Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020;10(4):1699-1707.
doi: 10.3233/JPD-202144.

Gastric Motility in Parkinson's Disease is Altered Depending on the Digestive Phase and Does Not Correlate with Patient-Reported Motor Fluctuations

Laura Ruck  1 , Marcus M Unger  1 , Jörg Spiegel  1 , Jan Bürmann  1 , Ulrich Dillmann  1 , Klaus Faßbender  1 , Wolfgang Reith  2 , Martin Backens  2 , Ruben Mühl-Benninghaus  2 , Umut Yilmaz  2
Affiliations

Gastric Motility in Parkinson's Disease is Altered Depending on the Digestive Phase and Does Not Correlate with Patient-Reported Motor Fluctuations

Laura Ruck et al. J Parkinsons Dis. 2020.

Abstract

Background: Altered gastric motility is a frequent non-motor symptom of Parkinson's disease (PD). It has been hypothesized that disturbed gastric motility contributes to motor fluctuations in PD due to an erratic gastro-duodenal transport and an unpredictable absorption of drugs.

Objective: We investigated whether patient-reported fluctuations are associated with parameters of gastric motility visualized by real-time magnetic resonance imaging (MRI) of the stomach.

Methods: We analyzed real-time MRI-scans of the stomach after an overnight fasting period in 16 PD patients and 20 controls. MRI was performed 1) in the fasting state, 2) directly after a test meal, and 3) 4 hours postprandially. Gastric motility indices were calculated and compared between groups.

Results: MRI showed an attenuated gastric motility in PD patients compared to controls. The difference was most obvious in the early postprandial phase. Gastric motility was not associated with patient-reported motor fluctuations. Using an iron-containing capsule we were able to retrace retention of drugs in the stomach.

Conclusion: The results of this study stress the importance of considering the phase of digestion when investigating gastric motility in PD. Despite theoretical considerations, we did not find robust evidence for an association between MRI parameters of gastric motility and patient-reported motor fluctuations. For future studies that aim to investigate gastric motility in PD by MRI, we suggest multiple short-time MRIs to better track the whole gastro-duodenal phase in PD. Such an approach would also allow to retrace the retention of drugs in the stomach as shown by our approach using an iron-containing capsule.

Keywords: Parkinson’s disease; gastrointestinal motility; real-time magnetic resonance imaging; stomach.

PubMed Disclaimer

Conflict of interest statement

The authors have no conflict of interest to report.

Figures

Fig. 1
Fig. 1
Gastric motility indices (GMI) for controls and PD patients before (1st MRI) and after (2nd and 3rd MRI) a standardized test meal visualized as boxplots.
Fig. 2
Fig. 2
TRUFI sequences (True Fast Imaging with Steady Precession) in the sagittal plane showing the typical artifact (green circle) of the iron-containing capsule.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Fasano A, Visanji NP, Liu LW, Lang AE, Pfeiffer RF (2015) Gastrointestinal dysfunction in Parkinson’s disease. Lancet Neurol 14, 625–639. - PubMed
    1. Knudsen K, Fedorova TD, Hansen AK, Sommerauer M, Haase AM, Svendsen KB, Otto M, Ostergaard K, Krogh K, Borghammer P (2019) Objective intestinal function in patients with idiopathic REM sleep behavior disorder. Parkinsonism Relat Disord 58, 28–34. - PubMed
    1. Goetze O, Nikodem AB, Wiezcorek J, Banasch M, Przuntek H, Mueller T, Schmidt WE, Woitalla D (2006) Predictors of gastric emptying in Parkinson’s disease. Neurogastroenterol Motil 18, 369–375. - PubMed
    1. Goetze O, Wieczorek J, Mueller T, Przuntek H, Schmidt WE, Woitalla D (2005) Impaired gastric emptying of a solid test meal in patients with Parkinson’s disease using 13C-sodium octanoate breath test. Neurosci Lett 375, 170–173. - PubMed
    1. Hardoff R, Sula M, Tamir A, Soil A, Front A, Badarna S, Honigman S, Giladi N (2001) Gastric emptying time and gastric motility in patients with Parkinson’s disease. Mov Disord 16, 1041–1047. - PubMed

Publication types