The Times They Are a-Changin’: Parkinson’s Disease 20 Years from Now

Abstract

In the last two decades it has become clear that Parkinson’s disease (PD) is associated with a plethora of gastroin-testinal symptoms originating from functional and structural changes in the gut and its associated neural structures. This isof particular interest not only because such symptoms have a major impact on the quality of life of PD patients, but alsosince accumulating evidence suggests that in at least a subgroup of patients, these disturbances precede the motor symptomsand diagnosis of PD by years and may thus give important insights into the origin and pathogenesis of the disease. In thismini-review we attempt to concisely summarize the current knowledge after two decades of research on the gut-brain axis inPD. We focus on alpha-synuclein pathology, biomarkers, and the gut microbiota and envision the development and impact of these research areas for the two decades to come.