TY - JOUR
T1 - Anorectal function in fluctuating (on‐off) Parkinson's disease
T2 - Evaluation by combined anorectal manometry and electromyography
AU - Ashraf, Waseem
AU - Wszolek, Zbigniew K.
AU - Pfeiffer, Ronald F.
AU - Normand, Marlene
AU - Maurer, Kenneth
AU - Srb, Faye
AU - Edwards, Loraine L.
AU - Quigley, Eamonn M.M.
PY - 1995/9
Y1 - 1995/9
N2 - Anorectal dysfunction and constipation are well recognized in Parkinson's disease and may reflect the direct involvement of the gastrointestinal tract by the primary Parkinson's disease process. We hypothesized, therefore, that anorectal function would alter in parallel with fluctuations in motor function related to on‐ and off‐periods in Parkinson's disease, and employed combined anorectal manometry and electromyography to investigate anorectal function during both on‐ and off‐periods in patients with Parkinson's disease. Manometric recordings revealed a deterioration in voluntary sphincter squeeze during off‐periods (squeeze index, on versus off, mean ± SEM: 46.4 ± 11.1 versus 29.6 ± 7.9 mm Hg, p < 0.05); correspondingly, simultaneous electromyographic (EMG) recordings showed poor recruitment of external anal sphincter and puborectalis muscles during off‐periods. A hypercontractile (“paradoxical”) rectosphincteric reflex response occurred during both on‐ and off‐periods, and was associated with an increase in EMG activity in the external sphincter and/or the puborectalis muscle. These changes in manometric and EMG parameters paralleled changes in overall motor function. These findings provide further support for the involvement of the pelvic floor musculature in the Parkinson's disease process and also provide EMG correlates for some of the manometric abnormalities described in Parkinson's disease.
AB - Anorectal dysfunction and constipation are well recognized in Parkinson's disease and may reflect the direct involvement of the gastrointestinal tract by the primary Parkinson's disease process. We hypothesized, therefore, that anorectal function would alter in parallel with fluctuations in motor function related to on‐ and off‐periods in Parkinson's disease, and employed combined anorectal manometry and electromyography to investigate anorectal function during both on‐ and off‐periods in patients with Parkinson's disease. Manometric recordings revealed a deterioration in voluntary sphincter squeeze during off‐periods (squeeze index, on versus off, mean ± SEM: 46.4 ± 11.1 versus 29.6 ± 7.9 mm Hg, p < 0.05); correspondingly, simultaneous electromyographic (EMG) recordings showed poor recruitment of external anal sphincter and puborectalis muscles during off‐periods. A hypercontractile (“paradoxical”) rectosphincteric reflex response occurred during both on‐ and off‐periods, and was associated with an increase in EMG activity in the external sphincter and/or the puborectalis muscle. These changes in manometric and EMG parameters paralleled changes in overall motor function. These findings provide further support for the involvement of the pelvic floor musculature in the Parkinson's disease process and also provide EMG correlates for some of the manometric abnormalities described in Parkinson's disease.
KW - Anal sphincter electromyography
KW - Anorectal function
KW - Anorectal manometry
KW - Parkinson's disease
KW - “On‐off” fluctuations
UR - http://www.scopus.com/inward/record.url?scp=0029157405&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0029157405&partnerID=8YFLogxK
U2 - 10.1002/mds.870100519
DO - 10.1002/mds.870100519
M3 - Article
C2 - 8552119
AN - SCOPUS:0029157405
SN - 0885-3185
VL - 10
SP - 650
EP - 657
JO - Movement Disorders
JF - Movement Disorders
IS - 5
ER -