Lookup NU author(s): Dr Rory Durcan,
Dr Paul Donaghy,
Dr Alison Yarnall,
Professor John-Paul Taylor,
Professor Ian McKeith,
Professor John O'Brien,
Professor Alan Thomas
This is the authors' accepted manuscript of an article that has been published in its final definitive form by John Wiley and Sons Ltd, 2019.
For re-use rights please refer to the publisher's terms and conditions.
© 2019 John Wiley & Sons, Ltd. Introduction: Lewy body disease is postulated, by the Braak model, to originate in the enteric nervous system, before spreading to the central nervous system. Therefore, a high prevalence of gastroparesis symptoms would be expected in prodromal dementia with Lewy bodies (DLB) and be highest in those with a dopaminergic deficit on imaging. The aim of this study was to explore whether gastroparesis symptoms are an early diagnostic marker of prodromal DLB and explore the relationship between symptoms and dopaminergic imaging findings on FP-CIT SPECT. Methods: We recruited 75 patients over 60 with mild cognitive impairment (MCI), 48 with MCI with suspected Lewy body disease (MCI-LB) and 27 with MCI with suspected Alzheimer's disease (MCI-AD). All patients completed the Gastroparesis Cardinal Symptom Index (GSCI) questionnaire and also underwent FP-CIT [ 123 I-N-fluoropropyl-2β-carbomethoxy-3β-(4-iodophenyl)] dopaminergic imaging. Results: At least one symptom suggestive of gastroparesis was reported in 48% (n = 23) MCI-LB vs 37% MCI-AD (n = 10) (P = 0.36). Rates of definite symptoms of gastroparesis, as defined by a GCSI total score ≥ 1.90, were rare and rates in MCI-LB were not different from MCI-AD (6% vs 0%, p = 0.55). After adjusting for gender differences between groups, no difference in gastroparesis symptom prevalence (2.27 vs 0.81 P = 0.05) or severity score (0.62 vs 0.28, p = 0.28) was noted between normally and abnormally visually rated FP-CIT SPECT scans. Conclusion: The GCSI is not a useful tool for differentiating MCI-LB from MCI-AD. A low rate of definite gastroparesis was detected in prodromal DLB. No association was found between gastroparesis symptoms and FP-CIT SPECT findings.
Author(s): Durcan R, Donaghy PC, Barnett NA, Olsen K, Yarnall AJ, Taylor J-P, McKeith I, O'Brien JT, Thomas AJ
Publication type: Article
Publication status: Published
Journal: International Journal of Geriatric Psychiatry
Print publication date: 01/07/2019
Online publication date: 22/03/2019
Acceptance date: 17/03/2019
Date deposited: 22/07/2019
ISSN (print): 0885-6230
ISSN (electronic): 1099-1166
Publisher: John Wiley and Sons Ltd
PubMed id: 30901488
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