Can constipation be the key to early diagnosis of Parkinson’s disease?

By the time Parkinson’s disease, one of the most common neurological disorders is diagnosed, the progression of the disease cannot be reversed, leaving doctors with one option: to treat the symptoms. However, a research team from the Hebrew University of Jerusalem discovered a potential way to diagnose the disease up to 20 years ago using what may seem like an unusual method: to study and understand the physiological process behind constipation.

“Let’s take a 55 to 60 year old patient with constipation,” Goldberg said. “We may one day design a test based on the neural changes we have discovered to determine if there is a neural factor at play that might hint at Parkinson’s disease.”

How does Parkinson’s disease work?

Dopaminergic cells stop reaching the brain, resulting in the loss of cells.

The number of cells lost in the process is huge by the time the disease is usually diagnosed, which is why recovery is so difficult. This leads to visible motor symptoms in the patient which indicate the presence of the disease.

Constipation is one of the rare non-motor symptoms of Parkinson’s disease. It is, in fact, quite common and can be a main indicator of the disease if it is analyzed as such early on – as early as 20 years old.

The hypothesis is based on the discovery of Lewy bodies, tiny deposits of protein waste in brain cells. The discovery was led by Dr. Friedrich Lewy in 1912.

In the early 2000s, researchers analyzed the path taken by Lewy bodies in the brains of patients with Parkinson’s disease. While nothing conclusive came out of it, they suggested that the buildup of protein waste did not occur in random places in the brain, but rather in intentional places, in places that control the healthy functioning of parts of the brain. body.

In particular, they saw that one of the first places Lewy bodies were found was the area that controls gastrointestinal movement, potentially explaining the connection.

Research confirmed this hypothesis by overexpressing alpha-synuclein protein, a specific protein known to increase Lewy body activity in the area of ​​the brain that controls gastrointestinal activity, in the brains of lab mice. A model for slowing down the digestive system following the expression of the protein alpha-synuclein in the brainstem. (Credit: J. GOLDBERG / J. ROEPER)

They found that by overexpressing the protein, the electrical activity of brain cells slowed down – the cells literally shrank. They were then able to establish a link with the human brain in the early stages of Parkinson’s disease.