Unimpaired postprandial pancreatic polypeptide secretion in Parkinson's disease and REM sleep behavior disorder

Mov Disord. 2012 Dec 12. doi: 10.1002/mds.25246. [Epub ahead of print]

Unger MM, Ekman R, Björklund AK, Karlsson G, Andersson C, Mankel K, Bohne K, Tebbe JJ, Stiasny-Kolster K, Möller JC, Mayer G, Kann PH, Oertel WH.

Source

Philipps-University Marburg, Department of Neurology, Marburg, Germany; Saarland University, Department of Neurology, Homburg, Germany. 

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. © 2012 Movement Disorder Society.