Constipation in Parkinson’s Disease: a Nuisance or Nuanced Answer to the Pathophysiological Puzzle?

Research output: Contribution to journalReview article

1 Citation (Scopus)

Abstract

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.

Original languageEnglish (US)
Article number1
JournalCurrent Gastroenterology Reports
Volume20
Issue number1
DOIs
StatePublished - Jan 1 2018

Fingerprint

Constipation
Parkinson Disease
Pathology
Brain
Prodromal Symptoms
Enteric Nervous System
Neural Pathways
Pelvic Floor
Brain Stem
Epidemiologic Studies
Spinal Cord
Colon
Biopsy

Keywords

  • Constipation
  • Dyssynergic defecation
  • Enteric nervous system
  • Lewy bodies/neurites/pathology
  • Parkinson’s disease
  • α-Synuclein

ASJC Scopus subject areas

  • Gastroenterology

Cite this

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title = "Constipation in Parkinson’s Disease: a Nuisance or Nuanced Answer to the Pathophysiological Puzzle?",
abstract = "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.",
keywords = "Constipation, Dyssynergic defecation, Enteric nervous system, Lewy bodies/neurites/pathology, Parkinson’s disease, α-Synuclein",
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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.

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