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Prevalence and severity of symptoms suggestive of gastroparesis in prodromal dementia with Lewy bodies

International Journal of Geriatric Psychiatry Apr 30, 2019

Durcan R, et al. - In view of the hypothesis (by the Braak model) that Lewy body disease originates in the enteric nervous system before spreading to the central nervous system, researchers investigated the diagnostic value of gastroparesis symptoms for prodromal dementia with Lewy bodies (DLB) and how symptoms and dopaminergic imaging findings on FP-CIT SPECT are correlated. Seventy-five patients over 60 with mild cognitive impairment (MCI), 48 with MCI with suspected Lewy body disease (MCI-LB), and 27 with MCI with suspected Alzheimer's disease (MCI-AD) filled out the Gastroparesis Cardinal Symptom Index (GSCI) questionnaire and had FP-CIT [123I-N-fluoropropyl-2β-carbomethoxy-3β-(4-iodophenyl)] dopaminergic imaging. In 48% of the MCI-LB group vs 37% of the MCI-AD group at least one gastroparesis-like symptom was seen. In prodromal DLB, they detected a low rate of definite gastroparesis (as defined by a Gastroparesis Cardinal Symptom Index total score ≥ 1.90); rates in MCI-LB were similar to MCI-AD. The MCI-LB cohort showed no correlation between gastroparesis symptoms prevalence or severity and dopaminergic imaging findings on FP-CIT SPECT. Findings suggest no utility of Gastroparesis Cardinal Symptom Index for differentiating MCI-LB from MCI-AD, and thereby do not support the Braak model of sequential alpha-synuclein spread in prodromal DLB.

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