الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Parkinson’s disease (PD) is the second most common neurodegenerative disorder following Alzheimer’s disease. In Egypt, statistical studies showed a remarkably high prevalence of PD, incidence rates reported from Egypt lie above the range of rates reported anywhere else.
Preclinical PD is the stage preceding the onset of the typical motor symptoms and may last many years making it an excellent research target to seek biomarkers that can help in early disease diagnosis and investigate new disease modifying treatments.
Many preclinical biomarkers have been suggested for PD but cannot be used alone to effectively predict the disease. Hence gut microbiome (GM) composition changes have evolved as a recent research area to investigate possible pathologic mechanisms, biomarkers, and treatment modalities.
Among the several results of PD GM studies outstands decreased abundance of Prevotella in fecal samples of PD patients compared to healthy controls.
This study was designed to compare between PD patients and their healthy controls as regards relative Prevotella abundance, prevalence of Prevotella-dominant enterotype, and constipation severity. And to correlate Prevotella changes with the severity of motor and non-motor symptoms of PD.
Twenty-five PD cases who presented to Alexandria University Hospital’s Neurology Clinic were enrolled in this study and cross-matched to 25 healthy subjects representing the control group. Parkinsonian symptoms were measured using the Unified Parkinson’s Disease Rating Scale (UPDRS) and the modified Hoehn & Yahr scale (H&Y). Overall NMS severity was assessed using the Non-Motor Symptoms Scale (NMSS). Constipation severity was quantified using Wexner Constipation Scoring System. Patients were grouped according to the predominant symptom into tremor-dominant (TD), postural instability and gait difficulty (PIGD), and mixed phenotype. Quantitative SYBR green Real Time PCR was performed for the identification and quantitation of Prevotella in stool. Results were expressed relative to the total bacterial DNA within the sample.
There was no statistical significance difference between cases and control groups as regards age, sex, or body mass index (BMI).
Prevotella relative abundance was 4-fold decreased in cases when compared to controls, however it failed to reach statistical significance, Prevotella-dominant enterotype was less presented in cases compared to controls, the result was statistically significant (P=.001).
There was highly statistically significant difference between two groups as regards total constipation score, median (Min-Max) in cases group was 13 (2-18) Vs 4 (0-16) with (P value = .0001). Also, severe and very severe constipation grades presented 64% of cases group Vs 12% of control group, the result was statistically significant (P value = .0001).