Fecal microbiota transplantation to treat Parkinson's disease with constipation

TLDR

Parkinson’s disease, a neurodegenerative disorder frequently accompanied by chronic constipation, is increasingly being considered for fecal microbiota transplantation (FMT) as a novel approach to restore gut microbiota. After partial response to dopaminergic drugs and failed laxatives, the patient received a fecal microbiota transplantation. FMT led to rapid relief of constipation (within 5 min) and sustained daily bowel movements, and temporarily reduced leg tremor, suggesting gut microbiota reconstruction may benefit Parkinson’s patients with gastrointestinal symptoms.

Abstract

Abstract Rationale: Fecal microbiota transplantation (FMT) is recognized as an emerging treatment through reconstruction of gut microbiota. Parkinson's disease is a neurodegenerative disorder, which is accompanied by constipation. Here we first reported a patient with Parkinson's disease and constipation that were obviously relieved after FMT. Patient concerns: A 71-year-old male patient presented with 7 years of resting tremor, bradykinesia (first inflicted the upper limbs and subsequently spread to lower limbs), and intractable constipation (defecation needing more than 30 minutes). Diagnoses: Parkinson's disease for 7 years; constipation >3 years. Interventions: The patient had used madopar, pramipexole, and amantadine for anti-Parkinson and showed partially mitigation while laxative therapy for constipation failed. Finally FMT was performed. Outcomes: The patient successfully defecated within 5 minutes and maintained daily unobstructed defecation until the end of follow-up. The patient's tremor in legs almost disappeared at 1 week after FMT but recurred in the right lower extremity at 2 months after FMT. Lessons: Gut microbiota reconstruction may have therapeutic effects for Parkinson's disease patients, especially those who have gastrointestinal symptoms and limited treatment choices.