Parkinson's Disease (PD) is a well-known neurodegenerative disorder, the second most common behind Alzheimer's. Although it affects roughly 10 million people worldwide, it doesn’t currently have a cure, but several different types of treatment exist.
In recent years, researchers have begun to better understand the microbiome-gut-brain axis, the bi-directional influence between intestinal microbes and the brain. While we have only just begun to understand this communication pathway, the initial findings have compelled research into the role that gut health plays for PD patients.
Probiotics, which are live microbes that produce a health benefit in adequate amounts, can help people with certain diseases such as Parkinson’s. Clinical trials are ongoing to look into which particular probiotic strains are more beneficial for PD patients.
Before we dive into the potential benefits of probiotics for PD patients, let’s take a closer look at Parkinson's disease, as well as the science behind probiotics and what role the gut-brain axis plays. Keep reading to learn more about how probiotics may help you, and learn about the exciting research behind PS128, the probiotic strain in Neuralli, a unique probiotic clinically researched for Parkinson’s patients.
What is Parkinson's Disease?
Parkinson's Disease is a progressive movement disorder that worsens over time. Most commonly, patients develop PD symptoms after 60 years of age. However, some people develop tremors and other symptoms much earlier. So-called “young-onset” or “early-onset” Parkinson's Disease” (YOPD or EOPD), affects roughly 5-20% of those who are diagnosed.
In PD patients, cell loss occurs in the region of the brain known as the substantia nigra. Dopamine is created in this region of the brain and helps facilitate and regulate bodily movement. This is where the motor symptoms of PD come into play, as the low dopamine levels cause the patient to lose the regulation of their movement. Patients typically only begin to experience tremors and other typical motor symptoms after about 50% of the cells have been damaged or lost.
In a Parkinson's disease brain, the protein alpha-synuclein clumps up into aggregates called Lewy bodies. Researchers believe that this aggregation within the substantia nigra may be a cause of PD.
What Causes PD?
As neurons within the substantia nigra die, dopamine levels decrease, leading to PD development. Dopamine is a neurotransmitter in the brain and other parts of the nervous system that helps control movements in the body. When these levels are compromised in a patient, they can experience slow or abnormal movements.
Although we know that the loss of dopamine-producing neurons causes PD, what remains open for debate is what causes these neurons to die in the first place. Some studies have pointed to genetics, with variations in over a dozen different genes correlating with an increased risk of developing Parkinson's disease. However, not everyone with these variations develops the disease. Another inconclusive theory points to the environment as a contributing factor by exposing people to pesticides and herbicides, as well as traffic and industrial pollution. It’s likely that for many PD patients, a variety of risk factors are involved.
Interestingly, many PD patients experience gastrointestinal problems years before developing motor symptoms, which has prompted researchers to look into a gut-brain connection for the cause of PD. In these “gut-first” patients, alpha-synuclein, a protein, begins to aggregate in the enteric nervous system (ENS) and spreads to the brain.
In these studies, researchers pointed to alpha-synuclein as a primary contributor to PD. They recognized that in some patients, alpha-synuclein originated in the ENS in the gut and later affected the CNS. However, not all patients have this “gut-first” accumulation of alpha-synuclein, which is why separate subtypes of gut-first and brain-first PD exist.
Can Probiotics Help PD Patients?
Given probiotics’ power and the gut-brain axis’s role in PD, could there be essential microbes that a Parkinson’s patient needs in their diet?
Food provides nutrients that are necessary for many functions in the body, including the production of neurotransmitters such as dopamine. Emerging research on the gut-brain axis suggests that some probiotics can impact the brain by influencing the signaling from the gut microbiome to the brain.
The microbial community in the gut is significant, containing bacteria, yeast, viruses, and protozoa that digest food, synthesize vitamins, and help us maintain a healthy barrier between what’s inside our gut and intestinal cells. The skin, mouth, vagina, and other organs also have their own microbial inhabitants that help maintain good overall health and wellness.
The microbiome contains both good and bad forms of bacteria, and poor gut health can result when there is “bad” bacterial overgrowth, a state called gut dysbiosis. Sometimes balance can be restored simply by adding prebiotic foods to the diet to support the growth of “good” bacteria. Other times, a probiotic that has shown specific benefits for gut health is needed to achieve health benefits beyond what can be found in foods.
Although live cultures can be found in many fermented foods, taking a probiotic with demonstrated clinical effects at specific amounts will be much more impactful.
Probiotics and medical probiotics are typically packaged in the form of a pill, capsule, drink, or powder. Gut health probiotics are a great option if your diet isn’t holistic or you want to take extra measures for your overall wellness. But not all probiotics are the same, and different strains can have different benefits, so it’s important to be aware of all the options to ensure you choose the right strain for your needs.
For PD patients, a medical probiotic that provides the missing microbes needed for signaling from the gut to the brain could result in meaningful differences in their quality of life. Not all probiotics are the same, so a PD patient, with the supervision of a health care practitioner, could consider a probiotic that has been tested in PD and shown to produce benefits.
Best Neurological Health Probiotics for PD
The gut and brain can influence each other through the activity of neurotransmitters like serotonin and dopamine. Psychobiotics specifically appear to influence the activity of neurotransmitters. Several psychobiotic strains provide dietary management for depression and anxiety may do so by signaling to the brain to adjust serotonin levels.
A handful of animal studies have suggested that certain probiotic mixtures with anti-oxidant effects can be neuroprotective, and improve movement in animal models of Parkinson’s (here is one example).
Interestingly, L. plantarum PS128, as of this writing, may be the only probiotic strain known to increase dopamine activity in the brain, which is a critical factor in PD. Two studies (here and here), have shown that mice taking PS128 have higher dopamine levels in their brains compared to the mice that did not take the probiotic.
A pilot study suggests that PS128 may signal to the brain to affect neurological activity relevant to Parkinson’s patients as well. Twenty-five patients who were taking levodopa and had had Parkinson’s for an average of 10 years took two capsules of PS128 per day for 12 weeks. At the end of the study, there was a significant improvement in motor function, as measured by the participants’ ability to perform finger, hand, and leg movements with agility. The majority of participants also said they received a noticeable benefit from PS128.
PS128 is available commercially as a medical probiotic called Neuralli.
Best Gut Health Probiotics for Parkinson's Disease
Over 80% of PD patients deal with constipation. This could be because of a degeneration of the vagus nerve, lack of enteric dopamine, or a side effect of the typical PD meds. Two common remedies are a diet low in protein/sugar and high in fiber, and stimulant laxatives like polyethylene glycol. Abdominal massage can also be helpful in stimulating movement of the intestinal contents. Increasing dietary fiber intake is also associated with greater stool frequency for those struggling with constipation.
Probiotics offer an easy and low-risk option for dealing with constipation. They may even do more than just help you move your bowels. Studies suggest that gut dysbiosis may lead to an overactive immune response, which can trigger a chain reaction of undesirable effects. These effects include a weakened intestinal barrier and reduced short-chain fatty acids, which have been demonstrated in cases of PD. Balancing the gut microbiome with beneficial bacteria from a probiotic may help with some or all of these issues.
Some studied probiotics have been accepted as safe and effective for PD-associated GI problems, including constipation, by the International Parkinson and Movement Disorder Society Evidence-Based Medicine Committee. While human clinical trials and studies are ongoing, certain Lactobacillus and Bifidobacterium strains have shown positive results for constipation in PD patients to date:
- Lactobacillus casei Shirota - In one study in which PD patients were given either a placebo or fermented milk containing the probiotic Lactobacillus casei Shirota, it was found that those who took the probiotic drink experienced a significant improvement in bowel movements, along with relief from abdominal pain, bloating, and a sense of emptiness in the stomach.
- Hexbio - Hexbio is a multi strain probiotic containing a mixture of Lactobacillus and Bifidobacterium species. 55 patients with PD and constipation were studied for eight weeks. Compared with placebo, Hexbio improved bowel movement frequency for these PD patients.
The Hopeful Connection Between Probiotics & Parkinson’s Disease
In the past, Parkinson's disease was recognized as a neurological disorder that was caused by and affected the brain. However, many researchers and physicians are beginning to point to a clear connection between the gut microbiome and PD. This has led researchers to wonder if getting ahead of gut health could not only help manage GI difficulties but also possibly slow neurodegeneration processes that start in the gut.
Neurologically active psychobiotics like PS128 may be a useful support for gut microbiome to brain signaling in Parkinson's. The clinically researched PS128 strain is present in Neuralli, a medical probiotic for the dietary management of neurological conditions like ASD and PD. More research is needed to further understand the way these unique probiotics impact neurological health and probiotics, but the results of clinical studies are encouraging.
If you or a loved one have PD, consider trying Neuralli.