Abstract Details

Title Lifelong Constipation in Synucleinopathies: An Incident Cohort Study in Olmsted County, MN (1991-2010).

Topic Movement Disorders

Presentation(s) P13 - Poster Session 13 (8:00 AM-9:00 AM)

Poster/Presentation
Number 5-006

Background Constipation is a well-described premotor feature of Parkinson’s disease (PD); however, only few studies have explored the lifelong rate of constipation in Parkinson’s disease dementia (PDD), Dementia with Lewy Bodies (DLB), and Multiple System Atrophy (MSA).

Objective To explore the lifelong association of constipation in α-Synucleinopathies compared to age- and sex-matched controls.

Design/Methods We used the Rochester Epidemiology Project (REP) to establish an incident cohort of α-Synucleinopathies between 1991-2010. A movement disorder specialist reviewed all medical charts to confirm the clinical diagnoses. Secondary causes for constipation were excluded. Every case was paired with an age- and sex-matched control.

Results

Among 453 cases of overt α-Synucleinopathies, 303 had PD, 80 DLB, 54 PDD, and 16 MSA. Constipation was present in about 50% of all α-Synucleinopathies (50% of PD, 53% of DLB, 44% of PDD, and 50% of MSA), with half of the cases having onset before overt α-Synucleinopathies onset.
Among all synucleinopathies, DLB had the earliest median onset of constipation in the pre-motor phase (3.8 years prior to symptoms onset, IQR= 1.7-5.9). Whereas in the post-motor phase, PD had the latest median onset of constipation (5.2 years after symptoms onset, IQR= 2.7-8.0). PD patients had the highest frequency (18.2%) of longstanding constipation (onset >20 years prior to motor symptoms onset).
All patients later diagnosed with α-Synucleinopathies, except for MSA (p= 0.09), had higher odds of reporting constipation prior to the onset of motor symptoms as compared to controls.

Conclusions PD, DLB, and PDD had higher odds of having constipation before motor symptoms onset, as compared to controls. PD was most likely associated with longstanding constipation (>20 years before symptoms onset). Our results indicate that constipation rates (overall, pre-, and post-motor) do not differ among α-Synucleinopathies; however, temporal onset of constipation showed differences among α-Synucleinopathies, possibly due to differences in disease etiology and/or α-Synuclein spread.

Authors/Disclosures
Pierpaolo Turcano, MD (Mayo Clinic) PRESENTER	Dr. Turcano has nothing to disclose.
Emanuele Camerucci, MD (Kansas University Medical Center)	Dr. Camerucci has nothing to disclose.
Aidan Mullan (Mayo Clinic)	No disclosure on file
Cole D. Stang	Mr. Stang has nothing to disclose.
Adil Bharucha	No disclosure on file
	No disclosure on file
Bradley F. Boeve, MD, FAAN (Mayo Clinic)	Dr. Boeve has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for Rainwater Charitable Foundation. The institution of Dr. Boeve has received research support from Alector. The institution of Dr. Boeve has received research support from EIP Pharma. The institution of Dr. Boeve has received research support from Transposon. The institution of Dr. Boeve has received research support from Cognition Therapeutics. Dr. Boeve has received publishing royalties from a publication relating to health care.
James H. Bower, MD, MSc, FAAN (Mayo Clinic)	The institution of Dr. Bower has received research support from Abbvie.
J. E. Ahlskog, MD, PhD (Mayo Clinic)	Dr. Ahlskog has received publishing royalties from a publication relating to health care.
Rodolfo Savica, MD, PhD, FAAN (Mayo Clinic)	The institution of Dr. Savica has received research support from ACADIA Pharmaceuticals, Inc.