Journal of Movement Disorders

Original Articles

Constipation is Associated With Mild Cognitive Impairment in Patients With de novo Parkinson’s Disease: Sung Hoon Kang, Jungyeun Lee, Seong-Beom Koh; J Mov Disord. 2022;15(1):38-42. Published online November 17, 2021; DOI: https://doi.org/10.14802/jmd.21074

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Objective
The association between gastrointestinal (GI) symptoms and cognitive profile in patients with Parkinson’s disease (PD) at diagnosis remains unclear, although GI symptoms and cognitive impairment are highly prevalent in patients with PD. We investigated the relationship between constipation and cognitive status. We also aimed to identify the correlation between constipation and each neuropsychological dysfunction.
Methods
A total of 427 patients with de novo Parkinson’s disease with normal cognition (PD-NC, n = 170) and Parkinson’s disease with mild cognitive impairment (PD-MCI, n = 257) at Korea University Guro Hospital in Seoul, Korea were included. All patients underwent comprehensive neuropsychological tests and completed the Non-Motor Symptoms Scale (NMSS). The frequency and severity of constipation were assessed using the NMSS GI symptoms scale, we used logistic regression analysis and partial correlation analysis to determine the associations between constipation score, MCI, and each neuropsychological dysfunction.
Results
Frequent and severe constipation was associated with MCI in patients with PD at diagnosis regardless of disease severity. Specifically, constipation was related to poor performance in frontal-executive and visuospatial functions after controlling for age and sex.
Conclusion
Our findings may provide an understanding of constipation as a marker associated with cognitive impairment in individuals with PD. Therefore, the evaluation of cognitive function is warranted in PD patients with constipation, while further studies are necessary to investigate the detailed mechanism of our results.

Citations

Citations to this article as recorded by

Defecation after magnesium supplementation enhances cognitive performance in triathletes
Chen-Chan Wei, M. Brennan Harris, Mengxin Ye, Andrew Nicholls, Ahmad Alkhatib, Luthfia Dewi, Chi-Yang Huang, Chia-Hua Kuo
Sports Medicine and Health Science.2024;[Epub] CrossRef
Constipation in Parkinson's Disease
Eamonn M. M. Quigley
Seminars in Neurology.2023; 43(04): 562. CrossRef
Interactions between gut microbiota and Parkinson's disease: The role of microbiota-derived amino acid metabolism
Wang Wang, Shujun Jiang, Chengcheng Xu, Lili Tang, Yan Liang, Yang Zhao, Guoxue Zhu
Frontiers in Aging Neuroscience.2022;[Epub] CrossRef

The Four Square Step Test for Assessing Cognitively Demanding Dynamic Balance in Parkinson’s Disease Patients: Jinhee Kim, Ilsoo Kim, Ye Eun Kim, Seong-Beom Koh; J Mov Disord. 2021;14(3):208-213. Published online May 26, 2021; DOI: https://doi.org/10.14802/jmd.20146

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Abstract PDF Supplementary Material

Objective
The Four Square Step Test (FSST) is a tool that assesses dynamic balance during obstacle step-over. To date, few studies have used the FSST to measure balance in patients with Parkinson’s disease (PD). This study aimed to verify that patients with PD, even at the de novo early stage, take more time to perform the FSST and identify which factors, cognitive status or cardinal motor symptoms, are related most to FSST scores.
Methods
Thirty-five newly diagnosed drug-naïve patients with PD and 17 controls completed the FSST. The Unified Parkinson’s Disease Rating Scale (UPDRS), Hoehn and Yahr (H&Y) stage, spatiotemporal gait parameters, and neuropsychological test battery were also assessed in the PD group.
Results
Mean FSST performance time was 8.20 ± 1.61 seconds in patients with PD, which was significantly more than the control group (7.13 ± 1.10 seconds, p = 0.018). UPDRS part III total score and H&Y stage were not significantly associated with FSST, but among the UPDRS subscores, only the postural instability/gait disturbance subscore showed a significant association. Regarding the association between FSST and cognition, the Trail Making Test-B and the Color Word Stroop Test showed strongly inverse correlations with FSST (rho = -0.598 and -0.590, respectively). With respect to gait parameters, double support time was significantly associated with FSST score (rho = 0.342, p = 0.044); however, other parameters, including velocity and step length, were not associated with the FSST.
Conclusion
The FSST can be used in the clinic to assess dynamic balance with cognitive demands even in the early stages of PD.

Citations

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Sensors.2024; 24(6): 2015. CrossRef
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