Gastric emptying after semi–solid food in multiple system atrophy and Parkinson disease
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Gastrointestinal symptoms such as nausea, abdominal pain, and bloating are frequent complaints in patients with Parkinson disease (PD) and in patients with multiple system atrophy (MSA), and may be associated with delayed gastric emptying (GE). Although several GE studies in patients with PD have been performed, scant data exist in patients with MSA.
We assessed GE half–times (T50) in 12 patients with MSA and compared them with those of 12 patients with PD and 12 age–matched healthy controls.GE was estimated scintigraphically using the left anterior oblique method after ingestion of a 99mTc colloid–labeled balanced semi–solid meal (yogurt). GE data were obtained every 15 minutes until there was complete emptying of the stomach. Blood pressure, heart rate, plasma glucose and glucosylated hemoglobin were regularly determined.
Reproducibility of the GE technique was excellent (Bland–Altman analysis, limits of agreement: –2.3 to 2.8). T50 was longer in MSA (82 ± 3.4 min) and in PD (90.6 ± 3.9 min) patients compared with controls (46.2 ± 0.7) (two–way ANOVA, p <0.0001). T50 did not differ between patients with MSA and those with PD. No correlation existed between T50 and age, duration of the disease, magnitude of postprandial hypotension, levels of plasma glucose and glucosylated hemoglobin (Kendall’s tau, p > 0.05).
Our results suggest that patients with MSA have GE rates similar to those of patients with PD, but slower than healthy agematched individuals. It remains to be investigated whether gastrointestinal dysfunction in MSA is related to both brain and peripheral pathology, as is presumed for PD.
Key wordsmultiple system atrophy Parkinson disease gastric emptying
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- 1.Chaudhuri KR, Hu M (2000) Central autonomic dysfunction. In:Vinken PJ, Bruyn GW, Appenzeller O (eds) Handbook of clinical neurology. The autonomic nervous system part II – Dysfunction. Elsevier Science, Amsterdam, pp 161–202Google Scholar
- 10.Handoff R, Sula M, Tamir A, Soil A, Front A, et al. (2001) Gastric emptying time and gastric motility in patients with Parkinson’s disease. Mov Disord 16:1044–1047Google Scholar
- 13.Kelly KA (1981) Motility of the stomach and gastroduodenal junction. In: Johnson LR (ed) Physiology of the gastrointestinal tract. New York, Raven Press, pp 393–410Google Scholar
- 16.Lanfranchi GA, Marzio L, Cortini C, et al. (1977) Effect of dopamine in gastric motility in man: evidence for specific receptors. In: Duthie HL (ed) Gastrointestinal motility in health and disease. Lancaster, England, MTP Publishers, pp 161–172Google Scholar
- 18.Martigoni E, Paccheti C, Godi L, Micieli G, Nappi G (1995) Autonomic disorders in Parkinson’s disease. J Neural Transm (Suppl) 45:11–19Google Scholar
- 20.Mathias CJ, Bannister R (1999) Postprandial hypotension in autonomic disorders. In:Mathias CJ, Bannister R (eds) Autonomic failure: a textbook of clinical disorders of the autonomic nervous system. Oxford, Oxford University Press, pp 283–295Google Scholar
- 21.Mathias CJ, Bannister R (1999) Investigation of autonomic disorders. In: Mathias CJ, Bannister R (eds) Autonomic failure: A textbook of clinical disorders of the autonomic nervous system. Oxford, Oxford University Press, pp 169–195Google Scholar
- 25.Schuurkes JA, Van-Neuten JM (1981) Is dopamine an inhibitor modulator of gastrointestinal motility? Scand J Gastroenterol (Suppl) 67:33–36Google Scholar
- 27.Vitti RA, Malmud LS, Fisher RS (1984) In: Freeman LM (ed) Clinical radionuclide Imaging. New York, Grune and Stratton, pp 1694–1728Google Scholar