Analysis of parkinson's disease patients with Gastrointestinal symptoms using structural and functional magnetic resonance imaging.

Abstract

Gastrointestinal symptoms are one of the most common non-motor symptoms in Parkinson's disease. This study aimed to investigate the neuroimaging mechanisms underlying gastrointestinal symptoms associated with Parkinson's disease using functional connectivity and voxel-based morphometry. The study included 50 healthy controls, 71 Parkinson's disease patients without gastrointestinal symptoms and 84 patients with gastrointestinal symptoms. Differences in gray matter volume among the three groups were assessed. Given a significant decrease in gray matter volume in the right cerebellar hemisphere, it was selected as the seed region for functional connectivity analysis.The Parkinson's disease patients with gastrointestinal symptoms showed significant differences in disease duration, levodopa equivalents daily dose, Hoehn and Yahr stage, unified Parkinson's disease rating scale part Ⅲ, Hamilton anxiety scale, Scales for Outcomes in Parkinson's disease-Autonomic, non-motor symptom scale, Montreal cognitive assessment, and orthostatic hypotension compared to the patients without gastrointestinal symptoms (p<0.05). Lower gray matter volume was observed in the group with gastrointestinal symptoms, particularly in the bilateral cerebellum hemisphere and the left superior temporal gyrus. Compared to the group without gastrointestinal symptoms, functional connectivity between the right cerebellar hemisphere and the right medial and lateral cingulate gyrus and left middle temporal lobe was significantly increased.Parkinson's disease patients with gastrointestinal symptoms present with a prolonged disease course and increased severity of both motor and non-motor symptoms. The gastrointestinal symptoms in Parkinson's disease patients may be associated with structural and functional brain alterations.