Abstract
Background
Recent studies reported a high prevalence of small intestinal bacterial overgrowth
(SIBO) in Parkinson's disease (PD), and a possible association with gastrointestinal
symptoms and worse motor function. We aimed to study the prevalence and the potential
impact of SIBO on gastrointestinal symptoms, motor function, and quality of life in
a large cohort of PD patients.
Methods
103 Consecutive PD patients were assessed using the lactulose-hydrogen breath test;
questionnaires of gastrointestinal symptoms and quality of life (PDQ-39); the Unified
PD Rating Scale (UPDRS) including “on”-medication Part III (motor severity) score;
and objective and quantitative measures of bradykinesia (Purdue Pegboard and timed
test of gait). Patients and evaluating investigators were blind to SIBO status.
Results
25.3% of PD patients were SIBO-positive. SIBO-positive patients had a shorter mean
duration of PD (5.2 ± 4.1 vs. 8.1 ± 5.5 years, P = 0.007). After adjusting for disease duration, SIBO was significantly associated
with lower constipation and tenesmus severity scores, but worse scores across a range
of “on”-medication motor assessments (accounting for 4.2–9.0% of the variance in motor
scores). There was no association between SIBO and motor fluctuations or PDQ-39 Summary
Index scores.
Conclusions
This is the largest study to date on SIBO in PD. SIBO was detected in one quarter
of patients, including patients recently diagnosed with the disease. SIBO was not
associated with worse gastrointestinal symptoms, but independently predicted worse
motor function. Properly designed treatment trials are needed to confirm a causal
link between SIBO and worse motor function in PD.
Keywords
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Article info
Publication history
Published online: March 17, 2014
Accepted:
February 19,
2014
Received in revised form:
February 10,
2014
Received:
November 26,
2013
Identification
Copyright
© 2014 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
