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A psychobiotic Approach to the Treatment of Parkinson’s disease: a systematic review and meta-analysis of Randomized Controlled Trials

neurology
nutrition

Abstract

Background: Numerous studies have demonstrated that probiotics/prebiotics/synbiotics can alter gut microbiota and serve as a treatment for Parkinson's disease (PD). This investigation encompassed 10 randomized controlled trials (RCTs) and thoroughly examined the efficacy and biological mechanisms of probiotic/prebiotic/synbiotic in PD. Our study deeply analyzed the therapeutic effects of these interventions on PD and the changes in intestinal microbiota, immunohistochemistry, metabolomics, and biochemical indicators before and after treatment.

Methods: 10 relevant RCTs were selected from 11 databases. The primary goals included alterations in defecation frequency and quality of life, while the secondary endpoints encompassed modifications in the Unified Parkinson's Disease Rating Scale (UPDRS), anxiety and depression scores, among others. We also extracted 48 potential biomarkers for analyzing potential mechanisms.

Results: Probiotics/prebiotics/synbiotics treatment significantly improved bowel frequency ( SMD =0.66, 95% CI: 0.36; 0.96, P <0.01, I² =61%, P =0.02) and quality of life ( SMD =-0.52, 95% CI: -0.81; -0.24, P <0.01, I 2 =54%, P =0.06), with certain efficacy and safety in improving non motor symptoms including cognitive function, depression and anxiety, without affecting UPDRS scores ( SMD =0.00, 95% CI: -0.29; 0.29, P =0.99, I² =0%, P< 0.32). Meanwhile, probiotic/prebiotic/synbiotic therapy plays a crucial role in improving the normalization of common gut microbiota dysbiosis in PD patients, and shows potential in reducing serum acetate and insulin levels in PD patients.

Conclusion: Probiotics/prebiotics/synbiotics therapy can improve non-motor symptoms of PD without improving UPDRS scores. Additional rigorous research is required to investigate the ideal dosage, duration, and strain type of probiotic therapy. Simultaneously, it is essential to perform a more comprehensive study on the mechanisms of action of probiotics and explore their combined effects with other treatment methods.

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