Constipation in Parkinson's Disease: a Nuisance or Nuanced Answer to the Pathophysiological Puzzle?
Constipation in Parkinson's Disease: a Nuisance or Nuanced Answer to the Pathophysiological Puzzle?
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DOI：
10.1007/s11894-018-0609-x
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发表时间：
2018-01-19
影响因子：
--
通讯作者：
Rao, Satish S C
中科院分区：
文献类型：
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作者：
Sharma, Amol;Kurek, Julie;Rao, Satish S C
综述目的：慢性便秘是帕金森病（PD）常见的非运动性前驱症状。其潜在的神经病理学可能提供PD的病理生理学见解。在这里，我们严格审查目前已知的神经解剖学和脑肠道的相互作用，和路易病理（LP）在三个层次的起源和进展-脑/脑干，脊髓，肠神经system.Recent发现：最近的许多研究已经说明了检查LP的组织中获得的PD患者的结肠活检的挑战。大规模流行病学研究尚未证实广泛接受的Braakpostula。在这篇综述中，我们提出了另一种起源和传播途径的LP在PD。我们描述了新型的非侵入性神经生理学测试，可以促进对LP和PD中复杂的双向脑-盆底神经通路的了解--PD是神经胃肠道疾病的真正疾病模型。这篇综述可能会为未来的研究提供动力，调查肠道和大脑的相互作用和便秘的PD。
PURPOSE OF REVIEW: Chronic constipation is a common, nonmotor, and prodromal symptom in Parkinson's disease (PD). Its underlying neuropathology may provide pathophysiological insight into PD. Here, we critically review what is currently known about the neuroanatomical and brain-gut interactions, and the origin and progression of Lewy pathology (LP) at three levels-brain/brainstem, spinal cord, and enteric nervous system.RECENT FINDINGS: Many recent studies have illustrated the challenges of examining LP in tissues obtained from colon biopsies of PD patients. Large-scale epidemiological studies have not confirmed the widely accepted Braakpostula. In this review, we propose an alternative origin and route of spread of LP in PD. We describe novel, noninvasive neurophysiological testing that could advance the understanding of LP and complex bidirectional brain-pelvic floor neural pathways in PD-a true disease model of a neurogastrointestinal disorder. This review may provide the impetus for future studies investigating gut and brain interaction and constipation in PD.