Can constipation be the key to early diagnosis of Parkinson's disease?

The research team has discovered a potential way to diagnose the disease up to 20-years prior using what may seem an unusual method: investigating and understanding the process behind constipation.

Nancy Van Der Stracten, 75-year-old suffering from Parkinson's disease, poses during a boxing practice break in the ring at a boxing club in the southern resort city of Antalya, Turkey, February 26, 2021. (photo credit: REUTERS/UMIT BEKTAS)
Nancy Van Der Stracten, 75-year-old suffering from Parkinson's disease, poses during a boxing practice break in the ring at a boxing club in the southern resort city of Antalya, Turkey, February 26, 2021.
(photo credit: REUTERS/UMIT BEKTAS)
By the time Parkinson's disease, one of the most common neurological disorders is diagnosed, the progression of the disease cannot be reversed, leaving doctors with one option: to treat the symptoms.
However, a Hebrew University of Jerusalem research team has discovered a potential way to diagnose the disease up to 20 years prior using what may seem an unusual method: investigating and understanding the physiological process behind constipation.
The research was conducted by the university's Prof. Joshua Goldberg, from the department of medical neurobiology, in collaboration with Prof. Jochen Roeperf from the Goethe University in Frankfurt, Germany. The study was published in Science Advances
"Consider a 55 to 60-year-old patient suffering from constipation," Goldberg said. "We may someday design a test based on the neural changes we discovered to determine whether there is a neural factor at play which could hint to Parkinson’s."
How does Parkinson's work? 
Dopamine cells cease to reach the brain, leading to the loss of cells. 
The number of cells that are lost in the process is massive by the time the disease is usually diagnosed, which is why recovery is so difficult. This leads to visible motor symptoms in the patient that indicate the presence of the disease. 
Constipation is one of the few non-motor symptoms of Parkinson's. It is actually quite common, and can be a lead indicator of the disease if it is analyzed as such early – as early as 20 years. 
The hypothesis is based on the discovery of Lewy bodies, tiny deposits of protein waste within brain cells. The discovery was headed by Dr. Friedrich Lewy in 1912. 
In the early 2000s, researchers analyzed the path that the Lewy bodies take in the brains of Parkinson's patients. Though nothing conclusive came of it, they suggested that the buildup of the protein waste wasn't occurring in random places in the brain, but rather in intentional ones, in places that control the healthy functioning of body parts. 
Particularly, they saw that one of the first places the Lewy bodies were found in was the area that controls gastrointestinal movement, potentially explaining connection. 
The research gave substantiated this hypothesis by over-expressing the alpha-synuclein protein, a specific protein that is known to heighten the activity of Lewy bodies in the area of the brain that controls gastrointestinal activity, in the brains of lab mice. 
A model for slowing down the digestive system following the expression of alpha-synuclein protein in the brainstem. (Credit: J. GOLDBERG/J. ROEPER)A model for slowing down the digestive system following the expression of alpha-synuclein protein in the brainstem. (Credit: J. GOLDBERG/J. ROEPER)
They found that by over-expressing the protein, the electrical activity of the brain cells slowed down – the cells literally shrunk. They were then able to link this to human brains in the early stages of Parkinson's.