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Oertel WH, Paule E, Hasemann T, Sittig E, Belke M, Unger MM, Mayer G, Werner R, Jansen A, Pape H, Höglinger GU, Vadasz D, Müller HH, Knake S, Janzen A. Reduced Gastric Contraction in Rapid-Eye-Movement Sleep Behavior Disorder and De Novo Parkinson's Disease. Mov Disord 2024; 39:53-63. [PMID: 37955157 DOI: 10.1002/mds.29652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 09/13/2023] [Accepted: 10/18/2023] [Indexed: 11/14/2023] Open
Abstract
BACKGROUND Reduced gastric motility in Parkinson's disease (PD) has been reported, but hardly any study exists in subjects with isolated rapid-eye-movement (REM) sleep behavior disorder (iRBD), a specific prodrome of α-synucleinopathies. OBJECTIVES We compared the gastric motility of 17 iRBD subjects with that of 18 PD subjects (15 drug naive, 3 early treated in defined off) and 15 healthy controls (HC) with real-time magnetic resonance imaging (rtMRI). METHODS After overnight fasting, participants consumed a standardized breakfast and underwent a 3-T rtMRI of the stomach. Amplitude and velocity of the peristaltic waves were analyzed under blinded conditions. Gastric motility index (GMI) was calculated. The procedure was repeated in 12 of 17 iRBD subjects ~2.5 years later. Nine of these 12 iRBD subjects were hyposmic. RESULTS In iRBD and PD subjects the amplitude of the peristaltic waves was significantly reduced compared with HCs (iRBD vs. HC: 8.7 ± 3.7 vs. 11.9 ± 4.1 mm, P = 0.0097; PD vs. HC: 6.8 ± 2.2 vs. 11.9 ± 4.1 mm, P = 0.0001). The amplitude in iRBD and PD subjects was decreased to the same extent. The GMI was reduced in only PD subjects (PD vs. HC: P = 0.0027; PD vs. iRBD: P = 0.0203). After ~2.5 years the amplitude in iRBD subjects did not significantly decrease further. CONCLUSION The amplitude of the peristaltic waves was markedly reduced in iRBD, a prodrome of α-synucleinopathies. This reduction was similar to the extent observed already in manifest early PD. This finding implies that the α-synuclein pathology affects the innervation of the stomach already in the prodromal stage. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Wolfgang H Oertel
- Department of Neurology, Philipps-University Marburg (UMR), Marburg, Germany
| | - Esther Paule
- Department of Neurology, Philipps-University Marburg (UMR), Marburg, Germany
| | - Theresa Hasemann
- Department of Neurology, Philipps-University Marburg (UMR), Marburg, Germany
| | - Elisabeth Sittig
- Department of Neurology, Philipps-University Marburg (UMR), Marburg, Germany
| | - Marcus Belke
- Department of Neurology, Philipps-University Marburg (UMR), Marburg, Germany
| | - Marcus M Unger
- Department of Neurology, Philipps-University Marburg (UMR), Marburg, Germany
- Department of Neurology, Saarland University, Saarbrücken, Germany
- Department of Neurology, SHG Kliniken Sonnenberg, Saarbruecken, Germany
| | - Geert Mayer
- Department of Neurology, Philipps-University Marburg (UMR), Marburg, Germany
| | - Rita Werner
- Department of Neurology, Philipps-University Marburg (UMR), Marburg, Germany
| | - Andreas Jansen
- Core-Facility Brain Imaging, Faculty of Medicine, Philipps-University Marburg, Marburg, Germany
- CMBB-Center for Mind, Brain and Behavior, Philipps-University Marburg, Marburg, Germany
| | - Heidi Pape
- Department of Neurology, Philipps-University Marburg (UMR), Marburg, Germany
| | - Günter U Höglinger
- Department of Neurology, Philipps-University Marburg (UMR), Marburg, Germany
- Department of Neurology, University Hospital Munich, Ludwig-Maximilians-University Munich, München, Germany
| | - Dávid Vadasz
- Department of Neurology, Philipps-University Marburg (UMR), Marburg, Germany
| | - Hans-Helge Müller
- Institute of Medical Bioinformatics and Biostatistics, Philipps-University Marburg, Marburg, Germany
| | - Susanne Knake
- Department of Neurology, Philipps-University Marburg (UMR), Marburg, Germany
- Core-Facility Brain Imaging, Faculty of Medicine, Philipps-University Marburg, Marburg, Germany
- CMBB-Center for Mind, Brain and Behavior, Philipps-University Marburg, Marburg, Germany
| | - Annette Janzen
- Department of Neurology, Philipps-University Marburg (UMR), Marburg, Germany
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