Objective: To investigate the association between esophageal motility and quantitative gait parameters in patients with Parkinson’s disease (PD).

Background: PD is the second most common neurodegenerative disease, with gastrointestinal symptoms occurring throughout the disease course. These include lower gastrointestinal symptoms such as constipation, as well as upper gastrointestinal symptoms including drooling and dyspepsia. Esophageal dysfunction in PD has been reported; however, the relationship between esophageal motility and gait impairment remains unclear.

Method: This cross-sectional study enrolled 65 PD patients from Korea University Guro Hospital (September 2023–September 2024). All patients underwent esophageal high-resolution manometry (HRM), quantitative gait analysis using the GaitRite system, PD-related clinical scales, and autonomic function tests. HRM parameters included upper esophageal sphincter (UES) and lower esophageal sphincter (LES) pressures, striated esophageal contractile integral (SECI), and distal contractile integral (DCI). Multivariable linear regression analyses adjusted for age, sex, UPDRS-III, and LEDD were performed.

Results: Mean age was 66.0 years (38.5% female), median disease duration was 12 months, and mean UPDRS-III score was 23.0. UES mean basal pressure was negatively associated with double support time and positively associated with single support and swing percentage—indicators of gait stability. Step length differential was negatively associated with UES basal pressure (β = −4.83, p = 0.024) but positively associated with DCI (β = 325.23, p < 0.001). LES residual pressure/IRP was positively associated with step time differential (β = 74.77, p = 0.039). No significant associations were observed between autonomic function tests and esophageal parameters.

Conclusion: Higher UES basal pressure correlates with gait stability, while higher lower esophageal parameters (LES residual pressure/IRP, DCI) are associated with greater gait asymmetry. The upper esophagus (striated muscle, somatic innervation via nucleus ambiguus) and lower esophagus (smooth muscle, autonomic innervation via dorsal motor nucleus) may be differentially affected in early PD through distinct mechanisms paralleling gait control. Esophageal dysfunction may serve as a potential marker reflecting gait impairment and disease burden in PD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/association-between-esophageal-motility-and-gait-in-parkinsons-disease-possible-differential-mechanisms-by-esophageal-region/