Updated on February 8, 2023
For patients with neurodegenerative disorders and their families, the possibility of effective management options provides a ray of hope in an otherwise challenging and frustrating situation. Medical professionals can offer advice about drugs and lifestyle changes that might help, but in many cases, the available therapeutics achieve only minimal benefits, and the “bad days” can increasingly outweigh the good ones as a disorder progresses. As a result, patients are continuing to call for the development of more and better therapies, and the research community is responding.
So far, researchers have developed a variety of pharmacological drugs that do help many patients manage their symptoms—including dopamine agonists, synthetic dopamine, anticholinergics, and enzyme inhibitors, among others—as well as non-pharmacological therapeutic options, such as brain training games, social stimulation, and physical exercise. Nevertheless, while many patients do respond remarkably well to these therapies, there are still some patients for whom the effects are only moderate, mild, or even nonexistent. There are also patients whose symptoms benefit from pharmacological therapies but who experience side effects that negatively affect their quality of life. Therefore, the quest for effective alternative strategies for the management of neurodegenerative disorders continues.
One emerging strategy is to use nutritional supplements to aid in the symptom management of neurodegenerative disorders. Although comprehensive clinical trials are lacking, preliminary research in animal models suggests there might be benefits to taking nutritional supplements that can modulate the gut microbiome or directly introduce metabolites of gut bacteria, such as short-chain fatty acids. Based on these early findings, practitioners and patients can now begin considering taking safe and effective nutritional supplements as a viable alternative therapy for the symptom management of neurodegenerative disorders.
One of the most intriguing studies on the potential benefits of nutritional supplements for the symptom management of neurodegenerative disorders was published in Nature Scientific Reports in May 2017. In this study, researchers from the University of Camerino in Italy examined the relationship between probiotic supplementation and the physiological and symptomatic manifestations of Alzheimer’s disease. Their work was premised on the notion that gut bacteria and their metabolites are involved in the regulation of several key neurochemical pathways, and the results of the study built on this idea by showing how microbiome modulation could directly benefit physiological signs of neurodegeneration in animal models.
The researchers conducted their study on mouse models of Alzheimer’s disease while the mice were in the early stages of the disease. They treated the mice with a novel probiotic formulation that included lactic acid bacteria and bacteria from the genus Bifidobacterium. The choice of these genera for the probiotic formulation is notable because both Bifidobacterium and lactic acid bacteria are known to be involved in the production of a key metabolite: butyric acid. Butyric acid is produced when bacteria in the gut metabolize fiber, and it thereafter plays a role in a wide range of bodily processes, including epigenetic regulation, energy metabolism, and the activation of critical protein signaling and communication pathways.
One of the most significant findings of the Camerino study is that the mouse models who took the probiotic formulation demonstrated significantly less cognitive decline than the controls. The researchers used two types of tests (novel object recognition and passive avoidance tests), both of which are widely accepted for measuring the functions of the hippocampus and the amygdala, the two parts of the brain implicated in the cognitive decline associated with neurodegenerative disorders. The researchers attribute the lack of cognitive decline in the mice who took probiotic supplements to restricting the brain damage and a reduction in the accumulation of amyloid beta aggregates—that is, the clumps of misfolded proteins that are a well-known hallmark of neurodegenerative disease.
The Camerino researchers elucidated a specific mechanistic explanation for the decline in beta-amyloid plaques. In the mice who took the probiotic supplement, they observed a partial restoration of the function of two proteolytic pathways that are impaired in mouse models of Alzheimer’s disease. Proteolytic pathways are pathways that degrade proteins, so when they are not functioning normally, it can lead to the buildup of amyloid beta aggregates, which can, in turn, contribute to the onset and exacerbation of neurodegeneration. Apparently, the probiotic supplement helped maintain the functioning of those two pathways, and the researchers linked this physiological result to the cognitive symptoms displayed by the mouse models.
The third important result of the Camerino study is that taking the probiotic had a modulating effect on the levels of inflammatory cytokines and neurodegeneration-related hormones in the blood. Inflammation is known to be an important factor in neurodegenerative disease progression, and the hormones they found are currently being considered by researchers as therapeutic targets for future Alzheimer’s disease therapies. Overall, taken together, the Camerino researchers’ results clearly suggest that probiotic supplements can have multiple benefits for patients with neurodegenerative disorders.
Although the results of the Camerino study provide significant support for the use of probiotics, they also suggest that other supplements might have a beneficial impact. In particular, butyric acid might be a potentially useful nutritional supplement for patients looking for a neurodegenerative disorder management option. The Camerino study shows that when the mouse models took the probiotic supplement, there was a statistically significant rise in the three short-chain fatty acids commonly found in the gut: butyric acid, propionic acid, and acetic acid. Ultimately, this came as no surprise, because (as previously noted), both lactic acid bacteria and Bifidobacterium are known to be involved in the production of butyric acid in the gut. However, the Camerino study offers new insight because it associates high levels of these compounds with physiological and behavioral improvements in mouse models of Alzheimer’s disease, suggesting that a direct introduction of butyric acid through a supplement might have the potential to produce similar results.As more studies like the Camerino study from 2017 enter the research pipeline, the relationships between the gut microbiome and neurodegenerative disorders will become increasingly clear. Clinical trials will also shed more light on the relative efficacy of different probiotic formulations and dietary supplements that contain butyric acid. Until then, patients and practitioners can consider both types of supplements as possibilities when exploring possible alternative strategies for the symptom management of neurodegenerative disorders.
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