Anonymous User
Login / Registration

a hepatologie

Gastroenterology and Hepatology

Gastroent Hepatol 2021; 75(4): 291–297. doi:10.48095/ccgh2021291.

Parkinson‘s disease and GIT involvement

Martin Ďuriček  1, Alžbeta Kráľová Trančíková2, Jana Harsányiová3,4, Patrik Kašovič5, Milan Grofik5, Peter Bánovčin  6

+ Affiliation


Involvement of the upper part of the gastrointestinal tract in patients with Parkinson disease is reported less frequently than the involvement of the lower part. Its clinical impact is, however, substantial because dysphagic symptoms considerably decrease the quality of life and may lead to life threatening complications. Even though the clinical symptoms related to esophageal motility disorders as a result of Parkinson disease are more common in the advanced stages of the disease, these could be dia­gnosed much earlier using high resolution manometry. The authors describe the basic principles of dia­gnostic management of dysphagia in patients with Parkinson disease and in the clinical part they present an analysis of their patient cohort. They found out that nonspecific and diverse motility disorders are present in most patients, even without dysphagic symptoms. In the experimental part, we outlined new possibilities for dia­gnostic procedures using the most up-to-date methods for the detection of pathological forms of alpha-synuclein and advanced microscopic methods.

Key words: esophageal motility disorders – manometry – Parkinson disease – alpha-synuclein – FLIM analysis – immunohistochemistry


imunohistochemie, manometry, poruchy motility jícnu, FLIM analýza, alfa-synuklein, Parkinsonova choroba

To read this article in full, please register for free on this website.

Benefits for subscribers

Benefits for logged users


1. Suttrup I, Suttrup J, Suntrup-Krueger S et al. Esophageal dysfunction in different stages of Parkinson‘s disease. Neurogastroenterol Motil 2017; 29 (1). doi: 10.1111/nmo.12915.
2. Kalf JG, de Swart BJ, Bloem BR et al. Prevalence of oropharyngeal dysphagia in Parkinson‘s disease: a meta-analysis. Parkinsonism Relat Disord 2012; 18 (4): 311–315. doi: 10.1016/j.parkreldis.2011.11.006.
3. Su A, Gandhy R, Barlow C et al. Clinical and manometric characteristics of patients with Parkinson‘s disease and esophageal symptoms. Dis Esophagus 2017; 30 (4): 1–6. doi: 10.1093/ dote/dow038.
4. Derrey S, Chastan N, Maltete D et al. Impact of deep brain stimulation on pharyngo-esophageal motility: a randomized cross-over study. Neurogastroenterol Motil 2015; 27 (9):  1214–1222. doi: 10.1111/nmo.12607.
5. Lashuel HA, Overk CR, Oueslati A et al. The many faces of alpha-synuclein: from structure and toxicity to therapeutic target. Nat Rev Neurosci 2013; 14 (1): 38–48. doi: 10.1038/nrn3406.
6. Oueslati A. Implication of alpha-synuclein phosphorylation at S129 in synucleinopathies: what have we learned in the last decade? J Parkinsons Dis 2016; 6 (1): 39–51. doi: 10.3233/JPD-160779.
7. Braak H, Rüb U, Gai WP et al. Idiopathic Parkinson‘s disease: possible routes by which vulnerable neuronal types may be subject to neuroinvasion by an unknown pathogen. J Neural Transm (Vienna) 2003; 110 (5): 517–536. doi: 10.1007/s00702-002-0808-2.
8. Beach TG, Adler CH, Sue LI et al. Multi-organ distribution of phosphorylated alpha-synuclein histopathology in subjects with Lewy body disorders. Acta Neuropathol 2010; 119 (6): 689–702. doi: 10.1007/s00401-010-0664-3.
9. Gelpi E, Navarro-Otano J, Tolosa E et al. Multiple organ involvement by alpha-synuclein pathology in Lewy body disorders. Mov Disord 2014; 29 (8): 1010–1018. doi: 10.1002/mds.25776.
10. Wakabayashi K, Takahashi H, Takeda S et al. Lewy bodies in the enteric nervous system in Parkinson‘s disease. Arch Histol Cytol 1989; 52 (Suppl): 191–194. doi: 10.1679/aohc.52.suppl_191.
11. Qualman SJ, Haupt HM, Yang P et al. Esophageal Lewy bodies associated with ganglion cell loss in achalasia. Similarity to Parkinson‘s disease. Gastroenterology 1984; 87 (4): 848–856.
12. Wakabayashi K, Takahashi H, Takeda S et al. Parkinson‘s disease: the presence of Lewy bodies in Auerbach‘s and Meissner‘s plexuses. Acta neuropathol 1988; 76 (3): 217–221. doi: 10.1007/bf00687767.
13. Mu L, Sobotka S, Chen J et al. Parkinson disease affects peripheral sensory nerves in the pharynx. J Neuropathol Exp Neurol 2013; 72 (7): 614–623. doi: 10.1097/NEN.0b013e3182965886.
14. Fenyi A, Leclair-Visonneau L, Clairembault T et al. Detection of alpha-synuclein aggregates in gastrointestinal bio­psies by protein misfolding cyclic amplification. Neurobio­l Dis 2019; 129: 38–43. doi: 10.1016/j.nbd.2019.05.002.
15. Harsanyiova J, Ru F, Zatko T et al. Vagus nerves provide a robust afferent innerva- tion of the mucosa throughout the body of the esophagus in the mouse. Dysphagia 2020; 35 (3): 471–478. doi: 10.1007/s00455-019-10051-8.
16. Wang L, Magen I, Yuan PQ et al. Mice overexpressing wild-type human alpha-synuclein display alterations in colonic myenteric ganglia and defecation. Neurogastroenterol Motil 2012; 24 (9): e425–436. doi: 10.1111/j.1365-2982.2012.01974.x.
17. Fricova D, Harsanyiova J, Kralova Tranci­kova A. Alpha-synuclein in the gastrointestinal tract as a potential bio­marker for early detection of Parkinson‘s disease. Int J Mol Sci 2020; 21 (22): 8666. doi: 10.3390/ijms21228666.
18. Plotegher N, Stringari C, Jahid S et al. NADH fluorescence lifetime is an endogenous reporter of alpha-synuclein aggregation in live cells. FASEB J 2015; 29 (6): 2484–2494. doi: 10.1096/fj.14-260281.
19. Pokusa M, Kráľová Trančíková A. FLIM analysis of intracellular markers associated with the development of Parkinson‘s disease in cellular model. Physiol Res 2018; 67 (Suppl 4):  S673–S683. doi: 10.33549/physiolres.934054.

Kreditovaný autodidaktický test