title: Prevalence of Prodromal Parkinson's Disease as Defined by MDS Research Criteria among Elderly Patients Undergoing Colonoscopy.
abstract: Gastrointestinal symptoms are a well-recognized and common premotor feature of Parkinson's disease (PD). Moreover, multiple studies have assessed the value of colonic α-synuclein as a potential marker of prodromal PD. Recently, the International Parkinson and Movement Disorders Society (MDS) defined research criteria for prodromal PD.
  
  
  
  The aim of our study was to test the MDS research criteria in patients undergoing diagnostic colonoscopies as potential candidates for inclusion in prospective trials evaluating colonic biopsies as a potential biomarker of prodromal PD.
  
  
  
  We evaluated elderly patients without manifest parkinsonism undergoing diagnostic colonoscopies. During the study we assessed all risks and prodromal markers of the MDS research criteria, excluding radiotracer imaging and genetic testing.
  
  
  
  The mean age of the 100 enrolled patients was 61.6±9.7 years; 42 were men. The most common prodromal marker in our cohort was constipation (40%), followed by MDS-UPDRS part III scores of >6 points, excluding action tremor items (39%) and hyposmia (37%). Substantia nigra hyperechogenicity was identified in 9%, and polysomnography confirmed REM sleep behavior disorder in 2% of the patients. Five of the 100 enrolled patients (5%) fulfilled the criteria for probable prodromal PD, while another 3 patients met the 50% probability threshold.
  
  
  
  Our findings suggest, that the prevalence of prodromal PD in patients undergoing diagnostic colonoscopies may be higher compared to the general elderly population, although this should be confirmed in further studies including also matched controls not undergoing colonoscopy. The real prevalence of prodromal PD in this cohort will have to be confirmed in longitudinal follow-up. Patients undergoing diagnostic colonoscopies may be good candidates for multistep screening and inclusion in prospective trials.
authors.affiliation: Department of Neurology, Medical Faculty, P. J. Safarik University, Kosice, Slovakia.|Department of Neurology, University Hospital of L. Pasteur, Kosice, Slovakia.
authors.forename: Matej
authors.initials: M
authors.lastname: Skorvanek
authors.affiliation: Department of Neurology, Medical Faculty, P. J. Safarik University, Kosice, Slovakia.|Department of Neurology, University Hospital of L. Pasteur, Kosice, Slovakia.
authors.forename: Zuzana
authors.initials: Z
authors.lastname: Ladomirjakova
authors.affiliation: Department of Neurology, Medical Faculty, P. J. Safarik University, Kosice, Slovakia.|Department of Neurology, University Hospital of L. Pasteur, Kosice, Slovakia.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Han
authors.affiliation: Department of Neurology, Medical Faculty, P. J. Safarik University, Kosice, Slovakia.|Department of Neurology, University Hospital of L. Pasteur, Kosice, Slovakia.
authors.forename: Norbert
authors.initials: N
authors.lastname: Lesko
authors.affiliation: Department of Neurology, Medical Faculty, P. J. Safarik University, Kosice, Slovakia.|Department of Neurology, University Hospital of L. Pasteur, Kosice, Slovakia.
authors.forename: Eva
authors.initials: E
authors.lastname: Feketeova
authors.affiliation: Department of Neurology, Medical Faculty, P. J. Safarik University, Kosice, Slovakia.
authors.forename: Dominika
authors.initials: D
authors.lastname: Jarcuskova
authors.affiliation: Department of Neurology, Medical Faculty, P. J. Safarik University, Kosice, Slovakia.
authors.forename: Barbora
authors.initials: B
authors.lastname: Repkova
authors.affiliation: Department of Neurology, Medical Faculty, P. J. Safarik University, Kosice, Slovakia.
authors.forename: Peter
authors.initials: P
authors.lastname: Spisak
authors.affiliation: Department of Neurology, Medical Faculty, P. J. Safarik University, Kosice, Slovakia.
authors.forename: Zuzana
authors.initials: Z
authors.lastname: Urbancikova
authors.affiliation: Department of Neurology, Medical Faculty, P. J. Safarik University, Kosice, Slovakia.
authors.forename: Adriana
authors.initials: A
authors.lastname: Vargova
authors.affiliation: 1st Department of Internal Medicine, University Hospital of L. Pasteur in Kosice, Slovakia.
authors.forename: Laura
authors.initials: L
authors.lastname: Gombosova
authors.affiliation: 1st Department of Internal Medicine, University Hospital of L. Pasteur in Kosice, Slovakia.
authors.forename: Maria
authors.initials: M
authors.lastname: Zakuciova
authors.affiliation: 1st Department of Internal Medicine, University Hospital of L. Pasteur in Kosice, Slovakia.
authors.forename: Eduard
authors.initials: E
authors.lastname: Veseliny
authors.affiliation: Gastroenterology Clinic Trebuna s.r.o., Kosice, Slovakia.
authors.forename: Frantisek
authors.initials: F
authors.lastname: Trebuna
authors.affiliation: Department of Histology and Embryology, Medical Faculty, P. J. Safarik University, Kosice, Slovakia.
authors.forename: Eva
authors.initials: E
authors.lastname: Mechirova
authors.affiliation: Department of Neurology, Medical Faculty, P. J. Safarik University, Kosice, Slovakia.|Department of Neurology, University Hospital of L. Pasteur, Kosice, Slovakia.
authors.forename: Zuzana
authors.initials: Z
authors.lastname: Gdovinova
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D003113:Colonoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology*; D015995:Prevalence; D062706:Prodromal Symptoms; D011446:Prospective Studies
chemical_list: D015415:Biomarkers
keywords: Parkinson’s disease; colonoscopy; prodromal; risk factors; screening