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Prevalence and severity of symptoms suggestive of gastroparesis in prodromal dementia with Lewy bodies

Lookup NU author(s): Dr Rory Durcan, Dr Paul Donaghy, Nicola Barnett, Kirsty Olsen, Dr Alison Yarnall, Dr John-Paul Taylor, Professor Ian McKeith, Professor John O'Brien, Professor Alan Thomas

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Abstract

© 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.


Publication metadata

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

Year: 2019

Pages: Epub ahead of print

Online publication date: 22/03/2019

Acceptance date: 17/03/2019

ISSN (print): 0885-6230

ISSN (electronic): 1099-1166

Publisher: John Wiley and Sons Ltd

URL: https://doi.org/10.1002/gps.5100

DOI: 10.1002/gps.5100

PubMed id: 30901488


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