At this year’s (2023) International Congress on Parkinson’s Disease and Movement Disorders (MDS) in Copenhagen, lead investigator Valentina Leta from the Department of Neurosciences at King’s College London presented a new randomized study. The results of the study show that giving a probiotic to patients with Parkinson’s disease and constipation for three months not only improved their gut microbiome, but also improved non-motor symptoms such as sleep, fatigue and constipation. Participants taking the probiotic also experienced less delay in starting treatment with levodopa (standard medication for Parkinson’s disease), reducing the time to treatment effectiveness. No such significant improvements were observed in the placebo group.
Giving a probiotic to patients with Parkinson’s disease and constipation for three months not only improved their gut microbiome, but also non-motor symptoms such as sleep, fatigue and constipation, according to the results of a new randomized study. Participants taking the probiotic also experienced less delay in starting treatment with levodopa (standard medication for Parkinson’s disease), reducing the time to treatment effectiveness, said lead investigator Valentina Leta, MD, PhD, Department of Neurosciences, King’s College London Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom. Leta presented the findings at the International Congress on Parkinson’s Disease and Movement Disorders (MDS) 2023. “Virtually every Parkinson’s patient has some degree of gastrointestinal dysfunction, and virtually the entire tract can be affected, from the mouth to the rectum,” Leta told the congress attendees. However, despite numerous preclinical studies showing potential beneficial effects on a number of pathological mechanisms in Parkinson’s disease, the clinical evidence is limited to the treatment of constipation,” she explained. The team, led by K. Ray Chaudhuri, MD, DSc, professor of movement disorders and neurology at King’s College London, conducted a multicenter, randomized, double-blind, placebo-controlled trial in which patients who had both Parkinson’s disease and constipation according to the Rome IV criteria were randomly assigned to receive a probiotic or a placebo for three months. The probiotic used was a liquid formulation (Symprove) and contained four strains: Lacticaseibacillus rhamnosus, Enterococcus faecium, Lactobacillus acidophilus and Lactiplantibacillus plantarum. A total of 74 patients were randomly assigned to the two study groups. The two groups were well matched in terms of sociodemographic, Parkinson’s and constipation-related characteristics, Leta reports, and only three patients in each group dropped out of the study. The probiotic intervention had a “good tolerability and safety profile, with a similar number of adverse events between the two groups and no serious adverse events,” she added. The probiotic was associated with a “statistically significant increase in the abundance of bacteria known to have health-promoting properties, such as Odoribacteraceae,” Leta said. This bacterium is known to be decreased in people with Parkinson’s disease,” she explained, “and it is involved in the production of short-chain fatty acids, which are known to have health-promoting properties. The secondary endpoint of the study included changes in motor and non-motor symptoms, and the probiotic was associated with a significant improvement in “time to onset” of levodopa treatment, with this time shortening from an average of 31.43 minutes at baseline to 23.95 minutes at the post-intervention assessment (P <.027). This, Leta said, was "due to improvements in sleep, fatigue and gastrointestinal outcomes". No such significant improvements were observed in the placebo group.