Small intestinal bacterial overgrowth in Parkinson's disease

Ai Huey Tan, Sanjiv Mahadeva, Abdul Malik Thalha, Peter Raymond Gibson, Chiun Khang Kiew, Chia Ming Yeat, Sheang Wen Ng, Sheau Phing Ang, Siew Kian Chow, Chong Tin Tan, Hoi Sen Yong, Connie Marras, Susan H Fox, Shen-Yang Lim

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Abstract

Recent studies reported a high prevalence of small intestinal bacterial overgrowth (SIBO) in Parkinson s disease (PD), and a possible association with gastrointestinal symptoms and worse motor function. We aimed to study the prevalence and the potential impact of SIBO on gastrointestinal symptoms, motor function, and quality of life in a large cohort of PD patients. Methods: 103 Consecutive PD patients were assessed using the lactulose-hydrogen breath test; questionnaires of gastrointestinal symptoms and quality of life (PDQ-39); the Unified PD Rating Scale (UPDRS) including on -medication Part III (motor severity) score; and objective and quantitative measures of bradykinesia (Purdue Pegboard and timed test of gait). Patients and evaluating investigators were blind to SIBO status. Results: 25.3 of PD patients were SIBO-positive. SIBO-positive patients had a shorter mean duration of PD (5.2?4.1 vs. 8.1?5.5 years, P=0.007). After adjusting for disease duration, SIBO was significantly associated with lower constipation and tenesmus severity scores, but worse scores across a range of on -medication motor assessments (accounting for 4.2-9.0 of the variance in motor scores). There was no association between SIBO and motor fluctuations or PDQ-39 Summary Index scores. Conclusions: This is the largest study to date on SIBO in PD. SIBO was detected in one quarter of patients, including patients recently diagnosed with the disease. SIBO was not associated with worse gastrointestinal symptoms, but independently predicted worse motor function. Properly designed treatment trials are needed to confirm a causal link between SIBO and worse motor function in PD.
Original languageEnglish
Pages (from-to)535 - 540
Number of pages6
JournalParkinsonism and Related Disorders
Volume20
Issue number5
DOIs
Publication statusPublished - 2014

Cite this

Tan, A. H., Mahadeva, S., Thalha, A. M., Gibson, P. R., Kiew, C. K., Yeat, C. M., ... Lim, S-Y. (2014). Small intestinal bacterial overgrowth in Parkinson's disease. Parkinsonism and Related Disorders, 20(5), 535 - 540. https://doi.org/10.1016/j.parkreldis.2014.02.019
Tan, Ai Huey ; Mahadeva, Sanjiv ; Thalha, Abdul Malik ; Gibson, Peter Raymond ; Kiew, Chiun Khang ; Yeat, Chia Ming ; Ng, Sheang Wen ; Ang, Sheau Phing ; Chow, Siew Kian ; Tan, Chong Tin ; Yong, Hoi Sen ; Marras, Connie ; Fox, Susan H ; Lim, Shen-Yang. / Small intestinal bacterial overgrowth in Parkinson's disease. In: Parkinsonism and Related Disorders. 2014 ; Vol. 20, No. 5. pp. 535 - 540.
@article{a2ed675ccc9244509af0ada468c8cbd0,
title = "Small intestinal bacterial overgrowth in Parkinson's disease",
abstract = "Recent studies reported a high prevalence of small intestinal bacterial overgrowth (SIBO) in Parkinson s disease (PD), and a possible association with gastrointestinal symptoms and worse motor function. We aimed to study the prevalence and the potential impact of SIBO on gastrointestinal symptoms, motor function, and quality of life in a large cohort of PD patients. Methods: 103 Consecutive PD patients were assessed using the lactulose-hydrogen breath test; questionnaires of gastrointestinal symptoms and quality of life (PDQ-39); the Unified PD Rating Scale (UPDRS) including on -medication Part III (motor severity) score; and objective and quantitative measures of bradykinesia (Purdue Pegboard and timed test of gait). Patients and evaluating investigators were blind to SIBO status. Results: 25.3 of PD patients were SIBO-positive. SIBO-positive patients had a shorter mean duration of PD (5.2?4.1 vs. 8.1?5.5 years, P=0.007). After adjusting for disease duration, SIBO was significantly associated with lower constipation and tenesmus severity scores, but worse scores across a range of on -medication motor assessments (accounting for 4.2-9.0 of the variance in motor scores). There was no association between SIBO and motor fluctuations or PDQ-39 Summary Index scores. Conclusions: This is the largest study to date on SIBO in PD. SIBO was detected in one quarter of patients, including patients recently diagnosed with the disease. SIBO was not associated with worse gastrointestinal symptoms, but independently predicted worse motor function. Properly designed treatment trials are needed to confirm a causal link between SIBO and worse motor function in PD.",
author = "Tan, {Ai Huey} and Sanjiv Mahadeva and Thalha, {Abdul Malik} and Gibson, {Peter Raymond} and Kiew, {Chiun Khang} and Yeat, {Chia Ming} and Ng, {Sheang Wen} and Ang, {Sheau Phing} and Chow, {Siew Kian} and Tan, {Chong Tin} and Yong, {Hoi Sen} and Connie Marras and Fox, {Susan H} and Shen-Yang Lim",
year = "2014",
doi = "10.1016/j.parkreldis.2014.02.019",
language = "English",
volume = "20",
pages = "535 -- 540",
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Tan, AH, Mahadeva, S, Thalha, AM, Gibson, PR, Kiew, CK, Yeat, CM, Ng, SW, Ang, SP, Chow, SK, Tan, CT, Yong, HS, Marras, C, Fox, SH & Lim, S-Y 2014, 'Small intestinal bacterial overgrowth in Parkinson's disease', Parkinsonism and Related Disorders, vol. 20, no. 5, pp. 535 - 540. https://doi.org/10.1016/j.parkreldis.2014.02.019

Small intestinal bacterial overgrowth in Parkinson's disease. / Tan, Ai Huey; Mahadeva, Sanjiv; Thalha, Abdul Malik; Gibson, Peter Raymond; Kiew, Chiun Khang; Yeat, Chia Ming; Ng, Sheang Wen; Ang, Sheau Phing; Chow, Siew Kian; Tan, Chong Tin; Yong, Hoi Sen; Marras, Connie; Fox, Susan H; Lim, Shen-Yang.

In: Parkinsonism and Related Disorders, Vol. 20, No. 5, 2014, p. 535 - 540.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Small intestinal bacterial overgrowth in Parkinson's disease

AU - Tan, Ai Huey

AU - Mahadeva, Sanjiv

AU - Thalha, Abdul Malik

AU - Gibson, Peter Raymond

AU - Kiew, Chiun Khang

AU - Yeat, Chia Ming

AU - Ng, Sheang Wen

AU - Ang, Sheau Phing

AU - Chow, Siew Kian

AU - Tan, Chong Tin

AU - Yong, Hoi Sen

AU - Marras, Connie

AU - Fox, Susan H

AU - Lim, Shen-Yang

PY - 2014

Y1 - 2014

N2 - Recent studies reported a high prevalence of small intestinal bacterial overgrowth (SIBO) in Parkinson s disease (PD), and a possible association with gastrointestinal symptoms and worse motor function. We aimed to study the prevalence and the potential impact of SIBO on gastrointestinal symptoms, motor function, and quality of life in a large cohort of PD patients. Methods: 103 Consecutive PD patients were assessed using the lactulose-hydrogen breath test; questionnaires of gastrointestinal symptoms and quality of life (PDQ-39); the Unified PD Rating Scale (UPDRS) including on -medication Part III (motor severity) score; and objective and quantitative measures of bradykinesia (Purdue Pegboard and timed test of gait). Patients and evaluating investigators were blind to SIBO status. Results: 25.3 of PD patients were SIBO-positive. SIBO-positive patients had a shorter mean duration of PD (5.2?4.1 vs. 8.1?5.5 years, P=0.007). After adjusting for disease duration, SIBO was significantly associated with lower constipation and tenesmus severity scores, but worse scores across a range of on -medication motor assessments (accounting for 4.2-9.0 of the variance in motor scores). There was no association between SIBO and motor fluctuations or PDQ-39 Summary Index scores. Conclusions: This is the largest study to date on SIBO in PD. SIBO was detected in one quarter of patients, including patients recently diagnosed with the disease. SIBO was not associated with worse gastrointestinal symptoms, but independently predicted worse motor function. Properly designed treatment trials are needed to confirm a causal link between SIBO and worse motor function in PD.

AB - Recent studies reported a high prevalence of small intestinal bacterial overgrowth (SIBO) in Parkinson s disease (PD), and a possible association with gastrointestinal symptoms and worse motor function. We aimed to study the prevalence and the potential impact of SIBO on gastrointestinal symptoms, motor function, and quality of life in a large cohort of PD patients. Methods: 103 Consecutive PD patients were assessed using the lactulose-hydrogen breath test; questionnaires of gastrointestinal symptoms and quality of life (PDQ-39); the Unified PD Rating Scale (UPDRS) including on -medication Part III (motor severity) score; and objective and quantitative measures of bradykinesia (Purdue Pegboard and timed test of gait). Patients and evaluating investigators were blind to SIBO status. Results: 25.3 of PD patients were SIBO-positive. SIBO-positive patients had a shorter mean duration of PD (5.2?4.1 vs. 8.1?5.5 years, P=0.007). After adjusting for disease duration, SIBO was significantly associated with lower constipation and tenesmus severity scores, but worse scores across a range of on -medication motor assessments (accounting for 4.2-9.0 of the variance in motor scores). There was no association between SIBO and motor fluctuations or PDQ-39 Summary Index scores. Conclusions: This is the largest study to date on SIBO in PD. SIBO was detected in one quarter of patients, including patients recently diagnosed with the disease. SIBO was not associated with worse gastrointestinal symptoms, but independently predicted worse motor function. Properly designed treatment trials are needed to confirm a causal link between SIBO and worse motor function in PD.

UR - http://www.sciencedirect.com/science/article/pii/S1353802014000728

U2 - 10.1016/j.parkreldis.2014.02.019

DO - 10.1016/j.parkreldis.2014.02.019

M3 - Article

VL - 20

SP - 535

EP - 540

JO - Parkinsonism and Related Disorders

JF - Parkinsonism and Related Disorders

SN - 1353-8020

IS - 5

ER -