Abstract
Objective: Constipation is one of the most frequent non-motor symptoms (NMS) in Parkinson's disease (PD), causing great disturbance to patients. The present study investigated the prevalence and the clinical features of constipation in patients with PD and explored the difference between prodromal and clinical constipation of PD.Methods: A total of 186 patients with PD were recruited into this study. Subjective constipation was defined by ROME III criteria. Demographic and PD-related clinical information of the participants were collected. The PD patients were objectively assessed by a spectrum of rating scales of motor symptoms, non-motor symptoms, and quality of life.Results: In total, 51.61% (96/186) of PD patients suffer from constipation. Compared with patients without constipation, the patients with constipation were prone to have restless leg syndrome, depression, and anxiety and have higher scores of the non-motor symptoms scale. Among patients with constipation, 21.88% (21/96) patients had constipation in prodromal stage. Compared with patients with constipation in clinical stage, patients with prodromal constipation had a lower age of constipation onset (56.48 ± 9.63 and 65.26 ± 8.42, χ2 = 4.091, P < 0.001), longer timespan from constipation onset to motor symptom onset (6.62 ± 3.91 and 3.18 ± 2.13, χ2 = −3.877, P = 0.001). Patients with prodromal constipation were predominantly tremor onset (χ2 = 4.405, P = 0.044) and usually had a better quality of life [28 (14.50–37.5) and 40 (25.0–55.0), χ2 = 2.011, P = 0.046]. Depression was the only risk factor of constipation in PD patients. Body mass index, depression, and anxiety were factors that affected the life quality in patients with constipation.Conclusions: Our results supported the high incidence of constipation in patients with PD and that, in some patients, constipation occurred before the onset of motor symptoms. The specific clinical characteristics of patients with constipation and with prodromal constipation help to make early diagnosis, to discover the relationship between constipation and PD, and to further explore the pathogenesis of this degenerative disease.
Highlights
Parkinson’s disease (PD) is a common neurodegenerative disorder characterized by motor and non-motor symptoms [1]
We aimed to investigate the prevalence of constipation in a Chinese population of PD patients and compare the demographic characteristics, property of constipation, and motor symptom and non-motor symptoms between premotor constipation and post-motor constipation in patients with PD
It has been reported that women are more prone to experience chronic constipation in general subjects [26] and that men are more likely to suffer from constipation [27], we did not find these in patients with PD in this study
Summary
Parkinson’s disease (PD) is a common neurodegenerative disorder characterized by motor (rigidity, bradykinesia, resting tremor) and non-motor symptoms (autonomic dysfunction, neuropsychiatric disturbance, abnormal sensation, and sleep disorders) [1]. Constipation is one of the most frequent non-motor symptoms of gastrointestinal dysfunction in the autonomic system, the prevalence of which has been reported with a wide spectrum ranging from 7 to 71% among different studies, mainly due to the different diagnostic criteria [2]. It has been reported that constipation can precede motor symptoms by as much as 20 years, and people with constipation may have a relatively high risk of developing PD [3]. Constipation is one of the predicted symptoms listed in the MDS research criteria for prodromal Parkinson’s disease, with a relatively high positive likelihood ratio of 2.2 [4]. Studies have suggested that a progressive and non-linear loss of serotonergic terminals takes place in PD and that serotonergic dysfunction in PD is associated with the development of motor and non-motor symptoms [5,6,7]
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