Summarized by Mark Boyland PT,DPT, CSCS
This was an interesting perspective paper due to the implications it has on how we can potentially test for Parkinson’s earlier and opens up avenues for treatment methods in a holistic style incorporating diet and nutrition in addition to exercise and pharmaceuticals. While this perspective primarily focuses on Parkinson’s Disease, the paper also mentions potential effects on other conditions including Alzheimer’s and Huntington’s.
Parkinson’s is the second most common neurodegenerative disorder. It has been primarily thought to be a brain disorder. However there have been suggestions that changes in the gut microbiome, gut dysbiosis, could be linked to Parkinson’s. Common symptoms of gut microbiome disruptions include constipation and increased inflammation. Neurodegenerative diseases such as Alzheimer’s, Huntington’s, and Parkinson’s gut dysbiosis has been linked to cognitive impairments/reduced performance and motor dysfunction. Motor dysfunction includes postural instability and gait impairments. The authors indicate that dysbiosis can be improved with exercise, which calls to question how?
First, we must understand how dysbiosis can affect the brain. The gut biome regulates immune function, signaling of neurotransmitters including dopamine (over 50% of dopamine production comes from the gut), and metabolism support. If there is disruption in our gut (dysbiosis) the impacts include increased inflammation, decreased neurotransmitter signaling, and deregulates metabolic function. This perspective paper suggests that Parkinson’s can begin at the gut level and that as the condition progresses it impacts the motor system progressively.
As mentioned previously, exercise can restore the gut microbiome. In those without Parkson’s having higher exercise capacity (aerobic/muscular strength) has been associated with higher bacterial diversity and reduced gut inflammation. Restoration of the gut microbiome comes with both aerobic and resistance based exercise. There are some differences in the benefits provided by each exercise modality however resistance exercise has been less studied at this point.
Exercise to promote physical capacity may not be the sole factor for improving patient outcomes however. For those with Parkinson’s exercise is now integral to their care but could be related to learning new skills which helps to keep the brain plastic (neuroplasticity). Additionally, as we begin to exercise more we also tend to eat a greater variety of healthy foods which could promote holistic changes as well.
The gut and its bacteria are the recent quick fix hot topic but may have implications for our future in prevention and care of neurodegenerative conditions and maybe more. Further research and study is required to establish a better understanding of the gut biome and it’s relation to our health at this time. Fortunately, improving gut health can be as simple as completing regular exercise and meeting the daily activity recommendations of the AHA as opposed to taking an unknown pill or supplement. Eat well, stay active, be well
Direct link to article: https://doi.org/10.1093/ptj/pzac022