title: Unimpaired postprandial pancreatic polypeptide secretion in Parkinson's disease and REM sleep behavior disorder.
abstract: BACKGROUND
  Pancreatic polypeptide is released immediately after food ingestion. The release is operated by vagal-abdominal projections and has therefore been suggested as a test for vagal nerve integrity. Pathoanatomical and clinical studies indicate vagal dysfunction in early Parkinson's disease (PD).
  
  
  METHODS
  We assessed the postprandial secretion of pancreatic polypeptide and motilin in healthy controls (n = 18) and patients with idiopathic rapid-eye-movement sleep behavior disorder (iRBD, n = 10), a potential premotor stage of PD, as well as in drug-naive (n = 19) and treated (n = 19) PD patients.
  
  
  RESULTS
  The postprandial pancreatic polypeptide secretion showed a physiological pattern in all groups and even an enhanced response in drug-naive PD and iRBD. Motilin concentrations correlated with pancreatic polypeptide concentrations.
  
  
  CONCLUSIONS
  Postprandial pancreatic polypeptide secretion is not a suitable test for vagal nerve integrity in PD. The unimpaired pancreatic polypeptide response in iRBD and PD might be explained by partially intact vagal-abdominal projections or compensatory mechanisms substituting a defective neuronal brain-gut axis.
authors.affiliation: Department of Neurology, Philipps-University Marburg, Marburg, Germany. marcus.unger@uks.eu
authors.forename: Marcus M
authors.initials: MM
authors.lastname: Unger
authors.forename: Rolf
authors.initials: R
authors.lastname: Ekman
authors.forename: Anna-Karin
authors.initials: AK
authors.lastname: Björklund
authors.forename: Gösta
authors.initials: G
authors.lastname: Karlsson
authors.forename: Chatarina
authors.initials: C
authors.lastname: Andersson
authors.forename: Katharina
authors.initials: K
authors.lastname: Mankel
authors.forename: Katharina
authors.initials: K
authors.lastname: Bohne
authors.forename: Johannes J
authors.initials: JJ
authors.lastname: Tebbe
authors.forename: Karin
authors.initials: K
authors.lastname: Stiasny-Kolster
authors.forename: Jens C
authors.initials: JC
authors.lastname: Möller
authors.forename: Geert
authors.initials: G
authors.lastname: Mayer
authors.forename: Peter H
authors.initials: PH
authors.lastname: Kann
authors.forename: Wolfgang H
authors.initials: WH
authors.lastname: Oertel
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009037:Motilin / Q000096:biosynthesis; D010191:Pancreatic Polypeptide / Q000096:biosynthesis*; D010300:Parkinson Disease / Q000378:metabolism* / Q000503:physiopathology; D019518:Postprandial Period / Q000502:physiology; D020187:REM Sleep Behavior Disorder / Q000378:metabolism* / Q000503:physiopathology
chemical_list: D009037:Motilin; D010191:Pancreatic Polypeptide