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We evaluated the effects of the dopaminergic agent apomorphine on defecation and anorectal function in patients with Parkinson's disease (PD).A gastrointestinal symptom survey,extrapyramidal assessment, defecating proctogram,and anorectal manometric study were performed in 8 subjects with PD.Basal studies showing abnormalities were repeated following apomorphine administration.Prior defecographic abnormalities were normalized following apomorphine injection in 1 of 3 subjects and significant improvements in manometric parameters were observed in all 5 subjects who underwent repeat anorectal manometry.We conclude that apomorphine can correct anorectal dysfunction in PD,and that these abnormalities may be a consequence of dopamine deficiency secondary to the PD process.These findings may also have therapeutic implications. |
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