Abstract
Background: Non-motor symptoms in PD usually arise at very early stage and vary during the whole disease progression. Deep brain stimulation (DBS) is considered as a highly efficient treatment option for PD's motor function. However, the effect of DBS on NMS, especially hyposmia, has not been fully understood and the deep connection between different NMS such as hyposmia and constipation is still unknown.Objective: The objective of this study was to evaluate the therapeutic effect of DBS on hyposmia in PD patients with or without constipation and find potential factors which might influence the efficacy.Methods: A retrospective analysis of 65 PD patients accepted STN-DBS operation in Qilu Hospital during 2019–2020 were conducted to evaluate the exact therapeutic effect of DBS on hyposmia in PD. Sub-group analyses about the relationship between hyposmia and constipation were carried out. Analysis of flora in nasal mucosa was also conducted to evaluate the abundance and variety in different PD groups.Results: Our study showed that DBS had clearly improved olfactory function in Parkinson patients (P = 0.012) and subgroup analysis found that PD patients with constipation have lower olfactory function scores (25.27 ± 3.44 vs. 33.90 ± 6.633, p = 0.014) and worse improvement after DBS operation (ΔTDI 12.11 ± 3.2 vs. 8.78 ± 2.91, p = 0.0072). Analysis of flora indicated the obvious discrepancy on olfactory function scores and degree of improvement might be related to the abundance and dysbiosis of microbiota.Conclusion: In summary, this article presents a study on PD with hyposmia and constipation after DBS operation, explored the relationship between different NMS and offer a potential explanation on why PD patients with constipation usually have worse olfactory function for the less abundance and variety of microbiota.
Highlights
Parkinson’s disease (PD) is the second most common neurodegenerative disease [1]
Comparing the two groups in this study, we found that the patients with PD had a significantly higher ratio of olfactory dysfunction (n = 2 vs. 35, 4 vs. 54.7%) and constipation (n = 11 vs. 39, 22 vs. 60.9%) (Table 1), which is in accordance with results from other studies [14]
We found that there were 28 persons presenting with both hyposmia and constipation in the group
Summary
Parkinson’s disease (PD) is the second most common neurodegenerative disease [1]. By 2030, morbidity is expected to double in developing countries [2]. A major challenge for patients is maintaining a satisfactory quality of life with nonmotor symptoms in the progression of PD. Traditional drugs, such as levodopa, have been reported to bring little benefits for, or to sometimes even worsen, non-motor symptoms in PD [3]. Non-motor symptoms (NMS), such as sleep disturbances, constipation, cognition, olfactory dysfunction, and changes in mood in Parkinson’s disease (PD) usually have a high incidence and emerge from a very early phase [4]. Studies have shed light on other interventions, such as deep brain stimulation (DBS), for amelioration of NMS other than motor function benefits. The effect of DBS on NMS, especially hyposmia, has not been fully understood and the deep connection between different NMS such as hyposmia and constipation is still unknown
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