{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:18:36Z","timestamp":1787015916269,"version":"build-2736575974"},"reference-count":54,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,12,17]],"date-time":"2023-12-17T00:00:00Z","timestamp":1702771200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Parkinson's disease (PD) is a neurodegenerative movement disorder with prodromal and highly prevalent gastrointestinal (GI) symptoms, especially constipation. Although PD models suggest gut\u2010brain axis dysfunction, the mechanistic underpinnings and their correlation with GI symptoms are poorly understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To examine the bidirectional gut\u2010brain axis function in PD and correlate it with constipation severity, PD duration, and severity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Rectal sensory thresholds and afferent cortical evoked potentials (CEP) were assessed using a 4\u2010ring EMG electrode probe. Efferent anal and rectal motor evoked potentials (MEPs) were obtained following transcranial and lumbosacral magnetic stimulation. Bowel symptoms were assessed by prospective stool diary. The CEP and MEP latencies, rectal sensory thresholds, and anorectal sensorimotor data were compared between PD subjects and age\u2010adjusted healthy subjects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Results<\/jats:title>\n                    <jats:p>\n                      Twenty\u2010five PD subjects with constipation (F\/M\u2009=\u20096\/19) and 20 healthy subjects (F\/M\u2009=\u200914\/6) were enrolled. The first and pain sensation thresholds were higher in PD subjects than healthy subjects (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.002) but lost significance after adjustment for age. Age\u2010adjusted rectal CEP and right\u2010sided cortico\u2010anal MEP latencies were prolonged in PD subjects compared to healthy subjects (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.04). Also, half (4 of 8) age\u2010adjusted spino\u2010anal and rectal MEP latencies in PD subjects were significantly longer. In multivariate linear analysis, first rectal sensation and right\u2010sided MEP latencies showed moderate correlation with constipation severity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions &amp; Inferences<\/jats:title>\n                    <jats:p>Parkinson's disease is associated with significant bidirectional gut\u2010brain axis dysfunction as evidenced by prolonged afferent and efferent neuronal signaling. Constipation severity in PD is correlated to abnormal rectal sensation and lateralized disturbance of efferent brain\u2010gut signaling.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nmo.14728","type":"journal-article","created":{"date-parts":[[2023,12,18]],"date-time":"2023-12-18T00:10:30Z","timestamp":1702858230000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Evaluation of bidirectional gut\u2010brain axis and anorectal function in Parkinson's disease with constipation"],"prefix":"10.1111","volume":"36","author":[{"given":"Yun","family":"Yan","sequence":"first","affiliation":[{"name":"Digestive Clinical Research Center, Medical College of Georgia Augusta University  Augusta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karunaratne","family":"Tennekoon","sequence":"additional","affiliation":[{"name":"Digestive Clinical Research Center, Medical College of Georgia Augusta University  Augusta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Audrey","family":"Eubanks","sequence":"additional","affiliation":[{"name":"Digestive Clinical Research Center, Medical College of Georgia Augusta University  Augusta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anam","family":"Herekar","sequence":"additional","affiliation":[{"name":"Digestive Clinical Research Center, Medical College of Georgia Augusta University  Augusta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dhanush","family":"Shimoga","sequence":"additional","affiliation":[{"name":"Digestive Clinical Research Center, Medical College of Georgia Augusta University  Augusta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepak","family":"Ayyala","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences, Medical College of Georgia Augusta University  Augusta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colin","family":"McLeod","sequence":"additional","affiliation":[{"name":"Department of Neurology, Medical College of Georgia Augusta University  Augusta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie A.","family":"Kurek","sequence":"additional","affiliation":[{"name":"Department of Neurology, Medical College of Georgia Augusta University  Augusta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John C.","family":"Morgan","sequence":"additional","affiliation":[{"name":"Department of Neurology, Medical College of Georgia Augusta University  Augusta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4446-8452","authenticated-orcid":false,"given":"Satish S. 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