Objective: This study aimed to investigate the association between constipation and the severity of motor and non-motor symptoms in PD patients with the G2019S LRRK2 mutation, and to examine its impact on treatment response.

Background: Constipation is a common non-motor symptom in PD. Although gastrointestinal dysfunction may be linked to other PD symptoms and treatment outcomes, its role in G2019S LRRK2 PD remains unclear.

Method: This retrospective study included 51 PD patients with G2019S LRRK2 mutation. Data were collected from patient records, including demographic characteristics, motor and non-motor symptoms (Unified Parkinson’s Disease Rating Scale [UPDRS]), onset delay of dyskinesias and motor fluctuations, and treatment details. Constipation was defined using item 1.11 of the MDS-UPDRS. Independent samples t-tests compared means of motor, non-motor symptoms, and treatment data, while chi-square tests assessed associations between constipation and categorical variables.

Results: Among 51 patients, 60.8% (31) had constipation with a sex-ratio of 0.76, a mean age of 65.61 years and a mean age at onset of 53.45.

According to UPDRS-III score, motor symptoms were more serious in the constipation group (50.47) compared to the non-constipation group (41.50), but the difference was not statistically significant (p = 0.218). Hoehn and Yahr scores were also higher in the constipation group (2.77 vs. 2.30, p = 0.192). furthermore, no significant difference was found in the delay to motor fluctuations (p = 0.592).

Regarding non-motor symptoms, anxiety was more severe in the constipation group (1.03 vs. 0.75, p = 0.261), as was pain (1.39 vs. 0.85, p = 0.054), but neither difference was statistically significant. No significant differences were observed for orthostatic hypotension (p = 0.885) or urinary problems (p = 0.679) as well.

In terms of treatment response, no significant differences were found. At 5 years, the mean L-Dopa Equivalent Dose (LED) was slightly higher in the constipation group (649.19 mg vs. 563.96 mg, p = 0.474). and at 10 years, the LED was similar between both groups (964.29 mg vs. 910.00 mg, p = 0.691).

Conclusion: Constipation is frequent in G2019S LRRK2 PD patients, but does not significantly impact symptom severity or treatment response. Further comparative studies with larger samples and longer follow-ups are needed to clarify these associations.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/impact-of-constipation-on-motor-and-non-motor-symptoms-in-g2019s-lrrk2-parkinsons-disease-a-retrospective-study/