Abstract Details

Title Proof of Concept Study of Prebiotics to Modulate Gut Microbiome in Parkinson's Disease

Topic Movement Disorders

Presentation(s) P13 - Poster Session 13 (8:00 AM-9:00 AM)

Poster/Presentation
Number 5-002

Background An abnormal, pro-inflammatory intestinal microbiome (dysbiosis) promotes intestinal barrier dysfunction, systemic and neuro- inflammation which collectively may influence PD pathogenesis / clinical progression. This study determined if using a precision prebiotic mixture designed to support diverse intestinal microbiota could mitigate dysbiosis, improve the intestinal barrier, blunt neuroinflammation in PD patients, and influence disease severity.

Objective To determine the impact of a microbiota-directed intervention in Parkinson’s Disease (PD) patients.

Design/Methods The study design was an open-label, non-randomized study in PD participants (n=20), including de novo PD (n=10) and treated PD participants receiving levodopa (LD; n=10). Fecal and blood samples were collected at baseline and after 10 days of prebiotic consumption (prebiotic fiber mixture). PD participants completed questionnaires to assess diet, stress, and adverse events.

Results Mean age of participants was 64.3±8 (n=20), with 55% men. GI Symptoms improved after prebiotic treatment (p=0.01). Additionally, MDS-Unified Parkinson’s Disease Rating Scale improved with treatment, with median values dropping from 11.5 to 9 (p=0.01). Concurrently, prebiotic consumption decreased relative abundance of putative pro-inflammatory bacteria (Proteobacteria, q=0.017; Escherichia coli, p=0.032) and increased relative abundance of bacteria that produce short chain fatty acids (SCFA) including Faecalibacterium prausnitizii (p?0.05), increased plasma total SCFA (p?0.007), improved intestinal barrier integrity (decreased plasma Zonulin; p?0.001), reduced levels of a peripheral marker of neurodegeneration (neurofilament light chain; p?0.003), and reduced intestinal inflammation (decreased fecal calprotectin; p?0.044).

Conclusions Consumption of a novel prebiotic mixture rapidly impacted the intestinal microbiota (10 days), reduced the abundance of pro-inflammatory bacteria and promoted the growth of beneficial SCFA-producing bacteria. In addition, prebiotic consumption increased plasma SCFA levels, and improved markers of intestinal barrier integrity and brain health. This proof-of-concept study provides evidence for the importance of intestinal microbiota in PD, and scientific rationale for future studies assessing prebiotics in PD.

Authors/Disclosures
Deborah Hall, MD, PhD, FAAN (Rush University) PRESENTER	Dr. Hall has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for American Academy of Neurology. Dr. Hall has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier - Parkinsonism and Related Disorders. Dr. Hall has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Annals of Neurology. The institution of Dr. Hall has received research support from Parkinson's Foundation. The institution of Dr. Hall has received research support from CHDI. The institution of Dr. Hall has received research support from Neurocrine. The institution of Dr. Hall has received research support from Uniqure. The institution of Dr. Hall has received research support from SAGE. The institution of Dr. Hall has received research support from NIH.
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Bichum Ouyang	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Christopher Goetz, MD, FAAN (Rush University Medical Center)	The institution of Dr. Goetz has received research support from Michael J. Fox Foundation. The institution of Dr. Goetz has received research support from NIH. The institution of Dr. Goetz has received research support from Department of Defense. Dr. Goetz has received publishing royalties from a publication relating to health care. Dr. Goetz has received publishing royalties from a publication relating to health care. Dr. Goetz has received publishing royalties from a publication relating to health care.
	No disclosure on file