Abstract
Background and aim Neuroinflammatory mechanisms have been closely related to the microbiota-gut-brain axis and could lead to degeneration of dopaminergic neurons with subsequent development and progression of Parkinson’s disease (PD). Targeting this pathway for the treatment of PD has sparked a lot of interest. Hence, this study investigates the therapeutic potential of a synbiotic supplement, in conjunction with l -dopa for the management of PD. Methods This randomized controlled trial enrolled 66 Parkinson's disease patients, who were randomly assigned to two groups: a control group ( n = 33) receiving standard l -dopa/carbidopa (100/25 mg) therapy three times daily for three months, and a synbiotic group ( n = 33) receiving the same l -dopa/carbidopa regimen with two sachets of the synbiotic supplement daily for three months. The outcome measures included assessment of Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) and serum levels of tumor necrosis factor-alpha (TNF-α), malondialdehyde (MDA), brain-derived neurotrophic factor (BDNF), and α-synuclein (α-Syn). Blood samples were collected from all patients for biomarker analysis in serum. Results Three months after intervention, the synbiotic group demonstrated significantly greater improvement in motor and non-motor symptoms compared to the control group evidenced by the change in the scores of each part of the MDS-UPDRS. Concurrently, the synbiotic group exhibited significantly lower serum levels of pro-inflammatory marker TNF-α and oxidative stress marker MDA, and significantly higher levels of the neuroprotective factor BDNF. Conclusion Supplementing with synbiotics exhibits promising neuroprotective and therapeutic effects in the treatment of Parkinson’s disease patients. Clinicaltrials.gov registration number NCT05576818. Retrospectively registered in October 2022.