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The Gut-Brain Axis and Neurodegenerative Diseases: Can treatment of chronic constipation be used as a disease-modification for Parkinson’s?

The Gut Brain Axis and Its Relationship to Diseases

In deciphering poorly explained pathologies, one of the communication pathways that has recently come into increased focus is the gut-brain axis. As a potential culprit in many physiological processes, this axis is a complex relationship of bidirectional signaling between the gastrointestinal (GI) tract and the brain. Involving multiple nervous and hormonal pathways, this relationship regulates homeostatic aspects such as temperature, digestion, sleep cycles, mood and more. It has been shown that, when disrupted, the gut–brain axis is involved in the pathogenesis of a broad range of diseases, including such neurodegenerative conditions as Parkinson’s disease (PD).

Your biological Clock: The effect of Rhythm on GI-Derived diseases

Circadian rhythms are the 24-hour patterns that regulate all living creatures, aligning macro and micro biological functions with normal environmental conditions. From sleep and wakefulness, to energy levels, to digestion and excretion, circadian rhythms are meant to optimize healthy functioning against regular, predictable environments.

Disrupting these rhythms (whether due to environment, lifestyle, or disease) can result in numerous pathologies, including in the GI tract. Studies in recent years have consistently linked between circadian rhythm alterations and the development of digestive pathologies related to metabolism, cell proliferation, immune homeostasis, microbial balance, and more.

The Parkinson’s Connection

One of the most common non-motor symptoms of Parkinson’s disease is constipation, which affects 50% to 80% of PD patients. This symptom may result from PD’s characteristic dopamine shortage, which can make it difficult for bowel muscles to expel matter through the GI tract; from slow movement of the GI tract and smooth muscle contraction due to improper autonomic nervous system function; and from PD medication side effects.

Conversely, constipation can also be a predictor of Parkinson’s, preceding motor symptoms by as much as 10-15 years, and indicating high risk of PD in patients who suffer from constipation. Studies have found correlation between constipation and PD duration and severity; and found an increased constipation frequency and severity as Parkinson’s progressed.

Normalizing the Rhythm – a treatment opportunity?

There is growing evidence suggesting that the pathogenesis of Parkinson’s disease originates in the intestine, beginning with the GI’s circadian rhythm being disrupted, and continuing with inflammation. Renowned American physician and researcher Dr. Michael Zasloff has suggested that, by stimulating the enteric nerves and restoring the circadian rhythm, many neurodegenerative diseases – including PD – could be impacted.

GI innovators Vibrant are proposing to further explore this mechanism through mechanical, drug-free stimulation of the gut-brain axis, in order to examine whether this stimulation may slow the progression of Parkinson’s disease symptoms – while providing direct relief for PD patients’ constipation issues.

Vibrant’s unique capsule stimulates bowel movement by mechanically inducing vibrations in the large intestine in unison with the underactive circadian rhythm. This sets the body’s natural evacuation mechanism in motion, resulting in effective and comfortable constipation relief. A recent ACG 2018 publication by Dr. Satish Rao et.al, demonstrated that when set to operate with the circadian rhythm, the vibrant capsule significantly increases the number and % of complete-spontaneous-bowl-movements (CSBM), during and near vibration time. By normalizing the GI’s circadian rhythm back to proper timing and intensities, Vibrant hopes to examine the possibility of directly impacting PD pathology.