Gastrointestinal Symptoms in Parkinson's Disease: Prevalence, Characterization, and Relationship to Disease Stage Open Access
Cloud, Leslie Jameleh (2011)
Published
Abstract
Abstract
Despite their high prevalence and well-documented impact on quality
of life, the
gastrointestinal (GI) features of Parkinson's Disease (PD) remain
scarcely investigated,
poorly understood and without effective treatments. Though once
thought to be a late
manifestation of the disease, emerging pathological data has
implicated the enteric
nervous system (ENS) as one of the earliest anatomic sites to
manifest Parkinson's
disease histopathology, and recent clinical data has suggested that
GI symptoms such as
constipation can manifest very early in the disease course,
sometimes occurring years
prior to the onset of motor features. These findings have led to
the controversial
hypothesis that the PD pathological process begins in the ENS and
subsequently spreads
to involve the central nervous system, at which time the classic
motor features develop.
Very few studies have explored the relationship between GI and
motor symptoms in PD.
Therefore, this study was designed to help clarify this
relationship as well as to estimate
the prevalence of GI symptoms in PD and better characterize them.
To accomplish these
aims, a novel scale for quantifying GI symptoms in PD was designed
and piloted in 61
PD patients and their spousal controls. Results not only confirm
that the prevalence and
severity of GI symptoms are higher in PD than controls, but also
that the prevalence and
severity of GI symptoms in PD increase as the motor features of the
disease advance.
Results also suggest that PD patients respond poorly to symptomatic
GI medications,
underscoring the need for novel therapeutic approaches.
Table of Contents
1. Introduction...1
2. Background...3
3. Methods...4
4. Results...12
5. Discussion...14
6. References...18
7. Figures/Tables...20
List of Tables, Figures, and Appendices
Figure 1...20
Subject screening and enrollment
Figure 2...21
Distributions of GIND total score by group
Figure 3...22
Distributions of GIND total score by H&Y stage
Figure 4...23
Mean Ln GIND total score in PD stages 1-4 and their matched
controls
Figure 5...24
Prevalence of GI symptoms by H&Y stage
Figure 6...25
Use of symptomatic GI medications by H&Y stage
Table 1...26
Baseline characteristics of study subjects
Table 2...27
Two-way ANOVA evaluating the effects of H&Y stage and
group on LnGIND
Table 3...28
Statistical evaluation of the frequency of individual GI
symptoms in PD patients vs. controls
Table 4...29
Percent of individual GI symptoms observed in the H&Y
stages
of PD
Table 5...30
Laxative use
Table 6...31
Final model
Table 7...32
ANOVA table for final model
Appendix 1...33
Hoehn and Yahr Scale
Appendix 2...34
Factor Analysis
Appendix 3...37
Distribution of GIND and Ln GIND
About this Master's Thesis
School | |
---|---|
Department | |
Degree | |
Submission | |
Language |
|
Research Field | |
Keyword | |
Committee Chair / Thesis Advisor | |
Committee Members |
Primary PDF
Thumbnail | Title | Date Uploaded | Actions |
---|---|---|---|
|
Gastrointestinal Symptoms in Parkinson's Disease: Prevalence, Characterization, and Relationship to Disease Stage () | 2018-08-28 13:13:49 -0400 |
|
Supplemental Files
Thumbnail | Title | Date Uploaded | Actions |
---|