Gastrointestinal Dysfunction Bears on the Clinical‐Biological Profile of Parkinson's Disease

BACKGROUND: Gastrointestinal dysfunction (GID) accompanies any phase of Parkinson's disease (PD), underlying differential clinical-pathological trajectories. OBJECTIVE: To investigate associations between GID and peripheral immune or neurodegeneration-related markers in PD. METHODS: One-hundred-and-fourteen patients (n = 55 de novo, DN; n = 59 middle-advanced, MA) completed the Gastrointestinal Dysfunction Scale for PD (GIDS-PD), and other motor and non-motor scales; paired measurement of amyloid-β42, amyloid-β42β/β40, total-tau, phosphorylated-181-tau, total α-synuclein CSF levels, albumin ratio, and peripheral blood cell count were collected. Group and correlation analyses were performed. RESULTS: MA patients had greater GID than DN. GIDS-PD scores directly correlated with MDS-UPDRS-III and non-motor scores in both groups, although more in DN. GIDS-PD scores were directly associated with α-synuclein and inversely with lymphocytes only in DN; conversely, they were positively associated with tau proteins and albumin ratio, and negatively with amyloid-β-peptides in both groups. CONCLUSIONS: The burden of GID increases along the PD course with associated stage-specific clinical-biological patterns.