Probiotic use may be associated with improved Parkinson disease (PD) symptoms, according to studies presented at the 2023 International Congress of Parkinson’s Disease and Movement Disorders. Results from one study suggest that prolonged probiotic use may have potential as a therapy for patients with PD who experience sleep deficits, constipation, and “off” periods in medication benefit.                                                                                    

Over a period of 12 weeks, 74 participants were randomized to receive either a 4-strain probiotic therapy comprised of Lacticaseibacillus rhamnosus, Enterococcus faecium, Lactobacillusacidophilus, and Lactiplantibacillus plantarum, or placebo. Researchers examined the participants’ gut microbiota composition using shallow shotgun sequencing and also evaluated PD symptoms according to the Movement Disorder Society Unified Parkinson’s Disease Rating Scale (UPDRS), the Non-Motor Symptoms Scale (NMSS), and “time to on”. At 12 weeks, compared to baseline, participants showed improvement in “time to on” (P=.027), as well as NMSS total score (P=.005), particularly in the sleep/fatigue and gastrointestinal domains. Researchers also identified an increase in beneficial bacteria within participants’ intestinal microbiome. The study authors are associated with King’s College London, King’s College Hospital, Instituto Neurologico Carlo Besta, Skåne University Hospital, and Lund University.

“The identification that the four-strain probiotic contributes to shortening this ‘time to on’ phase holds promise for substantial enhancements in patients' lives by diminishing these difficult ‘off’ intervals and enhancing overall well-being,” said Veronica Bruno, MD, MPH, Assistant Professor at the University of Calgary Department of Clinical Neurosciences.

An additional, separate systemic review and meta-analysis, conducted by researchers at Mansoura University, was also presented at the meeting. This analysis included data from 4 randomized control trials (RCTs) evaluating probiotic use in people with PD, comprising a total of 293 participants. Primary outcomes in the included studies were change in number of bowel movements each week and stool consistency. Analysis of data showed an improvement in mean difference of weekly bowel movements by 1.03 and stool consistency by 0.69 points, with additional improvements in patient-reported symptom severity, quality of life, and satisfaction. The findings suggest that probiotic use has a beneficial effect on constipation symptoms in PD.