Parkinson disease with constipation: clinical features and relevant factors

Qiu-Jin Yu,Piu Chan,Ying-Shan Piao,Rui-Dan Wang,Shu-Yang Yu,Li Liu,Li-Jun Zuo,Yang Hu,Teng-Hong Lian,Peng Guo,Li-Xia Li,Wei Zhang,Xiao-Min Wang,Zhao Jin,Sheng-Di Chen

doi:10.1038/s41598-017-16790-8

Abstract

Constipation is one of the most frequent non-motor symptoms of Parkinson disease (PD) and it may be ignored by PD patients, leading to this problem not to be reported in time. The relationships between constipation and demographic variables, motor symptoms and other non-motor symptoms of PD are still unknown. PD patients were evaluated by diagnostic criteria of functional constipation in Rome III and divided into PD with constipation (PD-C) and PD with no constipation (PD-NC) groups. PD patients were assessed by rating scales of motor symptoms and other non-motor symptoms, activity of daily living and quality of life. The frequency of constipation in PD patients was 61.4%, and 24.5% of PD patients had constipation before the onset of motor symptoms. PD-C group had older age and age of onset, longer disease duration, more advanced disease stage, and more severe motor symptoms and non-motor symptoms, including worse cognition and emotion, poorer sleep quality, severer autonomic symptoms, fatigue and apathy. Binary Logistic regression analysis showed that the age, H-Y stage, depression, anxiety and autonomic dysfunction increased the risk of constipation in PD patients. Constipation exerted serious impact on the activity of daily living and quality of life in PD patients.

Highlights

Parkinson disease (PD) is a common neurodegenerative disorder characterized by the progressive loss of neuromelanin-containing dopaminergic neurons in substantia nigra pars compacta (SNpc) and depletion of dopamine (DA) in striatum
Age of onset, disease duration, levodopa equivalent daily dose (LEDD), H-Y stage, the scores of Unified Parkinson Disease Rating Scale (UPDRS) III, UPDRS IV, Mini-Mental State Examination (MMSE), Hamilton Depression (HAMD), Hamilton Anxiety (HAMA), Pittsburgh Sleep Quality Index (PSQI), SCOPA-AUT, Fatigue Severity Scale (FSS) and Modified Apathy Evaluation Scale (MAES) between PD with constipation (PD-C) and PD with no constipation (PD-NC) groups were significantly different, these variables were put into an established binary logistic regression equation and set as independent variables, whereas, with or without constipation in PD patients was set as a dependent variable
The evaluation of constipation in PD-C group was showed in Supplemental Table 1

Summary

Introduction

Parkinson disease (PD) is a common neurodegenerative disorder characterized by the progressive loss of neuromelanin-containing dopaminergic neurons in substantia nigra pars compacta (SNpc) and depletion of dopamine (DA) in striatum. Age of onset, disease duration, LEDD, H-Y stage, the scores of UPDRS III, UPDRS IV, MMSE, HAMD, HAMA, PSQI, SCOPA-AUT, FSS and MAES between PD-C and PD-NC groups were significantly different, these variables were put into an established binary logistic regression equation and set as independent variables, whereas, with or without constipation in PD patients was set as a dependent variable.

Results

Conclusion