Can understanding constipation help diagnose Parkinson's disease earlier?

• Author: Arutz Sheva Staff
• Date: 11 March 2021
• Published date: 11 March 2021

Unfortunately by the time the disease is diagnosed too many dopamine cells are lost, limiting the prospects for recovery. Instead, the available treatments target the symptoms of PD, but cannot reverse the progression of the disease.

But a recent discovery by a team from the Hebrew University of Jerusalem led by Professor Joshua Goldberg of the Department of Medical Neurobiology has successfully identified a chain of cellular and physiological events that have the potential to provide some help in diagnosing the disease years earlier.

Specifically, the research conducted in collaboration with Professor Jochen Roeper of the Goethe University in Frankfurt, Germany and published in the journal Science Advances, hypothesizes that one possible key for diagnosing Parkinson's disease earlier is to better understand the physiological process underlying constipation, which is a common – while not usually discussed – non-motor symptom of PD. Importantly, constipation can predate diagnosis by up to 20 years.

The path to this latest discovery goes all the way back to 1912 when Dr. Friedrich Lewy first published the existence of a buildup of tiny deposits of protein waste within brain cells called Lewy bodies. Twenty years ago researchers elaborated on this finding and described how these Lewy bodies spread throughout the brain of PD patients. But while this finding was viewed as a potentially groundbreaking, the Lewy bodies remain clinically inaccessible preventing the ability to determine whether a person has them, even though they may be lurking in the brain for many years before diagnosis..

The science thus focused on trying to link the Lewy body buildup with specific known non-motor symptoms of Parkinson's. These included anxiety, sleep disorder, loss of the sense of smell and, notably, constipation.

Scientists proposed that the Lewy bodies were building up in specific areas of the brain and killing the brain cells that control the healthy functioning of relevant parts of the body. Interestingly, one of the first locations where Lewy bodies are found in the brain is an area that affects gastrointestinal motility, providing a potential explanation for constipation in Parkinson's patients.

The problem with this proposition is that Lewy bodies do not necessarily kill brain cells, and may instead represent the cells' coping mechanism. Therefore, Professor Goldberg's team, searched for a mechanistic explanation tying Lewy bodies to constipation that does not depend on...