Abstract
Parkinson's disease patients may experiencevarious gastrointestinal symptoms; however, the exactpathophysiology of these symptoms is not fullyunderstood. Therefore, the aim of this study was toinvestigate the pattern of gastric myoelectrical activityin patients with Parkinson's disease. Eleven patientswith Parkinson's disease and 10 healthy subjectsparticipated in the study. Patients were stratified as “receiving dopaminergic therapy” (N= 5) and “off therapy” (N = 6). Gastricmyoelectrical activity was measured by means of surfaceelectrogastrography (EGG) for 30 min before and for 90 min after a standardized meal. The dominantfrequency, postprandial EGG power change, and thepercentage of normal 2-4 cycles/min (cpm) slow-waveactivity in the three groups were calculated andcompared. The mean postprandial EGG power increase in theuntreated patients was smaller than in the treatedpatients (–3.11 ± 1.01 and 1.17 ±1.96 dB; P = 0.072). Moreover, both of these values weresignificantly decreased when compared to the control group(untreated vs control: d–3.11 ± 1.01 vs8.01 ± 1.86 dB; P = 0.04 and treated vs control:1.17 ± 1.96 vs 8.01 ± 1.86 dB; P = 0.02).The percentage of normal 2-4 cpm slow waves in untreated patients wasnot different from the treated patients (82.6 ±6.6% vs 75.8 ± 13.6%, P = NS) or from the controlgroup (88.2 ± 5.4%, P = NS). The dominantfrequency after the meal was similar to that in thefasting state both in the untreated (3.3 ± 0.1 vs3.2 ± 0.2 cpm; P = NS) and treated patients (3.2± 0.1 vs 3.1 ± 0.1 cpm, P = NS), whereasthe dominant frequency significantly increasedpostprandially in the control group (2.88 ± 0.12vs 3.05 ± 0.16; P < 0.05). Abnormalities ingastric myoelectrical activity in untreated Parkinson'sdisease patients reflect direct involvement of thegastrointestinal tract by the primary disease process.EGG can be regarded as a useful diagnostic tool inevaluating gastrointestinal involvement inneurodegenerative diseases.
Similar content being viewed by others
REFERENCES
Edwards L, Quigley EMM, Hofman R, Pfeiffer RF: Gastrointestinal symptoms in Parkinson's disease: 18-month follow-up study. Mov Disord 8:83–86, 1993
Edwards LL, Pfeiffer RF, Quigley EMM, Hofman R, Balluff M: Gastrointestinal symptoms in Parkinson's disease. Mov Disord 6:151–156, 1991
Hinder RA, Kelly KA: Human gastric pacesette r potential. Site of origin, spread, and response to gastric transection and proximal gastric vagotomy. Am J Surg 133:29–33, 1978
Kelly KA, Code CF, Elveback LR: Patterns of canine gastric electrical activity. Am J Physiol 217:461–470, 1969
Sarna SK: Gastrointestinal electrical activity; terminology. Gastroenterology 68:1631–1635, 1975
Chen JDZ, Lin Z, Pan J, McCallum RW: Abnormal gastric myoelectrical activity and delayed gastric emptying in patients with symptoms suggestive of gastroparesis. Dig Dis Sci 41:1538–1545, 1996
Mintchev MP, Otto SJ, Bowes KL: Electrogastrography canrecognize gastric electrical uncoupling in dogs. Gastroenterology 112:2006–2011, 1997
Soykan I, Sarosiek I, Schifflet J, Wooten GF, McCallum RW: The effect of chronic oral domperidone therapy on gastrointestinal symptoms and gastric emptying in patients with Parkinson's disease. Mov Disord 12:952–957, 1997
Koller WC: How accurately can Parkinson's disease be diagnosed? Neurology 41( suppl 1):6–16, 1992
Hoehn MM, Yahr MD: Parkinsonism: Onset, progression and mortality. Neurology 17:427–442, 1967
American Medical Association: Drug Evaluations Annual. 1995
Chen JZ, McCallum RW: EGG parameters and their clinical significance. In Electrogastrography: Principles and Clinical Applications. JZ Chen, RW McCallum (eds). New York, Raven Press, 1994, pp 45–73
Oppenheim AV, Schafer RW: Digital Signal Processing. Englewood Cliffs, New Jersey, Prentice Hall, 1975
Chen JDZ, McCallum RW: Gastric slow wave abnormalities in patients with gastroparesis. Am J Gastroenterol 87:477–482, 1992
Chen JDZ, Stewart WR, McCallum RW: Spectral analysis of episodic variations in the cutaneous electrogastrogram. IEEE Trans Biomed Eng 40:128–135, 1993
Tanner CM, Goetz CG, Klawans HL: Autonomic nervous system disorders in Parkinson' s disease. In Handbook of Parkinson's Disease. WC Koller (ed). New York, Marcel Dekker, 1992, pp 185–215
Byrne KG, Pfeiffer RF, Quigley EMM: Gastrointestinal dysfunction in Parkinson's disease, a report of clinical experience at a single center. J Clin Gastroenterol 19:11–16, 1994
Kaneoke Y, K oike Y, Sakurai N, Washimi Y, Hirayama M, Hoshiyama M, Takahashi A: Gastrointestinal dysfunction in Parkinson's disease detected by electrogastrography. J Auton Nerv Syst 50:275–281, 1995
Geldof H, van der Schee EJ, van Blankenstein M, Smout AJ, Akkermans LM: Effects of highly selective vagotomy on gastric myoelectrical activity. An electrogastrographic study. Dig Dis Sci 35:969–975, 1990
Qualman SJ, Haupt HM, Yang P, Hamilton SR: Esophageal Lewy bodies associated with ganglion cell loss in achalasia, similarity to Parkinson' s disease. Gastroenterology 87:848–856, 1984
Kupsky WJ, Grimes MM, Sweeting J, Bertsch R, Cote LJ: Parkinson's disease and megacolon: concentric hyaline inclusions (Lewy bodies) in enteric ganglion cells. Neurology 37:1253–1255, 1987
McCallum RW: Clinical pharmacology forum: Motility agents and the gastrointestinal tract. Am J Med Sci 312:19–26, 1996
Rights and permissions
About this article
Cite this article
Soykan, I., Lin, Z., Bennett, J.P. et al. Gastric Myoelectrical Activity in Patients with Parkinson's Disease (Evidence of a Primary Gastric Abnormality). Dig Dis Sci 44, 927–931 (1999). https://doi.org/10.1023/A:1026648311646
Issue Date:
DOI: https://doi.org/10.1023/A:1026648311646