Colonic biopsies to assess the neuropathology of Parkinson's disease and its relationship with symptoms
Open accessAbstract
BACKGROUND: The presence of Lewy bodies and Lewy neurites (LN) has been demonstrated in the enteric nervous system (ENS) of Parkinson's disease (PD) patients. The aims of the present research were to use routine colonoscopy biopsies (1) to analyze, in depth, enteric pathology throughout the colonic submucosal plexus (SMP), and (2) to correlate the pathological burden with neurological and gastrointestinal (GI) symptoms. METHODOLOGY/PRINCIPAL FINDINGS: A total of 10 control and 29 PD patients divided into 3 groups according to disease duration were included. PD and GI symptoms were assessed using the Unified Parkinson's Disease Rating Scale part III and the Rome III questionnaire, respectively. Four biopsies were taken from the ascending and descending colon during the course of a total colonoscopy. Immunohistochemical analysis was performed using antibodies against phosphorylated alpha-synuclein, neurofilaments NF 220 kDa (NF) and tyrosine hydroxylase (TH). The density of LN, labeled by anti-phosphorylated alpha-synuclein antibodies, was evaluated using a quantitative rating score. Lewy pathology was apparent in the colonic biopsies from 21 patients and in none of the controls. A decreased number of NF-immunoreactive neurons per ganglion was observed in the SMP of PD patients compared to controls. The amount of LN in the ENS was inversely correlated with neuronal count and positively correlated with levodopa-unresponsive features and constipation. CONCLUSION/SIGNIFICANCE: Analysis of the ENS by routine colonoscopy biopsies is a useful tool for pre-mortem neuropathological diagnosis of PD, and also provides insight into the progression of motor and non-motor symptoms.
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Levodopa-unresponsive features and constipation were positively associated with the amount of Lewy neurites in the enteric nervous system.
“Moreover, it has been shown that levodopa-unresponsive features and constipation were positively associated with the amount of Lewy neurites in the ENS (Lebouvier et al., 2010).”
From The Gut-Brain Axis in Parkinson’s Disease: Possibilities for Food-Based Therapies (2017) · cites this paper as Lebouvier et al., 2010
Prolonged use of levodopa induces severe side effects such as dyskinesia and motor fluctuation, and as the disease progresses patients might eventually develop levodopa-resistance.
“The prolonged use of levodopa induces severe side effects such as dyskinesia and motor fluctuation (Schrag and Quinn, 2000) and as the disease progresses patients might eventually develop levodopa-resistance (Lebouvier et al., 2010;Lee and Koh, 2015).”
From The Gut-Brain Axis in Parkinson’s Disease: Possibilities for Food-Based Therapies (2017) · cites this paper as Lebouvier et al., 2010
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“Moreover, it has been shown that levodopa-unresponsive features and constipation were positively associated with the amount of Lewy neurites in the ENS (Lebouvier et al., 2010).”
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- Authors
- Lebouvier, T., Neunlist, M., Bruley des Varannes, S., Coron, E., Drouard, A., N'Guyen, J.-M., Chaumette, T., Tasselli, M., Paillusson, S., Flamand, M., Galmiche, J.-P., Damier, P., & Derkinderen, P.
- Affiliations
- Inserm (FR)
- Corresponding author
- Lebouvier, Thibaud
- Neunlist, Michel
- Derkinderen, Pascal
- ORCID
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2010-09-14
- Volume
- 5
- Issue
- 9
- Pages
- e12728
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC2939055
- OpenAlex
- W2054107031
- Cited by
- 427
- References
- 58
- Citations by year
- 2026: 11 · 2025: 21 · 2024: 19 · 2023: 22 · 2022: 19 · 2021: 28 · 2020: 26 · 2019: 35 · 2018: 29 · 2017: 35 · 2016: 34 · 2015: 32 · 2014: 33 · 2013: 27 · 2012: 36
- FWCI
- 15.79
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- PLoS ONE (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Figshare (submittedVersion, cc-by)
- Funders
- Michael J. Fox Foundation for Parkinson's Research
- Institut National de la Santé et de la Recherche Médicale
- Association France Parkinson
- Topics
- Health Sciences › Medicine › Neurology › Parkinson's Disease Mechanisms and Treatments
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Neurology › Neurological disorders and treatments
- Keywords
- Parkinson's disease, enteric nervous system, Lewy bodies, Lewy neurites, colonic biopsy, submucosal plexus, alpha-synuclein phosphorylation, neurofilaments, tyrosine hydroxylase, constipation, gastrointestinal symptoms, disease progression
- MeSH terms
- Adult, Aged, Biopsy, Colon, Colonoscopy, Female, Humans, Male, Middle Aged, Parkinson Disease, Lewy Bodies, Enteric Nervous System
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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