Abstract

Background:

Gastrointestinal dysfunction and related clinical symptoms are common in Parkinson’s disease (PD), but the underlying mechanisms are still poorly understood.

Objective:

In this study, we investigated how PD affects the postprandial vascular response in the splanchnic circulation.

Methods:

23 patients with PD in the “ON-medication state” and 23 age- and sex-matched healthy control participants underwent serial phase-contrast magnetic resonance imaging (PC-MRI) to measure the postprandial blood flow response in the superior mesenteric artery (SMA). Participants ingested a standardized liquid test meal (∼400 kcal) and underwent four PC-MRI runs within the following hour. Each PC-MRI run consisted of six consecutive measurements of SMA blood flow.

Results:

In both groups, standardized food intake triggered an increase of blood flow in the SMA, but absolute and relative increases in blood flow were attenuated in patients compared to the control group (p < 0.001). While baseline blood flow in the SMA was comparable in both groups, the postprandial maximum blood flow was attenuated in patients (p = 0.03). The temporal dynamics of the postprandial blood flow did not differ between groups. Postprandial SMA blood flow increase in patients correlated neither with subjective reports of non-motor symptoms or upper gastrointestinal complaints, nor with levodopa equivalent daily dose or disease duration. Blood glucose measurements in between the PC-MRI runs showed a smaller postprandial increase in blood glucose in the patient group (p = 0.006).

Conclusion:

This study provides first-time evidence that patients with PD have an attenuated postprandial blood flow response in the SMA, indicating an impaired functional regulation of gastrointestinal perfusion in response to food intake in PD.

中文翻译：

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帕金森病患者肠系膜血流量的餐后增加减弱：动态 PC-MRI 研究

摘要

背景：

胃肠道功能障碍和相关临床症状在帕金森病 (PD) 中很常见，但其潜在机制仍知之甚少。

客观的：

在这项研究中，我们调查了 PD 如何影响内脏循环中的餐后血管反应。

方法：

23 名处于“药物治疗状态”的 PD 患者和 23 名年龄和性别匹配的健康对照参与者接受了系列相位对比磁共振成像 (PC-MRI) 以测量肠系膜上动脉 (SMA) 的餐后血流反应）。参与者摄入了标准化的液体测试餐（~400 kcal），并在接下来的一个小时内进行了四次 PC-MRI 运行。每次 PC-MRI 运行包括六次连续的 SMA 血流测量。

结果：

在这两个组中，标准化的食物摄入引发了 SMA 血流量的增加，但与对照组相比，患者血流量的绝对和相对增加减弱（p  < 0.001）。虽然两组的 SMA 基线血流量相当，但患者的餐后最大血流量减弱 ( p  = 0.03)。餐后血流的时间动态在各组之间没有差异。患者餐后 SMA 血流增加与非运动症状或上消化道不适的主观报告无关，也与左旋多巴等效日剂量或疾病持续时间无关。PC-MRI 运行之间的血糖测量结果显示，患者组的餐后血糖升高幅度较小。p  = 0.006）。

结论：

该研究首次提供证据表明 PD 患者的 SMA 餐后血流反应减弱，表明 PD 患者食物摄入后胃肠灌注的功能调节受损。