Abstract

Background:

Altered gastric motility is a frequent non-motor symptom of Parkinson’s disease (PD). It has been hypothesized that disturbed gastric motility contributes to motor fluctuations in PD due to an erratic gastro-duodenal transport and an unpredictable absorption of drugs.

Objective:

We investigated whether patient-reported fluctuations are associated with parameters of gastric motility visualized by real-time magnetic resonance imaging (MRI) of the stomach.

Methods:

We analyzed real-time MRI-scans of the stomach after an overnight fasting period in 16 PD patients and 20 controls. MRI was performed 1) in the fasting state, 2) directly after a test meal, and 3) 4 hours postprandially. Gastric motility indices were calculated and compared between groups.

Results:

MRI showed an attenuated gastric motility in PD patients compared to controls. The difference was most obvious in the early postprandial phase. Gastric motility was not associated with patient-reported motor fluctuations. Using an iron-containing capsule we were able to retrace retention of drugs in the stomach.

Conclusion:

The results of this study stress the importance of considering the phase of digestion when investigating gastric motility in PD. Despite theoretical considerations, we did not find robust evidence for an association between MRI parameters of gastric motility and patient-reported motor fluctuations. For future studies that aim to investigate gastric motility in PD by MRI, we suggest multiple short-time MRIs to better track the whole gastro-duodenal phase in PD. Such an approach would also allow to retrace the retention of drugs in the stomach as shown by our approach using an iron-containing capsule.

中文翻译：

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帕金森病中的胃动力会根据消化阶段而改变，并且与患者报告的运动波动无关。

摘要

背景：

胃动力改变是帕金森病 (PD) 的常见非运动症状。据推测，由于不稳定的胃十二指肠转运和不可预测的药物吸收，胃动力紊乱会导致 PD 的运动波动。

客观的：

我们调查了患者报告的波动是否与胃的实时磁共振成像 (MRI) 可视化的胃动力参数相关。

方法：

我们分析了 16 名 PD 患者和 20 名对照者在禁食过夜后胃的实时 MRI 扫描。MRI 在 1) 空腹状态下进行，2) 在测试餐后直接进行，以及 3) 餐后 4 小时进行。计算胃动力指数并在组间进行比较。

结果：

与对照组相比，MRI 显示 PD 患者的胃动力减弱。差异在餐后早期最为明显。胃动力与患者报告的运动波动无关。使用含铁胶囊，我们能够追溯药物在胃中的滞留情况。

结论：

本研究的结果强调了在研究 PD 胃动力时考虑消化阶段的重要性。尽管有理论上的考虑，但我们没有发现胃动力的 MRI 参数与患者报告的运动波动之间存在关联的有力证据。对于旨在通过 MRI 研究 PD 胃动力的未来研究，我们建议多次短时 MRI 以更好地跟踪 PD 的整个胃十二指肠阶段。这种方法还可以追溯药物在胃中的滞留，如我们使用含铁胶囊的方法所示。