Motor fluctuations and Helicobacter pylori in Parkinson's disease
2013 (English)In: Journal of Neurology, ISSN 0340-5354, E-ISSN 1432-1459, Vol. 260, no 12, 2974-2980 p.Article in journal (Refereed) Published
The presence of Helicobacter pylori(HP) in the gastrointestinal tract may limit the absorption of levodopa.The objectives of this study were to investigate whether HPinfection may affect the clinical response to levodopa aswell as levodopa dose requirement in patients with Par-kinson’s disease (PD) as well as to investigate whether HPinfection may affect plasma levels of vitamin B12, folicacid, and homocysteine. Seventy-five patients with PDdiagnosed at least 4 years ago were included. Symptomfluctuations were assessed by UPDRS-IV and the WOQ9wearing-off-scale. Plasma levels of vitamin B12, folic acid,and homocysteine were analyzed. Screening for HP wasperformed with a 13C-labeled urea breath test (DiabactUBT). A propensity-matched analysis was made where each patient in the HP-infected group was matched withone patient in the non-infected group with respect to age and gender. Of the 75 included patients, 20 were HPinfected (27 %). Median Hoehn & Yahr scores were 3 inboth HP infected patients and the matched group (n=20).HP-infected patients had decreased ‘‘complications of therapy’’ with average total UPDRS-IV score of 4.8±3.0vs. 7.7±3.8 (p\0.05), despite no significant differencein levodopa equivalent dose. Wearing-off and sleep disturbance were significantly less common in the HP group(p\0.05). There were no differences regarding vitaminB12, folic acid, or homocysteine values. HP infection in patients with PD may result in a decreased occurrence of symptom fluctuations according to this small study. This finding may be due to altered absorption of levodopa in the gastrointestinal tract in patients with HP infection, but further studies are required
Place, publisher, year, edition, pages
2013. Vol. 260, no 12, 2974-2980 p.
Research subject Neurology
IdentifiersURN: urn:nbn:se:uu:diva-211210DOI: 10.1007/s00415-013-7089-6ISI: 000327849400004OAI: oai:DiVA.org:uu-211210DiVA: diva2:665933