Gut Microbial Ecosystem in Parkinson Disease: New Clinicobiological Insights from Multi‐Omics
Abstract
OBJECTIVE: Gut microbiome alterations in Parkinson disease (PD) have been reported repeatedly, but their functional relevance remains unclear. Fecal metabolomics, which provide a functional readout of microbial activity, have scarcely been investigated. We investigated fecal microbiome and metabolome alterations in PD, and their clinical relevance. METHODS: Two hundred subjects (104 patients, 96 controls) underwent extensive clinical phenotyping. Stool samples were analyzed using 16S rRNA gene sequencing. Fecal metabolomics were performed using two platforms, nuclear magnetic resonance (NMR) spectroscopy and liquid chromatography-mass spectrometry. RESULTS: Fecal microbiome and metabolome composition in PD was significantly different from controls, with the largest effect size seen in NMR-based metabolome. Microbiome and NMR-based metabolome compositional differences remained significant after comprehensive confounder analyses. Differentially abundant fecal metabolite features and predicted functional changes in PD versus controls included bioactive molecules with putative neuroprotective effects (eg, short chain fatty acids [SCFAs], ubiquinones, and salicylate) and other compounds increasingly implicated in neurodegeneration (eg, ceramides, sphingosine, and trimethylamine N-oxide). In the PD group, cognitive impairment, low body mass index (BMI), frailty, constipation, and low physical activity were associated with fecal metabolome compositional differences. Notably, low SCFAs in PD were significantly associated with poorer cognition and low BMI. Lower butyrate levels correlated with worse postural instability-gait disorder scores. INTERPRETATION: Gut microbial function is altered in PD, characterized by differentially abundant metabolic features that provide important biological insights into gut-brain pathophysiology. Their clinical relevance further supports a role for microbial metabolites as potential targets for the development of new biomarkers and therapies in PD. ANN NEUROL 2021;89:546-559.
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Alterations in the various bacteria, fungi, viruses, and other biological kingdoms that make up the gut microbiome are associated with PD.
“It has been shown that alterations in the various bacteria, fungi, viruses, and other biological kingdoms that make up the gut microbiome are associated with PD [18].”
From The gut–brain axis in early Parkinson’s disease: from prodrome to prevention (2025) · cites this paper as [18]
Lower levels of butyrate are linked to postural instability, gait disorders, MDS-UPDRS part III motor scores and depression among Parkinson's disease patients showing a reduced count of Faecalibacterium.
“lower levels of butyrate are linked to postural instability, gait disorders, Movement Disorder Society-Sponsored Revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) part III motor scores and depression among PD patients showing a reduced count of Faecalibacterium [59,60,61,62,63]”
From The Interplay between Gut Microbiota and Parkinson’s Disease: Implications on Diagnosis and Treatment (2022) · cites this paper as [61]
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- Authors
- Tan, A. H., Chong, C. W., Lim, S., Yap, I. K. S., Teh, C. S. J., Loke, M. F., Song, S., Tan, J. Y., Ang, B. H., Tan, Y. Q., Kho, M. T., Bowman, J., Mahadeva, S., Yong, H. S., & Lang, A. E.
- Affiliations
- University of Malaya (MY)
- Monash University Malaysia (MY)
- Sarawak Research and Development Council Kuching Malaysia
- Xiamen University Malaysia (MY)
- IMU University (MY)
- Scripps Institution of Oceanography (US)
- Toronto Western Hospital (CA)
- Corresponding author
- Chong, Chun Wie
- ORCID
- Venue
- Annals of Neurology
- Publisher
- Wiley
- Published
- 2021-01-11
- Volume
- 89
- Issue
- 3
- Pages
- 546-559
- ISSN
- 0364-5134 (ISSN-L)
- 1531-8249
- OpenAlex
- W3108955779
- Cited by
- 196
- References
- 77
- Citations by year
- 2026: 26 · 2025: 37 · 2024: 39 · 2023: 39 · 2022: 40 · 2021: 15
- FWCI
- 7.62
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Annals of Neurology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Health Sciences › Medicine › Neurology › Parkinson's Disease Mechanisms and Treatments
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Keywords
- Parkinson's disease, gut microbiota, fecal metabolome, short-chain fatty acids, butyrate, gut-brain axis, neurodegeneration, cognitive impairment, body mass index, frailty, constipation, biomarkers, trimethylamine N-oxide, ceramide, salicylates, coenzyme Q10
- MeSH terms
- Gastrointestinal Microbiome, Frailty, Aged, Ceramides, Chromatography, Liquid, Constipation, Fatty Acids, Volatile, Feces, Female, Humans, Male, Methylamines, Middle Aged, Parkinson Disease, RNA, Ribosomal, 16S, Salicylates, Mass Spectrometry, Sphingosine, Thinness, Ubiquinone, Metabolomics, Sedentary Behavior, Cognitive Dysfunction, Proton Magnetic Resonance Spectroscopy
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