Small intestinal bacterial overgrowth in Parkinson's disease |
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| Institution: | 1. Faculty of Medicine (Divisions of Neurology and Gastroenterology), University of Malaya, Kuala Lumpur, Malaysia;2. Department of Gastroenterology, Central Clinical School, Monash University and Alfred Hospital, Melbourne, Australia;3. Institute of Biological Sciences, University of Malaya, Kuala Lumpur, Malaysia;4. Morton and Gloria Shulman Movement Disorders Centre, Toronto Western Hospital and the Edmond J. Safra Program in Parkinson''s Disease Research, University of Toronto, Toronto, Canada;1. Department of Medicine, NewYork-Presbyterian Hospital/Weill Cornell Medicine, 525 E. 68th Street, M-532, New York, NY, 10065, USA;2. Division of Gastroenterology and Hepatology, NewYork-Presbyterian Hospital/Weill Cornell Medicine, 1305 York Avenue, 4th Floor, New York, NY, 10065, USA;1. Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland;2. APC Microbiome Institute, University College Cork, Cork, Ireland;3. Division of Gastroenterology and Hepatology, Lynda K and David M Underwood Center for Digestive Disorders, Houston Methodist Hospital, and Weill Cornell Medical College, 6550 Fannin St, SM 1001, Houston, TX 77030, USA;1. Department of Biology, University of Rome Tor Vergata, Rome, Italy;2. UOSD Parkinson''s Center, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy;3. Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy;4. Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy;5. IRCCS Fondazione Santa Lucia, Rome, Italy;1. Research Institute of Petroleum Exploration & Development, PetroChina, Beijng 100083, China;2. School of Energy Resources, China University of Geosciences, Beijing 100083, China |
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| Abstract: | BackgroundRecent studies reported a high prevalence of small intestinal bacterial overgrowth (SIBO) in Parkinson's disease (PD), and a possible association with gastrointestinal symptoms and worse motor function. We aimed to study the prevalence and the potential impact of SIBO on gastrointestinal symptoms, motor function, and quality of life in a large cohort of PD patients.Methods103 Consecutive PD patients were assessed using the lactulose-hydrogen breath test; questionnaires of gastrointestinal symptoms and quality of life (PDQ-39); the Unified PD Rating Scale (UPDRS) including “on”-medication Part III (motor severity) score; and objective and quantitative measures of bradykinesia (Purdue Pegboard and timed test of gait). Patients and evaluating investigators were blind to SIBO status.Results25.3% of PD patients were SIBO-positive. SIBO-positive patients had a shorter mean duration of PD (5.2 ± 4.1 vs. 8.1 ± 5.5 years, P = 0.007). After adjusting for disease duration, SIBO was significantly associated with lower constipation and tenesmus severity scores, but worse scores across a range of “on”-medication motor assessments (accounting for 4.2–9.0% of the variance in motor scores). There was no association between SIBO and motor fluctuations or PDQ-39 Summary Index scores.ConclusionsThis is the largest study to date on SIBO in PD. SIBO was detected in one quarter of patients, including patients recently diagnosed with the disease. SIBO was not associated with worse gastrointestinal symptoms, but independently predicted worse motor function. Properly designed treatment trials are needed to confirm a causal link between SIBO and worse motor function in PD. |
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| Keywords: | Parkinson's disease/Parkinsonism Small intestinal bacterial overgrowth Gastrointestinal dysfunction |
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