Objective: To know the prevalence of Helicobacter Pylori infection among Nepalese Parkinson´s Disease patients and understand their clinical characteristics

Background: Helicobacter pylori (HP) is prevalent in more than 50 % of the world’s population and its incidence of infection is higher in developing countries. Parkinson’s Disease (PD) has higher HP prevalence than general population which suggest either HP is related to etiological factor of PD or there could be some association in its pathogenesis.

Method: We prospectively included all the patients with the diagnosis of Parkinson’s Disease presented to outpatient and inpatient of Neurology department of Tribhuvan University Teaching Hospital, from estimated date 15 June 2021 to 15 August 2021. Patient’s demography with motor and non-motor symptoms was recorded. Stool antigen test for H. Pylori was done in all the patients and positive cases were treated with standard treatment regimen. Patients with recent use of proton pump inhibitor within 2 weeks and use of any antimicrobials within 4 weeks were excluded.

Results: A total of 52 patients including 40 females (76.9%) were included in the study with the mean age of 64.02±11.94 years. Out of total 52 PD patients, stool antigen test for HP was positive in 10 patients (19.2%). Mean age of HP positive patient was 64.12±11.94 years and 63.75±12.14years in HP negative patients. In clinical staging of HP positive and negative PD patients, modified Hoehn and Yahr was 2.05±0.46 in HP positive group and 2.36±1.14 in HP negative group. Dyskinesia was present in 2 (20%) HP positive patients and 7 (16%) HP negative patients. Similarly, freezing of gait was present in 6 (60%) HP positive patients and 14 (33.3%) HP negative patients. In HP positive Constipation was seen in 6 (60%) in HP positive PD patients and 24 (57%).

Conclusion: HP prevalence is high among Nepalese PD patients, but not as high as previous few studies had reported as 3-4 times that of general population. Although HP positive PD patients were of earlier clinical staging, they had frequent freezing of gait with comparable rest common clinical manifestations. Further, the study of longer period with a large number of PD patients is warranted in future.

References: [1]. Tan AH, Lim SY, Mahadeva S, Loke MF, Tan JY, Ang BH, Chin KP, Mohammad Adnan AF, Ong SM, Ibrahim AI, Zulkifli N. Helicobacter pylori eradication in Parkinson’s disease: a randomized placebo‐controlled trial. Movement Disorders. 2020 Dec;35(12):2250-60.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/prevalence-of-helicobacter-pylori-infection-among-nepalese-parkinsons-disease-patients-and-their-clinical-manifestations/