XXX - Fecal Microbiota Transplantation (FMT) & Morbus Parkinson / Parkinson's Disease (PD)

Background:

There is an increasing body of evidence that highlights the effectiveness and safety of fecal microbiota transplantation (FMT) for treating Parkinson's disease (PD). Typically, fecal microbiota are transplanted using oral capsules, a nasojejunal tube, or a colonoscopy. However, the process of freezing can diminish the diversity and viability of the microbiota being transplanted. This study seeks to explore the efficacy and safety of using fresh Fecal Microbiota Transplantation (FMT administered through colonoscopy for the treatment of Morbus Parkinson / Parkinson's Disease (PD) (1)

Study overview:

A double-blind, randomized, placebo-controlled treatment trial evaluating Fecal Microbiota Transplantation (FMT) or placebo in thirty patients with mild-to-moderate Morbus Parkinson / Parkinson's Disease (PD) (Hoehn-Yahr stage I-III) (1)

Outcome measures:

Motor and non-motor symptoms, constipation, quality of life, cognitive function, emotional state and sleep quality were assessed using relevant scales. Fecal samples were harvested before and at 4, 8 and 12 weeks after treatment for metagenomic and metabolomics analyses (1)

Results:

At 12 weeks, there were notable changes in various scores for the FMT group. The UPDRS III scores showed a significant decrease with a group × time effect of B = −8.80 \ [−13.79, −3.81\]. Similarly, the PAC-QOL scores decreased significantly, with a group × time effect of B = −29.67 ([−45.35, −13.98]. The UPDRS II scores also saw a reduction, with a group × time effect of B = −5.07 [−8.85, −1.28]. Additionally, the NMSS scores decreased significantly, with a group × time effect of B = −35.60 [−53.59, −17.61]. The PDQ-39 scores showed a significant reduction, with a group × time effect of B = 17.80 [−28.21, −7.39]. The HAMA scores decreased with a group × time effect of B = −1.66 [−2.92, −0.40], and the HAMD scores also saw a reduction, with a group × time effect of B = −1.33 [−2.49, −0.16]. In contrast, the CSBM per week increased significantly, with a group × time effect of B = 3.03 [1.42, 4.63], and the Bristol Stool Scale score also increased, with a group × time effect of B = 1.95 [0.12, 3.79]. All these changes were statistically significant with P < 0.05. Furthermore, significant alterations were observed in the gut microbiota and fecal metabolites in the FMT group. Importantly, no adverse events were reported during the follow-up period (1)

Conclusions:

Fresh FMT administered through colonoscopy is considered a safe and well-tolerated method for addressing mild-to-moderate Parkinson's Disease (PD). This procedure has been shown to effectively reduce both motor and non-motor symptoms, which in turn aids in defecation and enhances the overall quality of life for patients. The benefits of this treatment can last for at least 12 weeks, likely due to the positive changes it brings about in gut microbiota and fecal metabolites (1)

References:

(1) Wang et al. 2025a Brain Behav Immun 130: 106086