Defecatory function in Parkinson's disease: response to apomorphine.
We evaluated the effects of the dopaminergic agent apomorphine on defecation and anorectal function in patients with Parkinson's disease (PD). A gastrointestinal symptom survey, extrapyramidal assessment, defecating proctogram, and anorectal manometric study were performed in 8 subjects with PD. Basal studies showing abnormalities were repeated following apomorphine administration. Prior defecographic abnormalities were normalized following apomorphine injection in 1 of 3 subjects and significant improvements in manometric parameters were observed in all 5 subjects who underwent repeat anorectal manometry. We conclude that apomorphine can correct anorectal dysfunction in PD, and that these abnormalities may be a consequence of dopamine deficiency secondary to the PD process. These findings may also have therapeutic implications.
Section of Neurology, University of Nebraska Medical Center, Omaha 68198-2045.
L L
LL
Edwards
E M
EM
Quigley
R K
RK
Harned
R
R
Hofman
R F
RF
Pfeiffer
D000368:Aged; D001003:Anal Canal / Q000187:drug effects / Q000503:physiopathology; D001058:Apomorphine / Q000494:pharmacology*; D003672:Defecation / Q000187:drug effects*; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D009130:Muscle, Smooth / Q000187:drug effects / Q000503:physiopathology; D010300:Parkinson Disease / Q000503:physiopathology*; D012007:Rectum / Q000187:drug effects / Q000503:physiopathology
D001058:Apomorphine