From the gut to the brain: faecal transplant shows promise in treating Parkinson’s disease

A recent study led by Prof. Arnout Bruggeman and his team at Ghent University Hospital reveals promising results for using faecal microbiota transplantation (FMT) to treat motor symptoms in Parkinson’s disease (PD). This innovative approach highlights the potential of gut microbiome modulation as a therapeutic strategy for this debilitating neurological disorder.

A new approach to Parkinson’s

The GUT-PARFECT trial, a double-blind, placebo-controlled phase 2 study, evaluated the safety and efficacy of a single FMT in patients with mild to moderate Parkinson’s disease. Participants, aged 50-65 years, were randomly assigned to receive FMT with either healthy donor stool or their own stool (placebo). The primary goal was to assess changes in the Movement Disorders Society-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) motor score over 12 months.

Surprising findings

One of the most surprising findings was the sustained response in the placebo group. Up to six months post-FMT, patients who received their own stool also showed notable improvements, although less pronounced than those in the healthy donor FMT group. This suggests that even autologous FMT can influence the gut microbiome in ways that may impact motor symptoms, emphasizing the complex role of the gut-brain axis in Parkinson’s disease.

The study also found significant improvements in colon transit time in the healthy donor FMT group compared to the placebo group.  Better gastrointestinal function is particularly relevant for PD patients, who often suffer from severe constipation. However, from the patients’ perspective this difference, was too minimal to result in a noticeable clinical improvement, and the patient-reported scores on the Wexner Constipation Scale have remained no significant between the groups.

Safety first and treatment next

Safety was a crucial aspect of this study. The FMT procedure was well-tolerated, with only mild and transient gastrointestinal symptoms reported, such as abdominal discomfort, which resolved within a week. No severe adverse events were observed, supporting the safety profile of FMT.

The GUT-PARFECT trial's results open up exciting possibilities for Parkinson’s disease treatment. If larger studies corroborate these findings, FMT could become a valuable tool in the therapeutic arsenal against PD. The future of Parkinson’s treatment may well lie in our gut. By harnessing the power of the microbiome, patient could pave the way for more effective and comprehensive management strategies for this challenging condition.