Small intestinal bacterial overgrowth in Parkinson's disease.

1. Faculty of Medicine (Divisions of Neurology and Gastroenterology), University of Malaya, Kuala Lumpur, Malaysia.
Authors
Tan AH¹
Mahadeva S¹
Thalha AM¹
Kiew CK¹
Yeat CM¹
Ng SW¹
Ang SP¹
Chow SK¹
Tan CT¹
Lim SY¹
(10 authors)
2. Department of Gastroenterology, Central Clinical School, Monash University and Alfred Hospital, Melbourne, Australia.
Authors
Gibson PR²
(1 author)
3. Institute of Biological Sciences, University of Malaya, Kuala Lumpur, Malaysia.
Authors
Yong HS³
(1 author)
4. Morton and Gloria Shulman Movement Disorders Centre, Toronto Western Hospital and the Edmond J. Safra Program in Parkinson's Disease Research, University of Toronto, Toronto, Canada.
Authors
Marras C⁴
Fox SH⁴
(2 authors)

ORCIDs linked to this article

Parkinsonism & Related Disorders, 02 Mar 2014, 20(5):535-540
https://doi.org/10.1016/j.parkreldis.2014.02.019 PMID: 24637123

Abstract

Background

Recent studies reported a high prevalence of small intestinal bacterial overgrowth (SIBO) in Parkinson's disease (PD), and a possible association with gastrointestinal symptoms and worse motor function. We aimed to study the prevalence and the potential impact of SIBO on gastrointestinal symptoms, motor function, and quality of life in a large cohort of PD patients.

Methods

103 Consecutive PD patients were assessed using the lactulose-hydrogen breath test; questionnaires of gastrointestinal symptoms and quality of life (PDQ-39); the Unified PD Rating Scale (UPDRS) including "on"-medication Part III (motor severity) score; and objective and quantitative measures of bradykinesia (Purdue Pegboard and timed test of gait). Patients and evaluating investigators were blind to SIBO status.

Results

25.3% of PD patients were SIBO-positive. SIBO-positive patients had a shorter mean duration of PD (5.2 ± 4.1 vs. 8.1 ± 5.5 years, P = 0.007). After adjusting for disease duration, SIBO was significantly associated with lower constipation and tenesmus severity scores, but worse scores across a range of "on"-medication motor assessments (accounting for 4.2-9.0% of the variance in motor scores). There was no association between SIBO and motor fluctuations or PDQ-39 Summary Index scores.

Conclusions

This is the largest study to date on SIBO in PD. SIBO was detected in one quarter of patients, including patients recently diagnosed with the disease. SIBO was not associated with worse gastrointestinal symptoms, but independently predicted worse motor function. Properly designed treatment trials are needed to confirm a causal link between SIBO and worse motor function in PD.

Full text links

Read article at publisher's site: https://doi.org/10.1016/j.parkreldis.2014.02.019

References

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Small intestinal bacterial overgrowth in Parkinson's disease.

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Gastrointestinal dysfunction in Parkinson's disease

Gastrointestinal dysfunction in Parkinson's disease

Small intestinal transit time in the elderly

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