Abstract
IntroductionAutonomic denervation in patients with Parkinson's disease (PD) and isolated REM-sleep behavior disorder (iRBD) could impede gallbladder function leading to increased fasting gallbladder volume (fGBV) and higher risk of gallstones. We aimed to determine fGBV in patients with PD, iRBD, and healthy controls (HCs). MethodsWe included 189 subjects; 100 patients with PD, 21 with iRBD, and 68 HCs. fGBV was determined from abdominal CT scans, and radiopaque gallstone frequency was evaluated. ResultsMedian fGBV was 35.7 ml in patients with PD, 31.8 ml in iRBD, and 27.8 ml in HCs (Kruskal-Wallis test: P = 0.0055). Post-tests adjusted for multiple comparison revealed a significant group difference between patients with PD and HCs (P = 0.0038). In the PD group, 23% had enlarged fGBV (cut-off at mean + 2 x standard deviation (SD) in the HC group). No difference in fGBV was observed between iRBD and the other two groups. The total prevalence of gallstones was 6.4% with no differences between the three groups. ConclusionAlmost a quarter of patients with PD in our cohort exhibited increased fGBV. This study illuminates a potentially overlooked topic in PD research and calls for more studies on biliary dysfunction.
Highlights
Autonomic denervation in patients with Parkinson’s disease (PD) and isolated REM-sleep behavior disorder could impede gallbladder function leading to increased fasting gallbladder volume and higher risk of gallstones
Using a cut-off score, defined as mean + 2 x SD of the healthy controls (HCs) group (53.82 ml), we found that 22/97 (23%) patients with PD had enlarged fasting gallbladder volume (fGBV)
We found that 23% of our PD cohort had increased fGBV, and the median fGBV in patients with PD was signifi cantly larger than in HCs
Summary
Autonomic denervation in patients with Parkinson’s disease (PD) and isolated REM-sleep behavior disorder (iRBD) could impede gallbladder function leading to increased fasting gallbladder volume (fGBV) and higher risk of gallstones. We aimed to determine fGBV in patients with PD, iRBD, and healthy controls (HCs). Methods: We included 189 subjects; 100 patients with PD, 21 with iRBD, and 68 HCs. fGBV was determined from abdominal CT scans, and radiopaque gallstone frequency was evaluated. Results: Median fGBV was 35.7 ml in patients with PD, 31.8 ml in iRBD, and 27.8 ml in HCs (Kruskal-Wallis test: P = 0.0055). Objective assessment of GI function shows that patients with PD have disturbed gastric emptying and increased small and large intestinal transit time [2,3]. Gallbladder motility and emptying are coordinated by a complex interplay of hormonal, paracrine, and neuronal mechanisms. Incomplete gallbladder emptying was reported in pa tients with reoccurrence of gallstones [8]
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