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Background  We previously reported gut dysbiosis in patients with Parkinson’s disease (PD).    Objective  The aim of this study is to examine whether gut dysbiosis correlates with the progression of PD.    Methods  We examined changes in gut microbiota and demographic features in 2 years in 36 PD patients.    Results  A change of total UPDRS scores in 2 years was predicted by the counts of  Bifidobacterium  and  Atopobium  cluster at year 0 with a correlation coefficient of 0.52. Correlation analysis additionally revealed that low counts of  Bifidobacterium  and  Bacteroides fragilis  at year 0 were associated with worsening of UPDRS I scores in 2 years. In addition, low counts of  Bifidobacterium  at year 0 were associated with worsening of hallucinations/delusions in 2 years. Similarly, low counts of  B .  fragilis  at year 0 were associated with worsening of motivation/initiative in 2 years. The patients were evenly divided into the deteriorated and stable groups based on the degree of worsening of total UPDRS scores. The deteriorated group had lower counts of  Bifidobacterium ,  B .  fragilis , and  Clostridium leptium  than the stable group at year 0 but not at year 2, suggesting that the deteriorated group may demonstrate accelerated lowering of these bacteria at year 0.    Conclusions  The total counts of intestinal bacterial decrease in the course of PD progression. Temporal profiles of lowering of bacterial counts are likely to be different from bacteria to bacteria, and also between the deteriorating and stable groups, which may be able to be exploited to differentiate patients with rapidly and slowly progressive PD pathology.

Progression of Parkinson's disease is associated with gut dysbiosis: Two-year follow-up study