Eradication of Helicobacter pylori infection might improve clinical status of patients with Parkinson's disease, especially on bradykinesia

- PD patients who HP eradication, the UPDRS-III scores were significantly lower 1 year later compared to baseline.
- Clinical status may be improved in HP eradicated PD patients more significantly than other two groups.
- HP eradication might contribute to the Parkinson's motor syndrome, especially in bradykinesia.

ObjectivesPrevious studies have shown that Helicobacter pylori infection might make clinical status worse in patients with Parkinson's disease and Helicobacter pylori eradication might improve clinical status by modifying the pharmacokinetics of L-dopa. Here, we investigate whether Helicobacter pylori eradication could benefit idiopathic parkinsonism and Helicobacter pylori infection will effect which aspect of motor symptom significantly.Patients and methodsA cohort study involving idiopathic Parkinson's disease patients, screened for Helicobacter status by 13C urea breath test. Clinical status was evaluated by using the Unified Parkinson's Disease Rating Scale (UPDRS) and Hoehn-Yahr stage. If patients had motor complications, they were quantified at the “on” time. The Helicobacter pylori positive patients could choose to receive Helicobacter pylori eradication or not by themselves. Group 1 was Helicobacter pylori negative patients. Group 2 was Helicobacter pylori positive patients who didn't receive eradication treatment. Group 3 was Helicobacter pylori positive patients who received successful eradication treatment. Repeat clinical assessments and 13C urea breath test was performed at 1 year later. Numerical data were expressed as mean ± standard deviation (SD)ResultsNinety-four consecutive patients with Parkinson's disease were recruited and underwent the initial 13C urea breath test, but only forty-eight patients successfully completed the total study. In Group 3, the UPDRS-III scores (=Motor Examination Section Scores) were significantly lower 1 year later compared to baseline (18.3 ± 8.38 vs. 25.9 ± 8.37, P = 0.007). The differences were main in UPDRS-23 (=Finger Taps) (1.7 ± 1.16 vs. 2.4 ± 1.51, P = 0.045), UPDRS-25 (Rapid Alternation Movements of Hands) (1.6 ± 1.35 vs. 2.4 ± 1.71, P = 0.031) and UPDRS-26 (=Leg Agility) (1.3 ± 1.25 vs.2.1 ± 0.99, P = 0.011). There was difference among three groups in the UPDRS-26 (P = 0.040) of clinical status change of one year.ConclusionThe eradication of Helicobacter might improve the clinical status of idiopathic parkinsonism, especially on bradykinesia.