Gastrointestinal Syndromes May Predict Parkinson's Disease, suggests Study

A recent study published in BMJ Gut conducted using a nationwide medical record network in the United States has shed light on potential links between gastrointestinal (GI) syndromes and the development of Parkinson's disease (PD). Researchers led by Bo Konings aimed to determine whether specific GI conditions and interventions precede the onset of PD when compared with negative controls, Alzheimer's disease (AD), and cerebrovascular diseases (CVD).

Here are the key findings from the study:

● PD-Specific Associations: The study identified several GI conditions that exhibited specific associations with PD in both case-control and cohort analyses. These conditions included gastroparesis, dysphagia, irritable bowel syndrome (IBS) without diarrhoea, and constipation.

● Significant Odds: Individuals with these GI issues had significantly higher odds of developing PD compared to those without these problems, as well as those with AD and CVD. For example, the odds ratios (ORs) for PD in those with gastroparesis, dysphagia, IBS without diarrhoea, and constipation were 4.64, 3.58, 3.53, and 3.32, respectively, all with p-values less than 0.0001.

● Non-PD Specific Conditions: In contrast, some GI conditions, including functional dyspepsia, IBS with diarrhoea, diarrhoea, and faecal incontinence, did not exhibit specific associations with PD.

● PD-Related Specificities: Notably, IBS with constipation and intestinal pseudo-obstruction demonstrated specific associations with PD, with an odds ratio of 4.11 in the case-control analysis and a relative risk of 1.84 in the cohort analysis.

● Impact of Appendectomy: Interestingly, individuals who had undergone an appendectomy appeared to have a reduced risk of developing PD, with a relative risk of 0.48 in the cohort analysis.

● No Associations with Other GI Conditions: The study did not find significant associations between PD and inflammatory bowel disease or vagotomy.

These findings suggest that specific GI syndromes and conditions may serve as potential predictors of Parkinson's disease. Dysphagia, gastroparesis, IBS without diarrhoea, and constipation appeared to be particularly relevant in predicting PD development. However,

further research is necessary to confirm these associations and understand the underlying mechanisms.

Identifying early markers or risk factors for PD can be instrumental in facilitating earlier diagnosis and intervention, ultimately improving outcomes for individuals affected by this neurodegenerative disorder.

Reference:

Konings, B., Villatoro, L., Van den Eynde, J., Barahona, G., Burns, R., McKnight, M., Hui, K., Yenokyan, G., Tack, J., & Pasricha, P. J. (2023). Gastrointestinal syndromes preceding a diagnosis of Parkinson’s disease: testing Braak’s hypothesis using a nationwide database for comparison with Alzheimer’s disease and cerebrovascular diseases. Gut, gutjnl-2023-329685. https://doi.org/10.1136/gutjnl-2023-329685.