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Electrogastrography in Patients with Parkinson’s Disease

Published online by Cambridge University Press:  02 December 2014

T. Naftali ,
N. Gadoth ,
M. Huberman  and
B. Novis
T. Naftali
Affiliation:
Department of Neurology, Meir General Hospital Kfar Saba and the Sackler Faculty of Medicine, Tel-Aviv University, Israel
N. Gadoth
Affiliation:
Department of Neurology, Meir General Hospital Kfar Saba and the Sackler Faculty of Medicine, Tel-Aviv University, Israel
M. Huberman
Affiliation:
Department of Gastroenterology, Meir General Hospital Kfar Saba and the Sackler Faculty of Medicine, Tel-Aviv University, Israel
B. Novis
Affiliation:
Department of Gastroenterology, Meir General Hospital Kfar Saba and the Sackler Faculty of Medicine, Tel-Aviv University, Israel
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Abstract

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Background:

Impaired gastrointestinal motility in Parkinson’s disease may affect absorption of levodopa and contribute to the disabling response fluctuations (RF). In this study gastric myoelectric activity was recorded with electrogastrography in patients with PD and correlated with the duration, severity and the presence of RF.

Method:

Electrogastrography (EGG) was performed in 36 patients with PD of which 22 were men. The mean age was 67 years (48-81), mean duration of disease was 7.07 years (1-20), and mean duration of treatment with levodopa was 5.07 years (1-20). Gastric dysrrythmia was diagnosed when either preprandial or postprandial dysrrythmia for more than 30% of the recording period was detected.

Results:

The EGG was abnormal in 24 of 36 patients. Significant association was found between preprandial dysrrythmia and duration of disease (P=0.002); duration of levodopa treatment (P=0.003), severity of 86RF (P=0.001), but not with age (P=0.076). Out of 18 patients with RF, 17 had at least one pattern of dysrrythmia. In 11 out of the 18 patients without RF, the EGG was normal while the remaining seven had at least one pattern of dysrrythmia.

Conclusion:

Abnormal EGG was quite common in this group of patients with PD, particularly in those with RF. The most common pattern of abnormality was preprandial dysrrythmia, which was positively associated with disease duration and length of levodopa treatment. Although frequently asymptomatic, preprandial dysrrythmia leading to impaired gastric emptying may contribute to irregular absorption of levodopa from the small intestine and contribute to disabling response fluctuations.

Résumé:

RÉSUMÉ:Introduction:

Une altération de la motilité gastro–intestinale dans la maladie de Parkinson (MP) peut perturber l’absorption de la lévodopa et contribuer aux fluctuations motrices (FM) observées. Dans cette étude, l’activité myoélectrique gastrique a été enregistrée au moyen de l’électrogastrographie (ÉGG) chez des patients atteints de MPet les données recueillies ont été corrélées à la durée, à la sévérité et à la présence de FM.

Méthode:

Trente–six patients, 22 hommes et 14 femmes, atteints de MP ont subi une ÉGG. L’âge moyen des patients était de 67 ans (48 à 81 ans), la durée moyenne de la maladie était de 7,07 ans (1 à 20 ans) et la durée moyenne du traitement par la lévodopa était de 5,07 ans (1 à 20 ans). On posait un diagnostic de dysrythmie gastrique quand l’enregistrement démontrait une dysrythmie pendant 30% ou plus de la période d’enregistrement, soit en période préprandiale ou postprandiale.

Résultats:

L’ÉGG était anormal chez 24 des 36 patients. Une association significative a été observée entre la dysrythmie préprandiale et la durée de la maladie (p = 0,002), la durée du traitement par la lévodopa (p = 0,014), la sévérité de la FM (p = 0,047). Aucune association avec l’âge n’a été observée (p = 0,1). Parmi les 18 patients ayant des FM, 17 avaient des signes de dysrythmie. Chez 11 des 18 patients sans FM, l’ÉGG était normal alors que les 7 autres avaient des signes de dysrythmie.

Conclusion:

Un enregistrement ÉGG anormal était fréquemment observé dans ce groupe de patients atteints de la MP, particulièrement chez ceux qui ont des FM. Le tableau le plus fréquent était une dysrythmie préprandiale associée de façon positive à la durée de la maladie et du traitement par la lévodopa. Bien qu’elle soit fréquemment asymptomatique, la dysrythmie préprandiale entraînant une altération de la vidange gastrique peut contribuer à une absorption irrégulière de la lévodopa au niveau de l’intestin grêle et contribuer aux FM invalidantes.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 32 , Issue 1 , February 2005 , pp. 82 - 86
Copyright
Copyright © The Canadian Journal of Neurological 2014

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