{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T14:38:22Z","timestamp":1787582302532,"version":"build-2736575974"},"reference-count":64,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T00:00:00Z","timestamp":1775606400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T00:00:00Z","timestamp":1775606400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Gastrointestinal (GI) symptoms such as constipation are prevalent autonomic symptoms seen in prodromal and end\u2010stage Parkinson\u2019s disease (PD). The aim of this systematic review and meta\u2010analysis is to assess the association of GI symptoms and constipation alone with progression and severity of PD\u2010associated cognitive impairment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We searched MEDLINE, Cochrane, and Embase from database inception to 2023 for studies reporting outcomes related to cognitive decline. A random\u2010effects meta\u2010analysis was performed using change in the Montreal Cognitive Assessment (MOCA) as the primary cognitive outcome, and heterogeneity was evaluated (\n                      <jats:styled-content>I<\/jats:styled-content>\n                      <jats:sup>2<\/jats:sup>\n                      ).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Eleven prospective, nine cross\u2010sectional, three retrospective, three case\u2013control, and one randomized controlled studies were included, totaling 7042 PD patients. The presence of GI symptoms like constipation was significantly associated with PD dementia (RR 1.37; 95% CI 1.09, 1.71;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005). However, over 5\u2009years, GI symptoms were not found to be associated with an increased prevalence of PD dementia. In subgroup analysis of three prospective studies, constipation was associated with worsened PD cognitive impairment over 5\u2009years (decreased MOCA score by 1.259 points; 95% CI \u22122.059, \u22120.459;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>GI symptoms, and constipation specifically, were commonly reported among patients with PD dementia. In a subgroup analysis of prospective studies, worsening constipation seemed to correlate with greater cognitive impairment over 5\u2009years. Although this meta\u2010analysis did not establish causation, these findings highlight the potential importance of monitoring constipation in PD individuals as ongoing research about the role of the gut\u2010brain axis continues.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgh.70373","type":"journal-article","created":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T08:27:02Z","timestamp":1775636822000},"page":"1659-1669","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Association of Gastrointestinal Symptoms With Severity and Progression of Cognitive Impairment in Parkinson\u2019s Disease: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-5366-8315","authenticated-orcid":false,"given":"Kimberly","family":"Ho","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Brown University  Providence Rhode Island USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeena","family":"Khan","sequence":"additional","affiliation":[{"name":"Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5489-4789","authenticated-orcid":false,"given":"Abraham\u00a0Z.","family":"Cheloff","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology NYU Langone  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashish","family":"Malhotra","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology NYU Langone  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aasma","family":"Shaukat","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology NYU Langone  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,8]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra2401857"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2018.00170"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415\u2010015\u20107888\u2010z"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0261302"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1155\/2020\/1694547"},{"key":"e_1_2_7_7_1","unstructured":"A.YadavandM.Tandon \u201cStudy of Non\u2010Motor Symptoms in a North Indian Cohort of Parkinson's Disease. presented at: Annals of Indian Academy of Neurology Conference \u201d 25th Annual Meeting of the Indian Academy of Neurology IANCON 2017 2017; Chennai India."},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/mdc3.13122"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnagi.2023.1240971"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2021.12.015"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.29399\/npa.27486"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/mdc3.13262"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.13290"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415\u2010012\u20106557\u20108"},{"key":"e_1_2_7_15_1","unstructured":"P.Bugalho F.Ladeira R.Barbosa et\u00a0al. \u201cProgression in Parkinson\u2019s Disease: Variation in Motor and Non\u2010Motor Symptoms Severity and Predictors of Decline in Cognition Motor Function Incapacity and Health Related Quality of Life [abstract] \u201d (2020) 35 (suppl 1) accessed January 18 2025 https:\/\/www.mdsabstracts.org\/abstract\/progression\u2010in\u2010parkinsons\u2010disease\u2010variation\u2010in\u2010motor\u2010and\u2010non\u2010motor\u2010symptoms\u2010severity\u2010and\u2010predictors\u2010of\u2010decline\u2010in\u2010cognition\u2010motor\u2010function\u2010incapacity\u2010and\u2010health\u2010related\u2010quality\u2010of\u2010life\/."},{"issue":"1","key":"e_1_2_7_16_1","article-title":"Non\u2010Motor Symptoms in Parkinson\u2019s Disease","volume":"36","author":"Elfekih M.","year":"2021","journal-title":"Movement Disorders"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.5152\/npa.2016.12758"},{"key":"e_1_2_7_18_1","article-title":"879 Study of Non\u2010Motor Symptoms in Patients With IPD in a Tertiary Care Centre in India","volume":"29","author":"Narula K. 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D.Wagner andS.Robert \u201cConstipation and Parkinson\u2019s Disease\u201d."},{"key":"e_1_2_7_65_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbi.2025.106086"}],"container-title":["Journal of Gastroenterology and Hepatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgh.70373","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jgh.70373","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgh.70373","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T14:07:26Z","timestamp":1781791646000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jgh.70373"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,8]]},"references-count":64,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1111\/jgh.70373"],"URL":"https:\/\/doi.org\/10.1111\/jgh.70373","archive":["Portico"],"relation":{},"ISSN":["0815-9319","1440-1746"],"issn-type":[{"value":"0815-9319","type":"print"},{"value":"1440-1746","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,8]]},"assertion":[{"value":"2025-11-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-23","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}