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Cited by 248Gastrointestinal motility and disordersParkinson's Disease Mechanisms and TreatmentsNeurological disorders and treatments

Gastric emptying time and gastric motility in patients with Parkinson's disease

Hardoff, Ruth, Sula, Michael, Tamir, Ada, Soil, Adrian, Front, Avi, Badarna, Samich, Honigman, Silvia, Giladi, Nir·2001·Movement Disorders
DOI 10.1002/mds.1203
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Abstract

Gastrointestinal symptoms such as nausea, abdominal pain, and bloating are frequent complaints of patients with Parkinson's disease (PD). It has been postulated that impaired gastrointestinal function may contribute to the development of motor fluctuations such as delay on and no on in patients with PD. Gastrointestinal impaired function and symptoms may be associated with the disease itself or secondary to levodopa treatment. Thus, we assessed gastric emptying (GE) and gastric motility in PD patients to examine the association between clinical status and gastric function. GE and antral contraction (frequency and amplitude) were evaluated by scintigraphy in 29 patients with mild PD (Hoehn and Yahr [H&Y] stage 1.0-2.0); 22 patients with moderate PD (H&Y stage 2.5-3.0); and 22 healthy volunteers, following the ingestion of a labeled standard meal. Gastric emptying (mean +/- SD of T(1/2)) and antral contraction were not significantly different between patients with mild PD (63.4 +/- 28.8 minutes) and moderate PD (54.7 +/- 25.5 minutes). In the control group, GE was 43.4 +/- 10.8 minutes (range 29.0 - 61.0 minutes). The prevalence of delayed emptying (>61 minutes) was not significantly different in patients with mild disease (48.3%) as compared with patients with moderate disease (36.4%). Antral contraction, both frequency and amplitude, were not significantly different between patients with mild and moderate PD throughout the entire 100 minutes of the study. Untreated patients (n = 28) had mean GE T(1/2) of 59 +/- 30.6 minutes. Patients with smooth response to levodopa showed slower GE (n = 10; 73.6 +/- 25.3 minutes), while treated patients with motor response fluctuations when tested at the on state (n = 13), had much faster GE (49.3 +/- 16.2 minutes). This shortened GE in the on state was similar to the GE of normal volunteers. We conclude that gastric emptying time in patients with PD was delayed compared with control volunteers. It was even slower in patients treated with levodopa. This effect of levodopa treatment was reversed to pseudonormalization (normal GE) at the advanced stages of the disease, when patients developed motor response fluctuation. Other clinical features of PD were not associated with delayed gastric emptying.

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  • Delayed gastric emptying in Parkinson's disease patients dampens the proper absorption of levodopa or dopamine agonists, causing lower peak plasma concentrations and on-off fluctuations of the drug.

    “Delayed gastric emptying in PD patients dampens the proper absorption of levodopa or dopamine agonists, causing lower peak plasma concentrations and on-off fluctuations of the drug (Doi et al., 2012;Hardoff et al., 2001;Marrinan et al., 2013).”

    From The Gut-Brain Axis in Parkinson’s Disease: Possibilities for Food-Based Therapies (2017) · cites this paper as Hardoff et al., 2001

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Authors
Hardoff, R., Sula, M., Tamir, A., Soil, A., Front, A., Badarna, S., Honigman, S., & Giladi, N.
Affiliations
Technion – Israel Institute of Technology (IL)
Corresponding author
Hardoff, Ruth
ORCID
Giladi, Nir
Venue
Movement Disorders
Publisher
Wiley
Published
2001-11
Volume
16
Issue
6
Pages
1041-1047
ISSN
  • 0885-3185 (ISSN-L)
  • 1531-8257
DOI
10.1002/mds.1203
OpenAlex
W1991349201
Cited by
248
References
29
Citations by year
2026: 6 · 2025: 5 · 2024: 11 · 2023: 9 · 2022: 11 · 2021: 16 · 2020: 10 · 2019: 8 · 2018: 11 · 2017: 11 · 2016: 23 · 2015: 15 · 2014: 14 · 2013: 7 · 2012: 9
FWCI
3.49
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor, 6 d)
Locations
  • Movement Disorders (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
  • Health Sciences › Medicine › Neurology › Parkinson's Disease Mechanisms and Treatments
  • Health Sciences › Medicine › Neurology › Neurological disorders and treatments
Keywords
Parkinson's disease, gastric emptying, gastric motility, antral contractions, levodopa, motor fluctuations, delayed gastric emptying, gastrointestinal symptoms, Hoehn and Yahr stage, scintigraphy, pseudonormalization, on-off phenomenon, levodopa response
MeSH terms
Aged, Antiparkinson Agents, Female, Gastric Emptying, Gastrointestinal Motility, Humans, Levodopa, Male, Middle Aged, Parkinson Disease, Severity of Illness Index, Technetium Tc 99m Aggregated Albumin, Tomography, Emission-Computed, Case-Control Studies, Disease Progression, Radiopharmaceuticals

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