There are opposing camps in the Parkinson’s conundrum: “brain first” and “gut first.” The former proposes that Parkinson’s starts in the brain, with a loss of dopamine-producing neurons that eventually leads to muscle stiffness and tremors. The latter suggests that the problem starts with abnormal proteins in the nerves of the digestive tract, which then work their way up to the brain. This is based on the fact that patients report gastrointestinal symptoms, such as constipation, years before the neurological symptoms appear, and that constipation is a big risk factor for Parkinson’s. Now, new research shows that upper gastrointestinal conditions are also a risk factor, according to The Washington Post.
Subhash Kulkarni, a professor at Harvard Medical School, and his colleagues found that people with upper gastrointestinal disease, such as stomach ulcers or damage to the lining of the esophagus or small intestine, were much more likely to develop Parkinson’s disease than those without. They analyzed data from 9,350 mostly middle-aged patients with no history of Parkinson’s disease who underwent upper endoscopy and biopsy between 2000 and 2005. Those who had damage to the mucosal lining of their gastrointestinal tract had a 76% higher risk of developing Parkinson’s disease during the follow-up period (average 15 years).
This supports the theory that damage to the intestinal wall leads to a flood of misfolded alpha-synuclein protein, which eventually spreads from the digestive tract to the brain via the vagus nerve, reports The Washington Post. For patients with upper gastrointestinal disease, “it’s worrying, but not cause for panic,” Kulkarni told KCBS Radio, urging timely treatment and increased patient monitoring. The good news is that if researchers can prove that mucosal damage is an early warning sign of Parkinson’s disease, vigilant doctors may be able to administer neuroprotective treatment before motor symptoms appear. The average time between patients reporting mucosal damage and being diagnosed with Parkinson’s was more than 14 years. (More articles on Parkinson’s disease)
