Download PDF
Nervenheilkunde 2012; 31(12): 909-914
DOI: 10.1055/s-0038-1628251
Parkinson
Schattauer GmbH

Gastroenterologische Probleme bei Parkinson-Syndromen

Gastroenterological problems in Parkinson syndromes
D. Woitalla
1   Neurologische Universitätsklinik der Ruhr-Universität Bochum, St. Josef Hospital, Bochum
,
S. Muhlack
1   Neurologische Universitätsklinik der Ruhr-Universität Bochum, St. Josef Hospital, Bochum
,
O. Götze
2   Universitätsspital Zürich, Klinik für Gastroenterologie und Hepatologie, Zürich
› Author Affiliations
Further Information

Publication History

eingegangen am: 10 August 2012

angenommen am: 22 August 2012

Publication Date:
23 January 2018 (online)

Also available at
    Permissions and Reprints

Zusammenfassung

Gastrointestinale Symptome zählen zu den häufigsten nicht motorischen Symptomen des Parkinson-Syndroms mit erheblichen Konsequenzen für die Lebensqualität der Patienten. Sie können früh im Krankheitsverlauf auftreten oder den motorischen Symptomen vorangehen. Durch die dopaminerge Medikation lassen sich diese Symptome nicht oder nur unzureichend therapieren. Diese Symptome sind Ausdruck einer Beteiligung des enterischen Nervensystems bei der Parkinson-Erkrankung, einem komplexen Teil des peripheren Nervensystems, welches durch zahlreiche Neurotransmitter, Hormone und kortikale Einflüsse moduliert wird. Die Beteiligung des enterischen Nervensystems stellt eine Herausforderung für die Neurologie dar, da sie sich in neuronalen Strukturen eines primär nicht als neuronal angesehenen Organs abspielt und die interdisziplinäre Zusammenarbeit zwischen Neurologie und Gastroenterologie voraussetzt.

Summary

Gastrointestinal symptoms are the most frequent non-motor symptoms in Parkinson`s disease with significant influence on quality of life. They appear early in the course of the disease or may precede the motor symptoms. Dopaminergic drugs are not able to cure or alleviate these symptoms. Most of these symptoms are due to an involvement of the enteric nervous system, which is a complex part of the peripheral nervous system. The enteric nervous system is modulated via several transmitters, hormones and cortical influences. The involvement of the enteric nervous system appears to be a challenge for neurologists, as the disease manifest in an organ, which is not primarily in the focus of neurology, therefore it requires the interdisciplinary cooperation of neurologists and gastroenterologists.

Schlüsselwörter

Parkinson-Syndrom - enterisches Nervensystem - gastrointestinal Symptome

Keywords

Parkinson`s disease - enteric nervous system - gastrointestinal symptoms
 

  • Literatur

  • 1 Parkinson J. An essay on the shaking palsy. London: Printed by Whittingham & Rowland for Sherwood, Neely & Jones; 1817
    Google Scholar
  • 2 Edwards LL, Quigley EM, Pfeiffer RF. Gastrointestinal dysfunction in Parkinson’s disease: frequency and pathophysiology. Neurology 1992; 42 (04) 726-32.
    CrossrefPubMedGoogle Scholar
  • 3 Jost WH, Schimrigk K. Constipation in Parkinson’s disease. Klin Wochenschr 1991; 69 (20) 906-9.
    CrossrefPubMedGoogle Scholar
  • 4 Barone P. et al. The PRIAMO study: A multicenter assessment of non motor symptoms and their impact on quality of life in Parkinson’s disease. Mov Disord 2009; 24 (11) 1641-9.
    CrossrefPubMedGoogle Scholar
  • 5 Pfeiffer RF. Gastrointestinal dysfunction in Parkinson’s disease. Parkinsonism Relat Disord 2011; 17 (01) 10-5.
    CrossrefPubMedGoogle Scholar
  • 6 Miller N. et al. Swallowing problems in Parkinson disease: frequency and clinical correlates. J Neurol Neurosurg Psychiatry 2009; 80 (09) 1047-9.
    CrossrefPubMedGoogle Scholar
  • 7 Braak H. et al. Gastric alpha-synuclein immuno-reactive inclusions in Meissner’s and Auerbach’s plexuses in cases staged for Parkinson’s disease-related brain pathology. Neurosci Lett 2006; 396 (01) 67-72.
    CrossrefPubMedGoogle Scholar
  • 8 Kuo YT. et al. The temporal sequence of gut peptide CNS interactions tracked in vivo by magnetic resonance imaging. J Neurosci 2007; 27 (45) 12341-8.
    CrossrefPubMedGoogle Scholar
  • 9 Yuan Y. et al. Functional brain imaging in irritable bowel syndrome with rectal balloon-distention by using fMRI. World J Gastroenterol 2003; 9 (06) 1356-60.
    CrossrefPubMedGoogle Scholar
  • 10 Schemann M, Neunlist M. The human enteric nervous system. Neurogastroenterol Motil 2004; 16 Suppl 1: 55-9.
    CrossrefPubMedGoogle Scholar
  • 11 Nezami BG, Srinivasan S. Enteric nervous system in the small intestine: pathophysiology and clinical implications. Curr Gastroenterol Rep 2010; 12 (05) 358-65.
    CrossrefPubMedGoogle Scholar
  • 12 Schemann M, Schaaf C, Mader M. Neurochemical coding of enteric neurons in the guinea pig stomach. J Comp Neurol 1995; 353 (02) 161-78.
    CrossrefPubMedGoogle Scholar
  • 13 Wakabayashi K, Takahashi H, Ohama E, Ikuta F. Parkinson’s disease: an immunohistochemical study of Lewy body-containing neurons in the enteric nervous system. Acta Neuropathol 1990; 79 (06) 581-3.
    CrossrefPubMedGoogle Scholar
  • 14 Wouters MM, Farrugia G, Schemann M. 5-HT receptors on interstitial cells of Cajal, smooth muscle and enteric nerves. Neurogastroenterol Motil 2007; 19 Suppl 2: 5-12.
    CrossrefPubMedGoogle Scholar
  • 15 Braak H, Rub U, Gai WP, Del Tredici K. Idiopathic Parkinson’s disease: possible routes by which vulnerable neuronal types may be subject to neuroinvasion by an unknown pathogen. J Neural Transm 2003; 110 (05) 517-36.
    CrossrefPubMedGoogle Scholar
  • 16 Singaram C. et al. Dopaminergic defect of enteric nervous system in Parkinson’s disease patients with chronic constipation. Lancet 1995; 346 8979 861-4.
    CrossrefPubMedGoogle Scholar
  • 17 Lebouvier T. et al. Colonic biopsies to assess the neuropathology of Parkinson’s disease and its relationship with symptoms. PLoS One 2010; 5 (09) e12728.
    CrossrefPubMedGoogle Scholar
  • 18 Wakabayashi K. et al. Parkinson’s disease: the presence of Lewy bodies in Auerbach’s and Meissner’s plexuses. Acta Neuropathol 1988; 76 (03) 217-21.
    CrossrefPubMedGoogle Scholar
  • 19 Shannon KM. et al. Alpha-synuclein in colonic submucosa in early untreated Parkinson’s disease. Mov Disord 2012; 27 (06) 709-15.
    CrossrefPubMedGoogle Scholar
  • 20 Derkinderen P. et al. Parkinson disease: the enteric nervous system spills its guts. Neurology 2011; 77 (19) 1761-7.
    CrossrefPubMedGoogle Scholar
  • 21 Abbott RD. et al. Frequency of bowel movements and the future risk of Parkinson’s disease. Neurology 2001; 57 (03) 456-62.
    CrossrefPubMedGoogle Scholar
  • 22 Johnson RJ, Schemann M, Santer RM, Cowen T. The effects of age on the overall population and on sub-populations of myenteric neurons in the rat small intestine. J Anat 1998; 192 Pt 4 479-88.
    CrossrefPubMedGoogle Scholar
  • 23 Noyce AJ. et al. Severe dysphagia as a presentation of Parkinson’s disease. Mov Disord 2012; 27 (03) 457-8.
    CrossrefPubMedGoogle Scholar
  • 24 Ali GN. et al. Mechanisms of oral-pharyngeal dysphagia in patients with Parkinson’s disease. Gastroenterology 1996; 110 (02) 383-92.
    CrossrefPubMedGoogle Scholar
  • 25 El Sharkawi A. et al. Swallowing and voice effects of Lee Silverman Voice Treatment (LSVT): a pilot study. J Neurol Neurosurg Psychiatry 2002; 72 (01) 31-6.
    CrossrefPubMedGoogle Scholar
  • 26 Baijens LW, Speyer R. Effects of therapy for dysphagia in Parkinson’s disease: systematic review. Dysphagia 2009; 24 (01) 91-102.
    CrossrefPubMedGoogle Scholar
  • 27 Logemann JA. et al. A randomized study of three interventions for aspiration of thin liquids in patients with dementia or Parkinson’s disease. J Speech Lang Hear Res 2008; 51 (01) 173-83.
    CrossrefPubMedGoogle Scholar
  • 28 Restivo DA, Palmeri A, Marchese-Ragona R. Botulinum toxin for cricopharyngeal dysfunction in Parkinson’s disease. N Engl J Med 2002; 346 (15) 1174-5.
    CrossrefPubMedGoogle Scholar
  • 29 Naftali T, Gadoth N, Huberman M, Novis B. Electrogastrography in patients with Parkinson’s disease. Can J Neurol Sci 2005; 32 (01) 82-6.
    CrossrefPubMedGoogle Scholar
  • 30 Pfeiffer RF. Gastrointestinal dysfunction in Parkinson’s disease. Lancet Neurol 2003; 2 (02) 107-16.
    CrossrefPubMedGoogle Scholar
  • 31 Tack J. et al. Functional gastroduodenal disorders. Gastroenterology 2006; 130 (05) 1466-79.
    CrossrefPubMedGoogle Scholar
  • 32 Goetze O. et al. Impaired gastric emptying of a solid test meal in patients with Parkinson’s disease using 13C-sodium octanoate breath test. Neurosci Lett 2005; 375 (03) 170-3.
    CrossrefPubMedGoogle Scholar
  • 33 Goetze O. et al. Predictors of gastric emptying in Parkinson’s disease. Neurogastroenterol Motil 2006; 18 (05) 369-75.
    CrossrefPubMedGoogle Scholar
  • 34 Muller T. et al. Impact of gastric emptying on levodopa pharmacokinetics in Parkinson disease patients. Clin Neuropharmacol 2006; 29 (02) 61-7.
    CrossrefPubMedGoogle Scholar
  • 35 Djaldetti R, Baron J, Ziv I, Melamed E. Gastric emptying in Parkinson’s disease: patients with and without response fluctuations. Neurology 1996; 46 (04) 1051-4.
    CrossrefPubMedGoogle Scholar
  • 36 Nutt JG. On-off phenomenon: relation to levodopa pharmacokinetics and pharmacodynamics. Ann Neurol 1987; 22 (04) 535-40.
    CrossrefPubMedGoogle Scholar
  • 37 Woitalla D. Relevance of plasma level determination of L-Dopa and 3-O-methyldopa in Park-inson’s disease. Aktuel Neurol 1998; 25: S279-S81.
    Article in Thieme ConnectGoogle Scholar
  • 38 Kurlan R. et al. Duodenal delivery of levodopa for on-off fluctuations in parkinsonism: preliminary observations. Ann Neurol 1986; 20 (02) 262-5.
    CrossrefPubMedGoogle Scholar
  • 39 Nutt JG. Effect of COMT inhibition on the pharmacokinetics and pharmacodynamics of levodopa in parkinsonian patients. Neurology 2000; 55 (04) S33-7.
    PubMedGoogle Scholar
  • 40 Antonini A, Cilia R. Behavioural adverse effects of dopaminergic treatments in Parkinson’s disease: incidence, neurobiological basis, management and prevention. Drug Saf 2009; 32 (06) 475-88.
    CrossrefPubMedGoogle Scholar
  • 41 Weintraub D. Dopamine and impulse control disorders in Parkinson’s disease. Annals of Neurology 2008; 64 (06) S93-S100.
    PubMedGoogle Scholar
  • 42 Muhlack S, Welnic J, Woitalla D, Muller T. Exercise improves efficacy of levodopa in patients with Parkinson’s disease. Mov Disord 2007; 22 (03) 427-30.
    CrossrefPubMedGoogle Scholar
  • 43 Shindler JS. et al. Domperidone and levodopa in Parkinson’s disease. Br J Clin Pharmacol 1984; 18 (06) 959-62.
    CrossrefPubMedGoogle Scholar
  • 44 Moses FM. The effect of exercise on the gastrointestinal tract. Sports Med 1990; 9 (03) 159-72.
    CrossrefPubMedGoogle Scholar
  • 45 Weihrauch TR, Ehl W. Effect of domperidone on the motility of antrum, pylorus and duodenum in man. Scand J Gastroenterol Suppl 1981; 67: 195-8.
    Google Scholar
  • 46 Reddymasu SC, Soykan I, McCallum RW. Domperidone: review of pharmacology and clinical applications in gastroenterology. Am J Gastroenterol 2007; 102 (09) 2036-45.
    CrossrefPubMedGoogle Scholar
  • 47 Parkman HP. et al. Domperidone treatment for gastroparesis: demographic and pharmacogenetic characterization of clinical efficacy and side-effects. Dig Dis Sci 2011; 56 (01) 115-24.
    CrossrefPubMedGoogle Scholar
  • 48 Larson JM. et al. Advantages of azithromycin over erythromycin in improving the gastric emptying half-time in adult patients with gastroparesis. J Neurogastroenterol Motil 2010; 16 (04) 407-13.
    CrossrefPubMedGoogle Scholar
  • 49 Seppi K. et al. The movement disorder society evidence-based medicine review update: Treatments for the non-motor symptoms of Parkinson’s disease. Mov Disord 2010; 26 Suppl 3: S42-80.
    Google Scholar
  • 50 Pasricha PJ. et al. Drug insight: from disturbed motility to disordered movement – a review of the clinical benefits and medicolegal risks of metoclopramide. Nat Clin Pract Gastroenterol Hepatol 2006; 3 (03) 138-48.
    CrossrefPubMedGoogle Scholar
  • 51 Nutt JG, Woodward WR. Levodopa pharmacokinetics and pharmacodynamics in fluctuating parkinsonian patients. Neurology 1986; 36 (06) 739-44.
    CrossrefPubMedGoogle Scholar
  • 52 Edwards L. et al. Gastrointestinal symptoms in Parkinson disease: 18-month follow-up study. Mov Disord 1993; 8 (01) 83-6.
    CrossrefPubMedGoogle Scholar
  • 53 Jost WH, Eckardt VF. Constipation in idiopathic Parkinson’s disease. Scand J Gastroenterol 2003; 38 (07) 681-6.
    CrossrefPubMedGoogle Scholar
  • 54 Zangaglia R. et al. Macrogol for the treatment of constipation in Parkinson’s disease. A randomized placebo-controlled study. Mov Disord 2007; 22 (09) 1239-44.
    CrossrefPubMedGoogle Scholar
  • 55 Seppi K. et al. The movement disorder society evidence-based medicine review update: Treatments for the non-motor symptoms of Parkinson’s disease. Movement Disord 2011; 26: S42-S80.
    CrossrefPubMedGoogle Scholar
  • 56 Edwards LL. et al. Defecatory function in Parkinson’s disease: response to apomorphine. Ann Neurol 1993; 33 (05) 490-3.
    CrossrefPubMedGoogle Scholar
  • 57 Mathers SE, Kempster PA, Swash M, Lees AJ. Constipation and paradoxical puborectalis contraction in anismus and Parkinson’s disease: a dystonic phenomenon?. J Neurol Neurosurg Psychiatry 1988; 51 (12) 1503-7.
    CrossrefPubMedGoogle Scholar
  • 58 Albanese A, Brisinda G, Bentivoglio AR, Maria G. Treatment of outlet obstruction constipation in Parkinson’s disease with botulinum neurotoxin A. Am J Gastroenterol. 2003; 98 (06) 1439-40.
    CrossrefPubMedGoogle Scholar
  • 59 Pfeiffer RF. Parkinson disease. Non motor symptoms in Parkinson disease: the PRIAMO study. Nat Rev Neurol 2009; 5 (10) 531-2.
    PubMedGoogle Scholar