Stool transplant could improve motor symptoms in Parkinson’s disease

ISLAMABAD, April 13 (ONLINE): Parkinson’s disease is one of the leading causes of disability worldwide, and while treatment options are available, they can become less effective over time.
A recent paper has highlighted the potential effect of fecal transplants on motor symptoms, which are one of the main markers of Parkinson’s disease.

The study could pave the way for further research into the role of the gut microbiome on neurodegenerative conditions, say experts.
Fecal transplants could have an effect on the motor symptoms of people with Parkinson’s disease, a recent study suggests.

A small, single-center clinical trial carried out in Belgium found that people with Parkinson’s disease who received a single dose of a fecal transplant from a healthy donor, had improved symptoms compared to those who received a placebo.

Results, published in eClinicalMedicine, suggested that the motor score for people who received a donor transplant had improved by 5.8 points after 12 months, compared with an improvement of 2.7 points in people who received a placebo transplant.

Significant improvements were also found for an objective measure of constipation (colon transit time), although there was no significant difference in patient-reported scores for constipation.

Mild gastrointestinal symptoms were a common negative side effect at the time of the transplant and were more frequently observed in people who received the donor transplant. Donor transplant recipients were also more likely to have worsened fatigue after 12 months.

Fatigue: A negative side effect of fecal transplantation?
For the study, a total of 22 participants with early-stage Parkinson’s disease received the transplants from healthy donors, and 24 received their own fecal matter as a placebo, as part of the GUT-PARFECT trial carried out at Ghent University Hospital, Belgium between December 1, 2020 and December 12, 2022.

The fecal transplant for both the treated cohort and the placebo cohort was delivered via a tube inserted in the jejunum, a part of the small intestine, via the nose.

Researchers followed up with the participants at 3, 6 and 12 months post-transplant. They collected data on gastrointestinal symptoms, non-motor symptoms, depression and anxiety, sleep and fatigue, and cognition.

While people who received fecal transplants from healthy donors registered improvements in their motor symptoms, they appeared to experience increased fatigue.

The reason for this negative effect was unclear, said lead author of the study Patrick Santens, MD, PhD, professor of neurology at Ghent University Hospital.

“We don’t have a good explanation [for this phenomenon], but suspect that inflammatory mechanisms may be involved. Fatigue is prevalent in inflammatory gut disorders,” he told Medical News Today.

Can ‘placebo’ fecal transplants also help?
One of the limitations of the study is that a strong placebo effect was observed, potentially because the placebo treatment was likely to have been viewed as invasive by the participants.

There is evidence to suggest that the more invasive a placebo treatment is, the greater the placebo effect.

It was also possible that some of the effect seen in the placebo group, was not just placebo effect, Santens suggested:

“The placebo effect was quite large. This may be due to the nature of the treatment with large expectations, on the one hand. On the other hand, there is preliminary evidence that [fecal transplant] with one’s own stool might also have a limited positive effect, at least on gut function. Therefore, we will try placebo treatment with colored inactive solutions in the next steps.”