TY - JOUR
T1 - Constipation in Parkinson’s Disease
T2 - a Nuisance or Nuanced Answer to the Pathophysiological Puzzle?
AU - Sharma, Amol
AU - Kurek, Julie
AU - Morgan, John C.
AU - Wakade, Chandramohan
AU - Rao, Satish S.C.
N1 - Publisher Copyright:
© 2018, Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Purpose of Review: Chronic constipation is a common, nonmotor, and prodromal symptom in Parkinson’s disease (PD). Its underlying neuropathology may provide pathophysiological insight into PD. Here, we critically review what is currently known about the neuroanatomical and brain-gut interactions, and the origin and progression of Lewy pathology (LP) at three levels—brain/brainstem, spinal cord, and enteric nervous system. Recent Findings: Many recent studies have illustrated the challenges of examining LP in tissues obtained from colon biopsies of PD patients. Large-scale epidemiological studies have not confirmed the widely accepted Braakpostula. Summary: In this review, we propose an alternative origin and route of spread of LP in PD. We describe novel, noninvasive neurophysiological testing that could advance the understanding of LP and complex bidirectional brain-pelvic floor neural pathways in PD—a true disease model of a neurogastrointestinal disorder. This review may provide the impetus for future studies investigating gut and brain interaction and constipation in PD.
AB - Purpose of Review: Chronic constipation is a common, nonmotor, and prodromal symptom in Parkinson’s disease (PD). Its underlying neuropathology may provide pathophysiological insight into PD. Here, we critically review what is currently known about the neuroanatomical and brain-gut interactions, and the origin and progression of Lewy pathology (LP) at three levels—brain/brainstem, spinal cord, and enteric nervous system. Recent Findings: Many recent studies have illustrated the challenges of examining LP in tissues obtained from colon biopsies of PD patients. Large-scale epidemiological studies have not confirmed the widely accepted Braakpostula. Summary: In this review, we propose an alternative origin and route of spread of LP in PD. We describe novel, noninvasive neurophysiological testing that could advance the understanding of LP and complex bidirectional brain-pelvic floor neural pathways in PD—a true disease model of a neurogastrointestinal disorder. This review may provide the impetus for future studies investigating gut and brain interaction and constipation in PD.
KW - Constipation
KW - Dyssynergic defecation
KW - Enteric nervous system
KW - Lewy bodies/neurites/pathology
KW - Parkinson’s disease
KW - α-Synuclein
UR - http://www.scopus.com/inward/record.url?scp=85040783083&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85040783083&partnerID=8YFLogxK
U2 - 10.1007/s11894-018-0609-x
DO - 10.1007/s11894-018-0609-x
M3 - Review article
C2 - 29350301
AN - SCOPUS:85040783083
SN - 1522-8037
VL - 20
JO - Current Gastroenterology Reports
JF - Current Gastroenterology Reports
IS - 1
M1 - 1
ER -