More than constipation – bowel symptoms in Parkinson's disease and their connection to gut microbiota

Background and purpose The majority of Parkinson's disease (PD) patients suffer from gastrointestinal symptoms of which constipation is considered the most prominent. Recently, in addition to constipation, a diagnosis of irritable bowel syndrome (IBS) was also found to be associated with increa...

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Published in:	European journal of neurology Vol. 24; no. 11; pp. 1375 - 1383
Main Authors:	Mertsalmi, T. H., Aho, V. T. E., Pereira, P. A. B., Paulin, L., Pekkonen, E., Auvinen, P., Scheperjans, F.
Format:	Journal Article
Language:	English
Published:	England John Wiley & Sons, Inc 01-11-2017
Subjects:	Abundance Aged Bacteria Basal ganglia Brain Brain diseases Case-Control Studies Central nervous system diseases Constipation Constipation - complications Constipation - microbiology Constipation - physiopathology Digestive system Feces - microbiology Female Gastrointestinal diseases Gastrointestinal Microbiome Gastrointestinal symptoms Gastrointestinal tract Humans Intestinal microflora Intestine Irritable bowel syndrome Irritable Bowel Syndrome - complications Irritable Bowel Syndrome - microbiology Irritable Bowel Syndrome - physiopathology Male microbiota Middle Aged Movement disorders Neurodegenerative diseases non‐motor symptoms Parkinson Disease - complications Parkinson Disease - microbiology Parkinson Disease - physiopathology Parkinson's disease Patients Ribonucleic acid RNA rRNA 16S Surveys and Questionnaires constipation microbiota Parkinson's disease irritable bowel syndrome non-motor symptoms
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Summary:	Background and purpose The majority of Parkinson's disease (PD) patients suffer from gastrointestinal symptoms of which constipation is considered the most prominent. Recently, in addition to constipation, a diagnosis of irritable bowel syndrome (IBS) was also found to be associated with increased PD risk. Gut microbiota alterations have been reported in IBS and recently also in PD. IBS‐like bowel symptoms in PD and their possible connection to other non‐motor symptoms and faecal microbiota were assessed. Methods This case−control study compared 74 PD patients with 75 controls without any signs of parkinsonism or potential premotor symptoms. IBS‐like symptoms were assessed using the Rome III questionnaire. The non‐motor symptoms were assessed using the Non‐Motor Symptoms Questionnaire and Non‐Motor Symptom Scale. Faecal microbiota were assessed by pyrosequencing of the V1–V3 regions of the bacterial 16S ribosomal RNA gene. Results Symptoms that were IBS‐like were significantly more prevalent in PD patients than in controls (24.3% vs. 5.3%; P = 0.001). Criteria for functional constipation were met by 12.2% of PD patients and 6.7% of controls (P = 0.072). PD patients with IBS‐like symptoms had more non‐motor symptoms and a lower faecal abundance of Prevotella bacteria than those without IBS‐like symptoms. Conclusion Our results indicate that PD patients may suffer from colonic dysfunction beyond pure constipation. Therefore, a more comprehensive assessment of bowel symptoms could provide valuable information. The lower abundance of Prevotella bacteria in PD patients with IBS‐like symptoms suggests that the microbiota−gut−brain axis may be implicated in the gastrointestinal dysfunction of PD patients.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1351-5101 1468-1331
DOI:	10.1111/ene.13398