Journal of Neurology

, 256:1972

Is there a difference in gastric emptying between Parkinson’s disease patients under long-term l-dopa therapy with and without motor fluctuations? An analysis using the 13C-acetate breath test

  • Yuji Tanaka
  • Tomohiro Kato
  • Hiroshi Nishida
  • Hiroshi Araki
  • Masahiko Murase
  • Masahito Nagaki
  • Hisataka Moriwaki
  • Takashi Inuzuka
Original Communication

DOI: 10.1007/s00415-009-5220-5

Cite this article as:
Tanaka, Y., Kato, T., Nishida, H. et al. J Neurol (2009) 256: 1972. doi:10.1007/s00415-009-5220-5

Abstract

The mechanism underlying the motor fluctuations that develop after long-term l-dopa therapy is not fully known. It has been speculated that malabsorption of l-dopa from the small intestine occurs. It was reported that gastric retention in Parkinson’s disease (PD) patients with motor fluctuations is increased as compared with that in PD without fluctuations. Because l-dopa therapy may worsen the symptoms of delayed gastric emptying (GE), it was not clear whether the delayed GE of PD patients with motor fluctuation was affected by l-dopa therapy. We assessed GE in PD patients with and without motor fluctuations. We investigated GE in 40 patients with PD under long-term l-dopa therapy, 20 fluctuators with “delayed-on” and “no-on” phenomena, 20 nonfluctuators, and 20 healthy volunteers. GE was examined by the 13C-acetate breath test (13C-ABT) [the half emptying time (HET), the peak time of the 13C-%-dose-excess curve (Tmax)], with expirations collected for 4 h after a test meal and analyzed for 13CO2 using an infrared (IR) spectrophotometer. The Tmax of GE as assessed using the 13C-ABT was significantly delayed in all PD patients as compared with controls (P = 0.002). The HET was significantly delayed in all PD patients as compared with controls (P < 0.001). The Tmax and HET were not significantly delayed in PD patients with motor fluctuations as compared with PD patients without motor fluctuations. These results demonstrated that GE is commonly delayed in PD patients with long-term l-dopa therapy. Delayed GE does not differ between PD patients with and without motor fluctuations. This finding demonstrated that the motor fluctuation in PD may not be influenced by GE.

Keywords

Parkinson’s disease Gastric emptying Motor fluctuations l-Dopa therapy 13C-acetate breath test 

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Yuji Tanaka
    • 1
    • 2
  • Tomohiro Kato
    • 2
  • Hiroshi Nishida
    • 1
    • 2
  • Hiroshi Araki
    • 2
  • Masahiko Murase
    • 2
  • Masahito Nagaki
    • 2
  • Hisataka Moriwaki
    • 2
  • Takashi Inuzuka
    • 1
  1. 1.Division of Neuroscience, Department of Neurology and Geriatrics, Research Field of Medicine, Graduate School of MedicineGifu UniversityGifuJapan
  2. 2.First Department of Internal Medicine, Graduate School of MedicineGifu UniversityGifuJapan

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