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Parkinson’s May Begin in Gut and Spread to the Brain Via the Vagus Nerve

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Parkinson’s May Begin in Gut and Spread to the Brain Via the Vagus Nerve
Neuroscience NewsJune 23, 2015
 

A major epidemiological registry-based study from Aarhus University and Aarhus University Hospital indicates that Parkinson’s disease begins in the gastrointestinal tract; the study is the largest in the field so far.

The chronic neurodegenerative Parkinson’s disease affects an increasing number of people. However, scientists still do not know why some people develop Parkinson’s disease. Now researchers from Aarhus University and Aarhus University Hospital have taken an important step towards a better understanding of the disease.

New research indicates that Parkinson’s disease may begin in the gastrointestinal tract and spread through the vagus nerve to the brain.

gut-parkinsons-public.jpg?resize=432%2C1

The research has presented strong evidence that Parkinson’s disease begins in the gastrointestinal tract and spreads via the vagus nerve to the brain. Many patients have also suffered from gastrointestinal symptoms before the Parkinson’s diagnosis is made. The image is for illustrative purposes only.

 

“We have conducted a registry study of almost 15,000 patients who have had the vagus nerve in their stomach severed. Between approximately 1970-1995 this procedure was a very common method of ulcer treatment. If it really is correct that Parkinson’s starts in the gut and spreads through the vagus nerve, then these vagotomy patients should naturally be protected against developing Parkinson’s disease,” explains postdoc at Aarhus University Elisabeth Svensson on the hypothesis behind the study.

A hypothesis that turned out to be correct:

“Our study shows that patients who have had the the entire vagus nerve severed were protected against Parkinson’s disease. Their risk was halved after 20 years. However, patients who had only had a small part of the vagus nerve severed where not protected. This also fits the hypothesis that the disease process is strongly dependent on a fully or partially intact vagus nerve to be able to reach and affect the brain,” she says.

The research project has just been published in the internationally recognised journal Annals of Neurology.

The first clinical examination

The research has presented strong evidence that Parkinson’s disease begins in the gastrointestinal tract and spreads via the vagus nerve to the brain. Many patients have also suffered from gastrointestinal symptoms before the Parkinson’s diagnosis is made.

“Patients with Parkinson’s disease are often constipated many years before they receive the diagnosis, which may be an early marker of the link between neurologic and gastroenterologic pathology related to the vagus nerve ,” says Elisabeth Svensson.

Previous hypotheses about the relationship between Parkinson’s and the vagus nerve have led to animal studies and cell studies in the field. However, the current study is the first and largest epidemiological study in humans.

The research project is an important piece of the puzzle in terms of the causes of the disease. In the future the researchers expect to be able to use the new knowledge to identify risk factors for Parkinson’s disease and thus prevent the disease.

“Now that we have found an association between the vagus nerve and the development of Parkinson’s disease, it is important to carry out research into the factors that may trigger this neurological degeneration, so that we can prevent the development of the disease. To be able to do this will naturally be a major breakthrough,” says Elisabeth Svensson.

About this Parkinson’s disease research

Facts

  • Parkinson’s disease is a chronic and neurodegenerative disease which affects approx. 1 out of every 1,000 people.
  • The first signs of the disease are most often seen between the ages of 50-60.
  • The researchers carried out a registry study involving 14,883 patients who had undergone a vagotomy.
  • The research project was supported by the Danish Parkinson’s Disease Association and PROCRIN (Program for Clinical Research Infrastructure).

Funding The research was funded by the Danish Parkinson’s Disease Association.

Source: Elisabeth Svensson – Aarhus University
Image Credit: Image is credited to the Gray’s Anatomy and is in the public domain
Original Research: Abstract for “Vagotomy and subsequent risk of Parkinson’s disease” by Elisabeth Svensson PhD, Erzsébet Horváth-Puhó PhD, Reimar W Thomsen PhD, Jens Christian Djurhuus DMSc, Lars Pedersen PhD, Per Borghammer DMSc and Henrik Toft Sørensen DMSc in Annals of Neurology. Published online June 2015 doi:10.1002/ana.24448

Abstract

Vagotomy and subsequent risk of Parkinson’s disease

Objectives: Parkinson’s disease (PD) may be caused by an enteric neurotropic pathogen entering the brain through the vagal nerve, a process that may take over 20 years. We investigated the risk of PD in patients who underwent vagotomy, and hypothesized that truncal vagotomy is associated with a protective effect, while super-selective vagotomy has a minor effect.

Methods: We constructed cohorts of all patients in Denmark who underwent vagotomy during 1977-1995 and a matched general population cohort, by linking Danish registries. We used Cox regression to compute hazard ratios (HRs) for PD and corresponding 95% confidence intervals [CIs], adjusting for potential confounders.

Results: Risk of PD was decreased in patients who underwent truncal [hr = 0.85, 95% CI= 0.56–1.27; follow-up of >20 years: HR = 0.58, 95% CI: 0.28–1.20] compared to super-selective vagotomy. Risk of PD was also decreased following truncal vagotomy when compared to the general population cohort [overall adjusted HR = 0.85, 95% CI 0.63–1.14; follow-up >20 years, adjusted HR = 0.53 [95% CI: 0.28–0.99]. In patients who underwent super-selective vagotomy, risk of PD was similar to the general population [hr = 1.09, 95% CI: 0.84–1.43; follow-up of >20 years: HR = 1.16, 95% CI: 0.80–1.70]. The statistical precision of the risk estimates was limited. Results were consistent after external adjustment for unmeasured confounding by smoking.

Interpretation: Full truncal vagotomy is associated with a decreased risk for subsequent PD, suggesting that the vagal nerve may be critically involved in the pathogenesis of PD.

“Vagotomy and subsequent risk of Parkinson’s disease” by Elisabeth Svensson PhD, Erzsébet Horváth-Puhó PhD, Reimar W Thomsen PhD, Jens Christian Djurhuus DMSc, Lars Pedersen PhD, Per Borghammer DMSc and Henrik Toft Sørensen DMSc in Annals of Neurology. Published online June 2015 doi:10.1002/ana.24448

 

http://neurosciencenews.com/parkinsons-gastrointestinal-tract-neurology-2150/?adbsc=social_Neuro_DBS_Prod_default_20160404_60034096&adbid=1620164568222581&adbpl=fb&adbpr=1397410597164647

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Great questions, as always. However, the study does not address food causes nor designate any foods to be used or avoided. Nor does it address the leaky gut syndrome.

 

I have been trying for a long time to find a connection between leaky gut, PD, and the enteric nervous system, but so far, there is no direct evidence. Persons with celiac disease have intestinal permeability; but I haven't been able to find evidence that people with PD have a greater incidence of celiac disease than the general population.

 

There is one case study of a gentleman with PD who was found to have "silent celiac disease." When gluten was removed from his diet, he experienced reduced PD symptoms. It appears that the celiac disease exacerbated his PD symptoms, but did not entirely reverse PD. So it appears premature to advise a gluten-free diet for everyone who has PD. I continue to follow the literature in the hope of finding more evidence.

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Sorry-I lost my previous post.  Colon cancer is huge and that alone could be a benefit of using turmeric.  If it can also help prevent Parkinson's in the gut-that would be huge.  I know that UCLA had a study on turmeric for Alzheimer's but it kind of went quiet.  What do you think about the blood-brain-barrier in the vagus nerve?  Thanks!

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Sorry-I lost my previous post.  Colon cancer is huge and that alone could be a benefit of using turmeric.  If it can also help prevent Parkinson's in the gut-that would be huge.  I know that UCLA had a study on turmeric for Alzheimer's but it kind of went quiet.  What do you think about the blood-brain-barrier in the vagus nerve?  Thanks!

 

This study did not address turmeric, but other studies have shown that the component curcumin appears to protect against Alzheimer's. A recent review article stated: "Curcumin derived from turmeric is well documented for its anti-carcinogenic, antioxidant and anti-inflammatory properties. Recent studies show that curcumin also possesses neuroprotective and cognitive-enhancing properties that may help delay or prevent neurodegenerative diseases, including Alzheimer's disease (AD)."

 

I haven't found information about curcumin vs the vagus nerve but I will certainly post it if I do. An Australian veterinary began using turmeric to treat animals and found it so successful he began researching it further, and devised a turmeric paste for humans as well. If you like you can visit his website at: http://www.turmericlife.com.au/

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Wow-what a fun website for the turmeric.  Graphics, cartoons, visuals, recipes, helpful information, etc.  I will definitely make the "golden paste" with coconut oil (and garlic for fabulous extra flavor).  I bookmarked it so I can spend some quality time going through all the fun pages that are on that website.  Thanks!  

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I'm happy you like the site. I think turmeric is long overdue for recognition. Not that it is a universal panacea, but its antioxidant properties have been demonstrated in numerous credible research studies.

 

I also think that using the entire root is preferable to extracting a single component, curcumin. It has been shown that there are at least a dozen substances in turmeric that have beneficial properties, and very often such substances support each other, such as the carotenoids and the range of vitamin E tocopherols. Isolating one component does not provide the same degree of benefit as use of the entire food. If you choose to use the turmeric, let us know the results.

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Uhh-I buy it in a spice bottle in the grocery store.  Does this count as the whole root? Is the powder the same as the ground up root?   I've seen the turmeric root in the fresh produce section in the grocery store but it would probably sit in the fruit bowl and just dry up, which is what happens with my fresh ginger and fresh garlic.  I have good intentions but the spice bottle is probably the easiest to keep and use.  I try to use the turmeric/garlic/salt shaker along with the Montreal Steak Seasoning as my primary seasonings and the dishes are delicious.  I love the fact that turmeric has such amazing qualities-it's basically a health food all by itself and I love the fact that it reduces inflammation at the cellular level which is now seen as setting off a lot of negative consequences.  It's anti-cancer activity is awesome and worth any extra effort that using it requires especially in the stomach, intestines and colon.  

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Uhh-I buy it in a spice bottle in the grocery store.  Does this count as the whole root? Is the powder the same as the ground up root?   I've seen the turmeric root in the fresh produce section in the grocery store but it would probably sit in the fruit bowl and just dry up, which is what happens with my fresh ginger and fresh garlic.  I have good intentions but the spice bottle is probably the easiest to keep and use.  I try to use the turmeric/garlic/salt shaker along with the Montreal Steak Seasoning as my primary seasonings and the dishes are delicious.  I love the fact that turmeric has such amazing qualities-it's basically a health food all by itself and I love the fact that it reduces inflammation at the cellular level which is now seen as setting off a lot of negative consequences.  It's anti-cancer activity is awesome and worth any extra effort that using it requires especially in the stomach, intestines and colon.  

 

That's fine to buy it as spice -- the rhizome has been dried and ground up, it's still the whole root, just in powder form. If you'd like to buy it fresh, just keep it in the freezer. Then take it out when you need it, and grate some on a microplane grater, and return the rest to the freezer. Or chop up the roots in a blender, put in a jar, and keep stored in the freezer.

 

The fresh and fresh-frozen definitely tastes best, and I wouldn't be surprised if it has better properties. But the powder is convenient, if that's what works best for you. I have it in both forms, and try to use it daily.

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Has there been any research on stomach ulcers "waking up" the Parkinson's, which then used the vagus nerve?

 

I'm not certain that Helicobacter pylori infection (the cause of stomach ulcers) exactly "wakes up" PD, nor of a direct connection with the vagus nerve. But H pylori does appear to be very common in PD, and to affect the absorption of medications, thus causing motor fluctuations; and is associated with greater severity of PD.

 

I am not certain of the role that the gut microbiome plays in PD at this point, but it appears prudent to maintain gut health by use of prebiotic and probiotic means. I highly recommend use of prebiotic foods such as the fibers found in barley (in the post on whole grains that I entered earlier today) and inulin; as well as probiotic foods such as yogurt and kefir. Fermented foods such as sauerkraut are also good if you are not using Azilect.

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I can't say enough good about turmeric. Azilect for PD is considered to be an MAOI - B Inhibitor to help stop the breakdown of dopamine in the brain. A few years back I googled a "natural" MAOI-B inhibitor and it said turmeric was one. Unfortunately once I started on prescription meds like carbo-levo it seemed like the turmeric decreased the effects of my prescription meds so I stopped taking it. I normally would go to my local natural foods co-op store and buy the powdered form in bulk. When I tried the dried form in capsule put out by Spring Valley at Walmart it was dead. Maybe just that one bottle but I never bought it again, I stuck with the bulk. When I would take it it helped with my psoriasis, my swelling big time, and so many other things. I don't sleep well at all so the other morning I took some at 2 in the morning and I could tell a difference in how I felt.

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I'm very happy that turmeric has been so beneficial for you. I had not previously heard from anyone that use of turmeric affected their Sinemet/levodopa use, so that is interesting, and I will bear it in mind. Research on turmeric as an MAOI-B is limited but suggests that its influence is slight, due to the poor absorption of curcumin, which is the component of concern.

 

And thank you for the information on turmeric helping your sleep, that's also good to know, as poor sleep is a problem for so many people with PD. We welcome any further comments you may have.

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I apologize, I didn't communicate very well. When I was up at 2 in the morning from not sleeping and I took the turmeric it helped me with my swelling a lot but not with my sleeping. Your website is wonderful, thank you so much.

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Could you please list few good probiotics that we can use buy from Amazon or other place that is good for gut health and reduce inflammation?

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I apologize, I didn't communicate very well. When I was up at 2 in the morning from not sleeping and I took the turmeric it helped me with my swelling a lot but not with my sleeping. Your website is wonderful, thank you so much.

 

That's still very good news, and thank you for updating us. It has been studied with good results for so many conditions -- cancer, arthritis, heart disease, inflammation, Alzheimer's, and even PD -- that is seems worthwhile to try it, and it's always good to hear from someone who has tried it and can report on its effect.

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Could you please list few good probiotics that we can use buy from Amazon or other place that is good for gut health and reduce inflammation?

 

The more organisms a product has, and the greater variety of organisms, the better. Here are some products approved by ConsumerLab; I do not know whether they are available on Amazon, though.

 

21st Century Ultra Potency Advanced Probiotic, 2 capsules, once daily; 20 billion organisms. Lactobacillus acidophilus, Lactobacillus casei, Lactobacillus rhamnosus, Bifidobacterium longum, Bifidobacterium lactis, Lactobacillus delbrueckii     APPROVED   

 

BioGaia® ProTectis - Lemon-Lemon Flavored (1 chewable tablet, once daily) ; 100 million organisms. Lactobacillus reuteri DSM 17938     APPROVED

 

Culturelle (1 capsule, once or twice daily) 10 billion to 20 billion organisms. Lactobacillus GG     APPROVED

 

Dr. Mercola® Complete Probiotics (2 capsules, once daily) 70 billion organisms. Lactobacillus acidophilus DDS-1, Bifidobacterium lactis, Lactobacillus plantarum, Lactobacillus casei, Lactobacillus rhamnosus, Lactobacillus brevis, Bifidobacterium longum, Lactobacillus salivarius, Streptococcus thermophilus, Bifidobacterium bifidum

 

Garden of Life® Primal Defense® Ultra (1 vegetarian capsule, once to three times daily)     5 to 15 billion. Saccharomyces boulardii, Lactobacillus plantarum, Bacillus subtilis, Lactobacillus paracasei, Bifidobacterium longum, Lactobacillus brevis, Bifidobacterium bifidum, Bifidobacterium breve, Bifidobacterium lactis, Lactobacillus acidophilus, Lactobacillus salivarius, Lactobacillus rhamnosus, Lactobacillus casei     APPROVED   

 

GNC Ultra 25 Probiotic Complex (1 vegetarian capsule, once daily) 25 billion. Lactobacillus acidophilus (CUL60), Lactobacillus acidophilus (CUL 21), Bifidobacterium bifidum (CUL 20), Bifidobacterium animalis subsp. lactis (CUL 34)     APPROVED   

 

Nutrition Now® PB8® (2 capsules, once daily)  14 billion organisms.

Lactobacillus acidophilus, Bifidobacterium lactis, Lactobacillus plantarum, Lactobacillus salivarius, Bifidobacterium bifidum, Bifidobacterium longum, Lactobacillus rhamnosus, Lactobacillus casei

 

Solgar® Probi® 30 Billion (1 vegetable capsule, once daily) 30 billion organisms. Lactobacillus plantarum LP299v™     APPROVED   

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Arent the best probiotics come in ice packs? Most probiotics purchased online dont come in ice packs usually sit outside in hot sun before i picked them up.

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This depends upon the particular organism, how the product is formulated, and the type of pill. Most commonly, probiotics are shelf-stable; that is why you can find good brands in health food stores on the shelves, although some may be refrigerated; and why you can buy good products online.

 

Some products will state on the label to refrigerate in order to prolong shelf life. And you should keep all probiotics in a cool, dry and dark place, so that the microbes will not be activated. If refrigeration is needed, the product should state this on its label, so be certain to check for any special storage requirements.

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It depends upon the reason for using a probiotic. If using for a specific concern, then a quantity of a single organism may be desirable. For example, with abdominal pain and constipation due to Irritable bowel syndrome (IBS), Bifidobacterium infantis may improve symptoms; for diverticular disease L. casei may help.

 

For general purposes, however, the greatest variety of organisms is likely to prove most beneficial, and for adults, should contain at least one billion cells.

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Based on what you have posted, garden of life probiotic seems to have the most variety out of the probiotics tested by consumer labs if I'm correct

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I have double-checked, and of the Adult Products (as opposed to Child, Women, Pet products) yes, you are correct -- Garden of Life has the greatest variety of organisms.

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Once you take a good probiotic for few months, do you need to keep taking them unless you go on antibiotics or ant-inflammatory medication that could harm the good bacteria?

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