Objective: To compare the gastrointestinal dysfunction in patients with early-onset Parkinson’s disease (EOPD) and late-onset Parkinson’s disease (LOPD).

Background: Gastrointestinal dysfunction is one of the most common and earliest non-motor symptoms in Parkinson’s disease (PD). The current study is one of the first studies comparing the gastrointestinal dysfunction in EOPD and LOPD patients.

Method: This was a single-center questionnaire-based cross-sectional study enrolling 75 patients each of EOPD and LOPD who met the UKPDS Brain Bank criteria with minimum 5 years of disease duration, with an equal number of age-matched young (YOC) and elderly controls (LOC).  Each participant underwent a detailed neurological evaluation and completed five gastrointestinal scales (Cleveland Constipation Scoring System (CCS), Fairfax Colon and Rectal Surgery Constipation Questionnaire (FCQ), Patient Assessment of Constipation on the Quality of Life (PAC-QoL), Gastrointestinal Dysfunction Scale for Parkinson’s Disease (GIDS-PD) and Mini Nutritional Assessment (MNA)) and three non-motor symptoms scales (Non-Motor Symptom Assessment Scale for Parkinson’s Disease (PDNMS), Parkinson’s Disease Questionnaire (PDQ-39) and Scale for Outcomes in Parkinson’s disease for Autonomic symptoms (SCOPA-AUT)).

Results: Women comprised 40% of the EOPD and 34.6% of the LOPD patients.  The mean age at disease onset was 35.51±7.82 years in EOPD and 55.11±6.28 years in LOPD; mean disease duration was 9.17±5.04 years in EOPD and 7.6±3.51 years in LOPD. The most common gastrointestinal symptom in the entire PD group was constipation (68%). The mean CCS score (EOPD 5.36±5.25, LOPD 7.64±6.00, p=0.014), FCQ part-3 score (EOPD 5.05±5.21, LOPD 6.91±5.58, p0.037), PAC-QoL score (EOPD 28.97±18.20, LOPD 37.04±21.27, p=0.014) and GIDS-PD score (EOPD 14.73±13.94, LOPD 20.77±14.01, p=0.008) were significantly higher in the LOPD patients. The prevalence of hypogeusia, dysphagia, heartburn, bloating and constipation was higher in the LOPD patients. There was an increase in the non-motor symptom score proportionate with the gastrointestinal dysfunction.

Conclusion: This study elucidates the higher prevalence and severity of gastrointestinal symptoms in LOPD than the EOPD patients.

Figure: Prevalence of Gastrointestinal Dysfunction

Table: Gastrointestinal Dysfunction Scales

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MDS Abstracts - https://www.mdsabstracts.org/abstract/comparison-of-gastrointestinal-dysfunction-in-early-onset-and-late-onset-parkinsons-disease/