Assessment of Prodromal Gastrointestinal Manifestations in Idiopathic Parkinson's Disease

Parkinson's disease (PD) is a neurodegenerative disorder characterized by both motor and non-motor symptoms, including gastrointestinal (GI) disturbances. Prodromal GI symptoms often precede motor symptoms, potentially serving as early indicators of the disease. This study aimed to assess the prodromal GI manifestations in idiopathic PD and explore their correlation with disease onset.

A retrospective cross-sectional study was conducted involving 41 idiopathic PD patients and 29 age- and sex-matched healthy controls. Clinical assessment was performed using the Movement Disorder Society-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS). GI symptoms were evaluated using the Gastrointestinal Dysfunction Scale for Parkinson’s Disease (GIDS-PD), Gastrointestinal (GIT) Non-Motor Symptoms Scale (GIT-NMSS), and ROME IV criteria for irritable bowel syndrome (IBS). The relationships between GI symptoms and various disease characteristics were then examined through correlation analysis.

PD patients exhibited significantly higher GI dysfunction compared to controls (p < 0.001), with constipation, drooling, and dysphagia being the most prevalent symptoms. The GIDS-PD total score was significantly correlated with disease duration, duration of GI manifestations, NMSS domain 6, and specific MDS- UPDRS items (constipation, drooling, and chewing/swallowing difficulties), with the most predicting variable being disease duration. Notably, GI symptoms often precede motor symptoms for several years.

Prodromal GI symptoms are common in idiopathic PD and correlate with disease progression. These findings suggest that early recognition of GI disturbances could facilitate earlier diagnosis and intervention, potentially improving disease management and patient outcomes.