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Abstract
Objective To evaluate gastric emptying (GE) and colonic transit in a cohort of patients with Parkinson disease and other parkinsonism disorders and to determine whether abnormal gut transit precedes motor onset of parkinsonism.
Methods Medical record review of 84 patients with parkinsonism who underwent clinically indicated transit studies at Mayo Clinic (2001–2019) and 11 patients with transit studies who subsequently developed parkinsonism. Data are summarized as median (interquartile range).
Results The 84 patients (52% female) with parkinsonism were aged 72 (66–76) years with a disease duration of 5 (2–8) years: Parkinson disease = 70, multiple system atrophy = 7, dementia with Lewy bodies = 4, progressive supranuclear palsy = 2, and parkinsonian syndrome = 1. Ten had delayed GE, 10 slow colonic transit, 16 accelerated GE (14 Parkinson disease, 1 multiple system atrophy, and 1 parkinsonian syndrome), and 49 normal transit. One patient with parkinsonian syndrome had both slow colonic and accelerated gastric transit. Longer disease duration and higher levodopa equivalent daily dose were observed for Parkinson disease compared with other parkinsonisms and with slow compared with normal colonic transit. Of 11 patients (5 female) with transit studies who later developed motor parkinsonism after 4 (3–5) years, 1 had accelerated GE, 1 had delayed GE, and 1 had both delayed GE and colonic transit.
Conclusions Accelerated GE was newly identified in patients with parkinsonism, in addition to delayed GE or colonic transit. Furthermore, gut dysmotility was objectively identified to precede the motor onset of parkinsonism.
Footnotes
Funding information and disclosures are provided at the end of the article. Full disclosure form information provided by the authors is available with the full text of this article at Neurology.org/cp.
- Received June 8, 2020.
- Accepted September 21, 2020.
- © 2021 American Academy of Neurology
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