-delay better, giving good specificity (85%), but low sensitivity (56%). Transverse colon marker count appeared age-associated only in PD. In PD, those correctly classified by bowel dysfunction had higher depression scores (p=0.02) and longer cognitive-processing times than the misclassified (p=0.05). Controls misclassified as PD by bowel dysfunction had higher depression and anxiety scores than the correctly classified (p=0.002 & 0.003), but not slower cognitive-processing. Measures of motor-features were independent of sub-classification by bowel function in PD and in controls. In conclusion, constipation in PD has distinct localized pathophysiology and is associated with bradyphrenia.

AB - Depression is associated with constipation within and outside Parkinson’s disease (PD). Since impaired cognitive-processing (bradyphrenia) features in PD and an enterokinetic agent improved cognitive performance in healthy individuals, bradyphrenia may be associated with constipation. We aim to define the archetypical bowel function of PD, and its association with cognition, mood and motor-features within and outside PD. We assessed colonic transit-time (oral radio-opaque markers over 6 days), bowel function and psychometric questionnaires and measures of PD-facets, including bradyphrenia, in 58 participants with diagnosed-PD and 71 without (controls). Best abdominal x-ray (day-7) predictors of PD-status were total retained marker count and transverse colon segmental-delay. However, Rome functional constipation-status complemented segmental-delay better, giving good specificity (85%), but low sensitivity (56%). Transverse colon marker count appeared age-associated only in PD. In PD, those correctly classified by bowel dysfunction had higher depression scores (p=0.02) and longer cognitive-processing times than the misclassified (p=0.05). Controls misclassified as PD by bowel dysfunction had higher depression and anxiety scores than the correctly classified (p=0.002 & 0.003), but not slower cognitive-processing. Measures of motor-features were independent of sub-classification by bowel function in PD and in controls. In conclusion, constipation in PD has distinct localized pathophysiology and is associated with bradyphrenia.

U2 - 10.3390/jcm9061916

DO - 10.3390/jcm9061916

M3 - Article

SN - 2077-0383

JO - Journal of Clinical Medicine

JF - Journal of Clinical Medicine

ER -