Gastrointestinal Motility and Response to Levodopa in Parkinson's Disease: A Proof-of-Concept Study

Delaram Safarpour; Barbara H. Brumbach; Monica Arena; Joseph Quinn; Sarah Diamond; Jay G. Nutt; Ronald F. Pfeiffer

doi:10.1002/mds.29176

Gastrointestinal Motility and Response to Levodopa in Parkinson's Disease: A Proof-of-Concept Study

Delaram Safarpour, Barbara H. Brumbach, Monica Arena, Joseph Quinn, Sarah Diamond, Jay G. Nutt, Ronald F. Pfeiffer

Research output: Contribution to journal › Article › peer-review

3 Scopus citations

Abstract

Background: Simultaneous measurement of gastrointestinal transit time (GITT) and plasma levodopa concentration (PLC) is crucial to understanding the effect of dysfunctional motility on levodopa response in patients with Parkinson's disease (PwPD). Objective: The aim is to determine if altered segmental GITT correlates with clinical response and PLC variability in PwPD. Methods: Ten typical and 10 erratic responders ingested the SmartPill (SP) wireless motility capsule. Serial PLC and finger tapping, obtained every 30 minutes for 3 hours after SP/levodopa ingestion, evaluated the correlation between GITT, clinical response, and PLC. Glucose breath testing assessed small intestinal bacterial overgrowth (SIBO). Results: GITT was not significantly different in “typical” and “erratic” responders. SIBO was positive in half of the erratic and negative in most typical responders. Conclusion: SP is a feasible technology for assessing GITT in PwPD. A larger study may be able to significantly differentiate/correlate GITT in different segments of the GI tract with response to levodopa.

Original language	English (US)
Pages (from-to)	2153-2158
Number of pages	6
Journal	Movement Disorders
Volume	37
Issue number	10
DOIs	https://doi.org/10.1002/mds.29176
State	Published - Oct 2022

Keywords

Parkinson's disease
gastrointestinal dysmotility
gastrointestinal transit time
levodopa response
small intestinal bacterial overgrowth

ASJC Scopus subject areas

Neurology
Clinical Neurology

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10.1002/mds.29176

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title = "Gastrointestinal Motility and Response to Levodopa in Parkinson's Disease: A Proof-of-Concept Study",

abstract = "Background: Simultaneous measurement of gastrointestinal transit time (GITT) and plasma levodopa concentration (PLC) is crucial to understanding the effect of dysfunctional motility on levodopa response in patients with Parkinson's disease (PwPD). Objective: The aim is to determine if altered segmental GITT correlates with clinical response and PLC variability in PwPD. Methods: Ten typical and 10 erratic responders ingested the SmartPill (SP) wireless motility capsule. Serial PLC and finger tapping, obtained every 30 minutes for 3 hours after SP/levodopa ingestion, evaluated the correlation between GITT, clinical response, and PLC. Glucose breath testing assessed small intestinal bacterial overgrowth (SIBO). Results: GITT was not significantly different in “typical” and “erratic” responders. SIBO was positive in half of the erratic and negative in most typical responders. Conclusion: SP is a feasible technology for assessing GITT in PwPD. A larger study may be able to significantly differentiate/correlate GITT in different segments of the GI tract with response to levodopa.",

keywords = "Parkinson's disease, gastrointestinal dysmotility, gastrointestinal transit time, levodopa response, small intestinal bacterial overgrowth",

author = "Delaram Safarpour and Brumbach, {Barbara H.} and Monica Arena and Joseph Quinn and Sarah Diamond and Nutt, {Jay G.} and Pfeiffer, {Ronald F.}",

note = "Publisher Copyright: {\textcopyright} 2022 International Parkinson and Movement Disorder Society.",

year = "2022",

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doi = "10.1002/mds.29176",

language = "English (US)",

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AU - Quinn, Joseph

AU - Diamond, Sarah

AU - Nutt, Jay G.

AU - Pfeiffer, Ronald F.

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AB - Background: Simultaneous measurement of gastrointestinal transit time (GITT) and plasma levodopa concentration (PLC) is crucial to understanding the effect of dysfunctional motility on levodopa response in patients with Parkinson's disease (PwPD). Objective: The aim is to determine if altered segmental GITT correlates with clinical response and PLC variability in PwPD. Methods: Ten typical and 10 erratic responders ingested the SmartPill (SP) wireless motility capsule. Serial PLC and finger tapping, obtained every 30 minutes for 3 hours after SP/levodopa ingestion, evaluated the correlation between GITT, clinical response, and PLC. Glucose breath testing assessed small intestinal bacterial overgrowth (SIBO). Results: GITT was not significantly different in “typical” and “erratic” responders. SIBO was positive in half of the erratic and negative in most typical responders. Conclusion: SP is a feasible technology for assessing GITT in PwPD. A larger study may be able to significantly differentiate/correlate GITT in different segments of the GI tract with response to levodopa.

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Gastrointestinal Motility and Response to Levodopa in Parkinson's Disease: A Proof-of-Concept Study

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