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J Parkinsons Dis. 2018;8(s1):S31-S39. doi: 10.3233/JPD-181477.

The Gut and Parkinson's Disease: Hype or Hope?

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Department of Neurology, Helsinki University Hospital and Department of Clinical Neurosciences (Neurology), University of Helsinki, Helsinki, Finland.
Department of Neurology, CHU Nantes and Inserm, Nantes, France.
Department of Nuclear Medicine & PET Centre, Aarhus University Hospital, Aarhus, Denmark.


In the last two decades it has become clear that Parkinson's disease (PD) is associated with a plethora of gastrointestinal symptoms originating from functional and structural changes in the gut and its associated neural structures. This is of particular interest not only because such symptoms have a major impact on the quality of life of PD patients, but also since accumulating evidence suggests that in at least a subgroup of patients, these disturbances precede the motor symptoms and diagnosis of PD by years and may thus give important insights into the origin and pathogenesis of the disease. In this mini-review we attempt to concisely summarize the current knowledge after two decades of research on the gut-brain axis in PD. We focus on alpha-synuclein pathology, biomarkers, and the gut microbiota and envision the development and impact of these research areas for the two decades to come.


Alpha-synuclein; constipation; dysautonomia; gut-brain-axis; microbiota; prion

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