My PD Story

Cindy Finestone sitting at a table
People with PD

Cindy Finestone

Cindy Finestone does it all. The on-the-go, soon-to-be first-time grandmother serves on community boards, enjoys the challenge of cooking a Sunday feast for her three adult children with minimal warning, goes to the gym six days a week and fundraises for causes she believes in. And she does it all fighting Parkinson’s disease (PD). 

Cindy was diagnosed with Parkinson’s 10 years ago. She’s heard enough misdiagnosis stories to know she is “one of the lucky ones.” After ruling out carpel tunnel, her neurologist told her to return if she noticed a tremor or funny feeling in her hand. “A lot of times people put things off and don’t address health problems right away, making it worse. A year after my initial visit, I began trembling in one hand. It happened twice in one day, so I got it checked out,” Cindy said.

Cindy thought it was unusual that her doctor was standing at the exam room door waiting for her. She later found out he was observing her gait and whether her arm was swinging. “He asked me questions like ‘Do you notice yourself drooling?’ and ‘How is your sense of smell?’ I left with a Parkinson’s diagnosis, an Azilect® prescription and a referral for a movement disorders specialist.”

Shortly following her diagnosis, Cindy began experiencing severe cervical dystonia (sustained and repetitive muscle spasms or cramps). The pain caused her to constantly look up and had an impact on her daily life. Her movement disorders specialist started Cindy on Botox injections, every three to five months, in her neck. “Parkinson’s caused the muscles in my neck to atrophy, so I started exercising like I never had before to strengthen my body,” Cindy said.

Fast forward to 10 years later, Cindy goes to the gym six days a week, sometimes seven. Once she found Rock Steady Boxing classes, her life changed for the better. “I don’t think she knows we have Parkinson’s,” a fellow boxing student once told her during a class. Cindy wouldn’t have it any other way. She now works with the Rock Steady Boxing instructor two times a week, in addition to her four weekly group boxing and core stretching classes.

Exercise is not just about physical health, but mental health. I believe that the more you push yourself when exercising, the better your movements will be every day,” Cindy said. “I used to exercise before being diagnosed, but nothing like now. If I don’t go to the gym, I feel like something is not right.”

Between her treatments and her Rock Steady Boxing instructor focusing on strengthening her neck muscles (one of which was making her hold a tennis ball under her chin) Cindy’s dystonia dramatically improved. She was feeling better and ready to get involved in the PD community.

Cindy Finestone at a Moving Day Walk

Community engagement is nothing new for Cindy. She grew up with parents who valued volunteering, she was a classroom mom, PTA leader and served on numerous local boards. She eventually found the Parkinson’s Foundation walk, Moving Day Rochester, NY. “I didn’t ask anyone to go with me. I didn’t feel comfortable asking people for money. I went by myself for years.”

One day her son’s teacher was diagnosed with Parkinson’s, and he asked Cindy if she had heard of Moving Day. He could not believe his mom had been attending alone and insisted on not only going with her, but helping her team. Rock Steady Boxing Flower City was launched, and Cindy went into planning mode. She created jewelry and T-shirts to raise funds, along with her first Facebook account and page — and raised $5,000 in four weeks.   

Cindy eventually applied and was selected to serve on the Parkinson’s Foundation People with Parkinson's Advisory Council, a group of dedicated people in the PD community who advise and collaborate with the organization on a volunteer basis. She is also president elect and serves on the board of the Parkinson’s Foundation New York New Jersey Chapter.

“Being involved in the Parkinson’s Foundation makes me feel like I’m doing something that’s helping. Everything I do is somehow related to the Foundation. I attend a PD support group of 60 women, some of whom have become my closest friends—and I found this group through the Foundation. I call the Helpline for referrals. I go on Parkinson.org every time I feel a new symptom coming."

Cindy Finestone with her family at a graduation

Cindy often gets asked about Parkinson’s because of the Parkinson’s Foundation lanyard she wears for her keys. She doesn’t shy away from hard topics and always advocates for finding your community, volunteering, and exercising. 

“Somedays Parkinson’s is more emotional than physical. You just don’t want to exercise; you want to get off the ‘train.’ But then I start thinking ‘What am I going to stay home for?’ You can modify everything you do based on how you feel,” Cindy said.

Cindy considers living with Parkinson’s to be a non-stop job. She even tailors her hobbies to find activities that can help with symptom management. While she notices that Parkinson’s has slowed her down, especially in the morning, she doesn’t let it stop her from living life. “I love being outside, golfing, and taking brisk walks. I play mahjong, do pottery and knitting classes — classes that can help in fine motor skills. I love cooking and spending time in my craft room, but volunteering is what keeps me busy, it keeps me aware.” 

This April, help the Parkinson’s Foundation advocate for Parkinson’s Awareness Month. Learn More.

Raise Awareness

Rehabilitation Care & Parkinson’s: Start Early and Assess Often

Man doing physical therapy exercises using a stretch band

A serious misconception about Parkinson’s disease (PD) is that rehabilitative care should only come into play in the later stages of the disease. In fact, rehabilitation can play a crucial role in managing and improving PD symptoms, function, and quality of life and reducing disability from day one.

In January 2024, the Parkinson’s Foundation published a paper on the importance of delivering rehabilitation care in Parkinson’s in the Journal of Parkinson’s Disease. This paper was written by the Parkinson’s Foundation Global Rehabilitation Medicine Task Force, which was formed to help healthcare professionals incorporate rehabilitation into PD care.

“Our goal is to raise awareness of the importance of rehabilitation care in PD. We want to motivate people living with Parkinson’s to advocate for their best care, and that means knowing that they can start rehabilitative care at any point in their disease. We also want to motivate professionals to include evidence-based rehabilitation interventions when providing care to every person with Parkinson’s,” said Jennifer Goldman, MD, MS co-chair of the Parkinson’s Foundation Rehabilitation Medicine Task Force.

Rehab infographic

Parkinson’s rehabilitation services should start early and be assessed every year.

Rehabilitation is defined as a set of treatments and therapies that can help people with Parkinson’s maintain or improve activities of daily living and independence. PD rehabilitation can include:

Trained rehabilitation professionals provide care with the goal of keeping people with PD communicating well, engaging in activities they love and moving well. Rehabilitative care plays a crucial role in PD care and improving health outcomes, with growing evidence showing the benefit for movement and non-movement symptom management, activities of daily living and quality of life.

Key Highlights

The Parkinson’s Foundation Global Rehabilitation Medicine Task Force published the following takeaways regarding rehabilitative care and PD: 

  • Rehabilitation should involve the person with PD and care partner and should incorporate shared decision-making to promote symptom management and independence.

  • Care coordination and communication among the rehabilitation team, the entire PD care team, the person with PD, and care partner are critical for best results.

  • Rehabilitative care professionals should have knowledge and expertise in treating people with Parkinson’s disease.

  • Since Parkinson’s is a progressive disease, rehabilitative care should be offered at diagnosis and regularly throughout the disease course with repeated assessments and interventions adapted to changes in a person’s condition or needs.

  • Rehabilitative interventions are critical in treating PD, alongside medical, surgical and other PD-related interventions.

What is the takeaway for people with Parkinson’s?

More than half of people with PD are never referred to rehabilitative therapy in their lifetime. Research shows that these therapies help with symptom management and help people with PD stay independent longer. Many healthcare professionals and people with PD remain unaware of the potential impact of rehabilitative care, thereby limiting their use and availability in the PD community. These therapies are greatly under-utilized for people living with PD.

Rehab infographic

Participating in rehabilitation care leads to:

The Parkinson’s Foundation recommends that every person with PD ask their PD doctor at least once a year if they can benefit from rehabilitative services.

Learn more about Physical, Occupational & Speech Therapies. For a referral to a rehabilitation expert near you, call our Helpline at 1-800-4PD-INFO (1-800-473-4636).

My PD Story

Herbert Wennink headshot
People with PD

Herbert Wennink

I was 56 when I was diagnosed with Parkinson's disease (PD). Now, almost 10 years later, I look back on how the disease has affected my life but also how I continue to adapt. I never thought I’d be at the gym so much, or that I’d have to take early retirement, but I have learned that I am resilient and that even as the disease progresses, I can still have a great deal of joy in my life.

A few months before being diagnosed, I noticed symptoms of Parkinson’s, such as a small tremor in my hand and a loss of smell. At the urging of my wife, I saw my primary care doctor, who suspected Parkinson’s. I then saw a general neurologist who confirmed the diagnosis.

I sought a second opinion at Northwestern Medicine Parkinson’s Disease and Movement Disorders Center because it is a Parkinson’s Foundation Center of Excellence. Northwestern Medicine Neurologist Danny Bega, MD, confirmed my diagnosis and created a personalized treatment plan addressing not only medications, but also lifestyle changes and exercise to manage symptoms and enhance my quality of life.

A central element of my life is attending Rock Steady Boxing classes specifically designed for people with Parkinson’s. I also attend Parkinson’s-specific ping pong, golf and Second City Improv classes. Who knew Parkinson’s could be so funny? Many of these initiatives have received Parkinson’s Foundation community grants.

The Parkinson’s Foundation has been a key resource for providing me and my family with ongoing education. I found the Hospital Safety Guide to be helpful when I was diagnosed and continue to use it as a resource. Each year, I attend the Parkinson’s Disease Patient and Caregiver Symposium, co-hosted by the Parkinson’s Foundation and Northwestern Medicine, to stay updated on treatments and research. Through the Foundation’s events like Moving Day walks and Parkinson's Players activities, I have found support, camaraderie and a sense of belonging.

My journey with Parkinson’s disease has taught me many things. One is that Parkinson’s isn’t limited to older adults; it affects people of all ages and can happen to anyone.

Herbert Wennink on a hike

I’ve also learned to celebrate milestones. I’ve been living with Parkinson’s for nearly a decade, and every year that my symptoms are managed is a milestone. I appreciate that I have been able to live well enough to take several international trips with my wife and daughter since my diagnosis.

I am proud to have stuck with a vigorous exercise program over the years, and it’s paying off. I have definitely learned that exercise equals medicine, and the community of supportive coaches and friends is invaluable. I hope fellow people with PD will approach this disease with a positive attitude and a commitment to being active — and keep pushing to live the best life possible.

Learn more about the Northwestern Medicine Parkinson's Disease and Movement Disorders Center

Find the Parkinson’s exercise class that works for you! For virtual options, explore our Fitness Friday videos. For in-person classes, visit your local chapter’s webpage or call our Helpline at 1-800-4PD-INFO (1-800-473-4636).

My PD Story

Kayla Giese at Parkinson's Revolution
Family Members

Kayla Giese

In 2021, I received a weekly newsletter email from the local spin studio I’m a regular at in Sacramento, CA. The email was promoting the first Parkinson’s Revolution that would be held in just a few months. My grandfather (who we call “Papa”) was diagnosed with Parkinson’s disease (PD) about 10 years prior. I immediately clicked the link to sign up because I had to support this cause that I had a close connection with.

Once I signed up and learned that I could also fundraise for the event, I thought “hey, why not?!” and I started bugging family and friends to donate. Ride day arrived and I was eager to participate and maybe connect with other people who were indirectly affected by Parkinson’s in the way that I was. As I approached the check-in table, I was greeted with welcoming smiles from the lead volunteer and Parkinson’s Foundation staff who hyped me up for being the top fundraiser! I was so excited. Once the event was over, Foundation staff asked if I would be interested in volunteering and almost four years later… I’m still here!

Kayla Giese and her papa

My Papa is a retired fire captain, was an avid golfer, enjoyed running marathons and could build just about anything before his battle with PD. He is the strongest and most humble man I know. When he was diagnosed with PD, I didn’t understand what was ahead of us as a family. I never really knew what Parkinson’s was. Through his battle with the disease, we’ve watched him lose his ability to do the things he loves.

Volunteering for the Parkinson’s Foundation has not only been rewarding, but also humbling and cathartic for me. During my time as a volunteer, I have been so lucky to meet other amazing volunteers who do not let their diagnosis get in their way from achieving anything and everything they want. I’ve met other family members of people with Parkinson’s who understand the heartbreak of watching your loved ones lose the ability to do the things they love as they age in their battle.

The connections I have made through the Parkinson’s Foundation have taught me what perseverance, strength and support really mean. I am so grateful to my fellow committee members, event participants and Foundation staff for being the community I never knew I needed.

The resources the Parkinson’s Foundation provides are just as important to caregivers and family members as they are to those living with the disease. My Papa is a pillar in my support system and saved so many lives in his career, and so my volunteer work through the Foundation is the best way I can honor him.

The Parkinson’s Foundation has created a community that is unmatched, and I am so thankful to be a part of it and to keep fighting for those who can’t always fight for themselves.

Sign up for a Parkinson’s Revolution event near you and explore Parkinson’s Foundation volunteer opportunities.

My PD Story

Cecelia Beam teaching a class
General PD Community

Cecelia Beam

When I was training for a professional dancing career, I never dreamed that the art form I was learning and loved with such passion would give me the skills to one day be of service to people with physical and cognitive limitations. But that is exactly what happened!

After performing, I had a long career teaching adult ballet technique in colleges and private studios. When I retired from my “day job” as human resources manager for San Francisco Ballet, I was asked to teach adult ballet at the San Francisco Ballet School. Shortly after joining the faculty, Patrick Armand,  then the director of the Ballet School, asked if I would be interested in teaching a dance class for people with Parkinson’s disease (PD). Adaptive dance for adults was a new offering and Patrick was an advocate of the program as his mother, a respected ballet teacher died with Parkinson’s.

I enthusiastically accepted the offer, and promptly made my way to receive training at the Mark Morris Dance Center where the Dance for PD program held teacher trainings. I immediately found teaching and choreographing for this population creative and rewarding. After teaching the class for a year, I met Gena Lennon, Director at the Parkinson’s Foundation who educated me about the Foundation and the many ways it supports the community (explore Parkinson’s Foundation resources and upcoming events).

Cecelia Beam and group

With the support from a Parkinson’s Foundation Community Grant, San Francisco Ballet School offers free weekly classes, social gatherings, tickets to ballet performances, dance education and more. Our classes are based in ballet — emphasizing joyful movement, artistry and fun. A ballet school pianist accompanies our class with beautiful music, while accessible choreography propels us forward in our love of the very thing that anyone with Parkinson’s must do — and that is to MOVE!

I have been motivated to learn more about how dance can improve the lives of older adults and recently attended Canada’s National Ballet School’s Teacher Training where I worked closely with the Sharing Dance Program Faculty which brings dance to adults with dementia at residential care facilities. 

We all learned through research and from clinicians that movement is medicine for people with Parkinson’s. San Francisco Ballet School invites all people affected by Parkinson’s, their family members and care partners to class in the studio or online.

Movement is a healthful and beautiful gift we can give ourselves.

Find the Parkinson’s exercise class that works for you! To explore nearby in-person classes visit your local chapter’s webpage or call our Helpline at 1-800-4PD-INFO (1-800-473-4636).

My PD Story

Harlee
People with PD

Harlee Abromson-Kuth

For four years, my neurologist told me my tremors were nothing. One day, I was getting a haircut. My hairdresser asked me if I had ever been evaluated for Parkinson’s disease (PD), because my walk reminded her of her Dad who had PD. That shook me up! 

I asked my neurologist to reassess me. He said he thought my hairdresser was right. I switched doctors and my wonderful new neurologist confirmed that my tremors, coordination, slowness and rigidity challenges were indeed Parkinson’s. 

My usual upbeat mood became dark. For a while I isolated as fear of an unknown future gripped me. I called the Parkinson’s Foundation Helpline, and asked many questions, read everything I could get my hands on. 

I learned of the Rock Steady boxing program for PD. I never imagined, at 71, that I would be learning how to box! I also started water aerobics. I’d always been a walker, as my husband and I have three rescue golden doodles who need as much exercise as we do!

I looked at boxing and water aerobics as chores I had to undertake for PD. However, what surprises me is that I have come to truly enjoy both activities! I also enjoy the socialization aspect of both, and not feeling alone. Over the last few months my boxing improved so much that I’ve added a regular class! 

Last week I saw my new neurologist. She told me that I have improved remarkably! My tremors are less frequent, less intense. My rigidly is gone. My coordination is better. I attribute this improvement to not only carbadopa levadopa, which I only recently started, but to boxing, water aerobics and walking.  

PD professionals who encourage vigorous exercise are right! The Parkinson’s Foundation Helpline specialists and my doctor stress exercise all the time!

I’ve come to know how critical it is to incorporate other resources as well. A loving, compassionate support system is vital. Socializing is paramount. Having fun with friends and family is medicine! A “most of the time” healthy diet matters! Meditation, rest and yoga are helpful as well! 

My advice is to find what works best for you! My mantra is the 3 P’s…Positivity, Peace, Proactivity. Living a full life is possible. Don’t give up. Help is out there.

Find the Parkinson’s exercise class that works for you! For virtual options, explore our Fitness Friday videos and events. For in-person classes, visit your local chapter’s webpage or call our Helpline at 1-800-4PD-INFO (1-800-473-4636).

My PD Story

Ann Boylan
People with PD

Ann Boylan

I’d like my Parkinson’s story to not be about living with limitations but rather about living with possibility. 

In 2015, my hometown of Union City, CA, and my fellow Mark Green Community Sports Center class attendees became the first Moving Day team, and received a Parkinson's Foundation community grant that made Union City’s Mark Green Sports Center the first Parkinson’s exercise program in the South East Bay a reality! Robert Magbanua Jr, our Parkinson’s fitness leader, trainer and program designer, and Corina Hahn, community program administrator were instrumental in making this happen.  

Over the years this program has grown to include caregiver support and classes that are offered five days a week and at home through Zoom. Robert’s charisma and enthusiasm keeps him in demand for speaking and leading attendees at Parkinson’s Foundation events all around the San Francisco Bay Area.  

About the same time as our first Moving Day event, I also became an advocate for awareness of the unique needs of women diagnosed with Parkinson's disease. In good part, looking at inequities when it comes to decisions about efficacy of drugs and treatments, that in the first place ignored gender differences in research with predominantly male subjects, and therefore skewed dosages and outcomes. Moreover single women, either without spouses or widowed, are more often relegated to nursing home care because they lack the means to advocate for aging in place, a familiar home, or for a clean home-like setting with the privacy and dignity of individual care.

These days my Parkinson’s story focuses on living with possibility thanks to a Parkinson’s breakthrough now dating back 20 years ago called deep brain stimulation (DBS) surgery, which I had two months ago. Still a miracle of science, it is a precision-driven, courageous team effort that has given me time in which some of the most debilitating features of Parkinson’s such as tremor and dystonia pain might be kept at bay, and I can have time to pursue activities and commitments  that promote heart, hope, energy, awe, curiosity and love. 

My Parkinson’s story? It is about “flourishing” with Parkinson’s disease and the “community to be found within it.”

Our Moving Day San Jose “Hop on the Union City A Train” team begins its ninth year raising funds, awareness and heartfelt support for the Parkinson’s Foundation. Let's not have to wait another 20 years for a breakthrough for Parkinson's! 

Thanks to my family and especially, my friends, my "ohana," my family through love, My Parkinson’s story continues!

Sex and gender differences can drastically impact health and are important to consider when it comes to Parkinson's. Explore our Women & Parkinson's page.

My PD Story

Christian Spence on a run
Family Members

Christian Spence

In 2019, my dad, Mark Spence, told us news that no amount of preparedness could brace for — he had a neurodegenerative disease by the name of Parkinson’s. This was a bittersweet moment — finally, we had an answer. Unfortunately, that answer was the beginning of an unceasing fight. A lifelong commitment to which my father had no choice except to partake in.

Seventeen at the time, I didn’t see the gravity of the situation. What I did see, however, was an absence of fear in my parents’ resolve. Uncertainty? Sure. Confusion? Certainly. Fear? Hopelessness? Absolutely not.

In the years that have followed, my parents have made sacrifices, changed their life plans, and been through an uncertain valley that is hard to imagine. Yet, they never changed their resolve. Certainly, sacrifices were nothing new — they did raise my sisters and me after all.

Challenges and obstacles were not a phenomenon unique to this new era of their lives. They are both incredibly hard workers who know the meaning of persistence. Regardless, their strength through it all became a beacon for my adolescent self. Twenty-one years old now, I have decided it’s my turn to be strong for my dad.

For years, I wanted to make a difference in Parkinson’s research and awareness, but simply could not think of how to go about that. On June 11, however, I was struck with an idea. While driving home from Athens, GA, I had been mulling over training for an endurance event, alongside my studies, when it hit me — why not combine my love for endurance events with my desire to help the PD community?

Honestly, this was a convicting moment. I knew I had a valid idea, but the process would inevitably require putting immense pressure on myself — to complete such a challenging event with so many eyes on me was terrifying. It was at this moment, however, that the strength of my parents was exactly the beacon I needed it to be. I can do it. I must do it.

The next day, I emailed the Parkinson’s Foundation about my idea. Not only did the Foundation support my idea, but they could also not have been more helpful in connecting me to the right people, answering all my questions, and helping me lay the groundwork for what the fundraiser has become. Throughout the past few months, I have made wonderful connections with amazing people within the PD community, and I am so excited to continue pushing forward as a Parkinson’s Champion.

Parkinson’s Champions raise funds and awareness for the Parkinson’s Foundation while competing in some of the more prestigious endurance events. Are you ready to #Run4PD? Explore upcoming Champions events.

My PD Story

Robert Magbanua Jr. boxing
General PD Community

Robert Magbanua Jr.

In late 2014, a gym member comes up to me after one of my exercise classes and told me that I would be the perfect person to teach exercise classes for the Parkinson’s community. Not knowing much about Parkinson’s disease (PD) at the time, I thanked her for the suggestion, and told her that I’d give it some thought.

I was so busy finishing up my graduate course work at the time that the idea quickly escaped my mind. However, over the course of the next year, this gym member was quite persistent in reminding me of the good I could do for the PD community with my Kinesiology and Personal Training background.

One particular day, she came up to me and told me about this great opportunity to apply for a Parkinson’s Foundation community grant, and that is where my journey with PD really began. That gym members name is Ann Boylan, and she was the inspiration for the Parkinson’s Exercise Program in Union City California.

Robert Magbanua Jr. boxing

My director (Corina Hahn), Ann, and I worked on the community grant application together. In our discussions, we planned to offer three premier PD exercise classes at the Mark Green Sports Center: Rock Steady Boxing, PWR! Moves, and Dance for Parkinson’s.

When we learned of the acceptance of our application, we were elated! Along with a few hand-picked instructors, I spent the year learning about PD and getting certified to teach PD exercise classes. My passion and previous experience with boxing and personal training helped me grasp the concepts quickly.

Since 2016, I have been involved with teaching and coordinating PD-specific exercise classes, support groups and special events that benefit the PD community. Throughout the years, we’ve been awarded additional community grants to help expand our reach, both in-person and virtually.

The Parkinson’s Foundation has made this incredible journey I’ve been on possible. I pay it forward by participating in the Parkinson’s Foundation Moving Day event each year through fundraising, leading exercise demonstrations and lending my voice on stage, when needed.

Keeping this program going was not without its hardships. In getting to know our students, we also began to know their struggles, pain and darkest thoughts. In these moments, the one approach and mindset I’ve had was to focus on what was within my own control: my attitude, my exercise prescription, and my energy in and out of class.

I’ve seen first-hand just how effective exercise can be in improving movement quality and mental health. This benefit only increases when we put exercise into a group setting with others who are walking the same path and experiencing the same struggle. It has been a pleasure to lend my hand and expertise to the fight against PD. I want to thank my fellow instructors: Carmen Davis, Michael Quebec, Nancy Flores, Jessica Vazquez, and all the staff who have ever assisted in our exercise classes.

Find the Parkinson’s exercise class that works for you! For virtual options, try our on-demand Fitness Friday videos through our PD Health @ Home program. For an in-person class near you, visit your local chapter’s webpage or call our Helpline at 1-800-4PD-INFO (1-800-473-4636).

Raise Awareness

The Gut-Brain Connection: Why Diet Can Help Parkinson’s Symptoms & Brain Health

Microbiome of intestine

The brain and gastrointestinal (GI) system are connected. Resident bacteria, including that in the gut, are unique to every person and a major part of our makeup — bacteria even outnumber cells in the body. The capability of that bacteria, known as the microbiome, is enormous. New research strongly suggests a link between the gut and Parkinson’s disease (PD). Learn what science is finding and discover how you can begin improving gut health today.

This article is based on Parkinson's and the Gut-Brain Connection a Parkinson’s Foundation Expert Briefing webinar presented by Carley Rusch, PhD, RDN, LDN, Medical Science Liaison at Abbott Nutrition.

The Gut’s Microbiome

The gut microbiome spans from the mouth to the colon. It is the network of microorganisms — bacteria, viruses, fungi and more — and their collective genetic material that lives within the intestinal tract. The greatest density and diversity of these microorganisms are found within the colon.

Studies on the relationship between gut bacteria and health date back hundreds of years. Research on the benefits of bacteria in yogurt for treating diarrhea was recorded as early as the 1400s. Today, technology known as high-throughput DNA sequencing gives researchers the power to rapidly identify the thousands of bacterial DNA present in individual stool samples.

Science is uncovering the many ways the gut microbiome can influence brain health, body function and overall wellbeing. It can even impact how the body processes oral medications.

Exploring the Gut-Brain Relationship in PD

Research suggests that what happens in the gut influences the brain by way of the gut-brain axis — a biochemical communication between the gastrointestinal tract and the central nervous system.

While research on Parkinson's and the microbiome is in its infancy, scientists have found the gut bacteria in people living with PD differs from that of people without PD.

In Parkinson's, alpha-synuclein proteins misfold and form clumps in the brain. These clusters are called Lewy bodies. It has been suggested that these clumps, which are also found in other neurodegenerative diseases, may trigger the loss of dopaminergic neurons. As scientists have dug deeper into Parkinson’s progression, they have also been able to find alpha-synuclein pathology along the GI tract in people with Parkinson's.

What Science Can Tell Us

Gastrointestinal dysfunctions are some of the most common and troublesome non-movement symptoms in PD. Constipation affects up to 70% of people with Parkinson's and often begins before the onset of PD’s telltale movement symptoms and other early signs.  It's estimated that up to 75% of people with Parkinson's will also experience speech and swallowing issues. Gastroparesis, delayed emptying of the stomach, is another common PD symptom.

Knowing that alpha-synuclein pathology can also be found along the GI tract in Parkinson’s, over the years researchers have genetically sequenced the microbiome of different people with Parkinson's. They found that some beneficial bacteria, such as Prevotella, Faecalibacterium and Roseburia, are reduced in people with Parkinson's, when compared to someone without the disease. However, researchers also found a boost in other bacteria, such as Bifidobacterium and Lactobacillus, in people with PD — possibly due to constipation.

Research also shows zonulin, a protein marker of intestinal absorbency, found in inflammatory GI conditions such as celiac disease, inflammatory bowel disorders (IBD), diabetes and other autoimmune diseases, is also significantly elevated in people with Parkinson’s. This increased intestinal permeability potentially leads to what is referred to as “leaky gut” (a decrease in the intestinal barrier that can set off inflammation and disease).

Diversity Matters

A healthy microbiome is a diverse one. Research shows decreased microbial diversity in people with inflammatory bowel disorders, such as ulcerative colitis and Crohn's disease, compared to the resident gut bacteria in healthy people.

Diseases, including Parkinson's and IBD, diet and lifestyle all impact gut bacteria diversity. What we eat, how often we exercise, where we live and stage of life all play a role. Other influences include stress, antibiotic and pharmaceutical drug use and pollutants.

Researchers theorize that these factors influence the production of signaling metabolites, which determine whether the gut makes beneficial, anti-inflammatory or inflammatory molecules, such as those that impact cholesterol metabolism, cardiovascular and brain health and more. Communication among signaling metabolites can influence the GI tract, immune system, the liver, brain, lungs, skeletal muscle and other areas of the body.

While various factors can impact on gut microbiota, generally, the microbiome is very stable. Antibiotic or probiotic use often shows short-term changes in resident microbiota, but over time — as a person discontinues use of such medication or supplements and reverts into a familiar diet — the resident microbial makeup typically returns to where it was.

Taking Charge Through Diet

One of the best strategies to improve gut health is increasing fiber. While a probiotic may only introduce one bacteria strain, a fiber-fueled diet can be broken down by multiple types of gut bacteria to encourage a new microbial community to take up residence in the gut, benefitting GI and heart health, improving immune function and easing constipation.

When gut bacteria break down fiber it naturally produces health-boosting short chain fatty acids. These acids boost the gut’s mucus barrier to fight inflammation, protect brain and heart function and more.

Research shows a high-fiber, whole food, plant-fueled diet, with high consumption of fruits and vegetables (known as a Mediterranean-style diet) can increase butyrate and other beneficial bacteria. Right now, researchers are interested in butyrate, a fatty acid that is a major energy source for creating healthy new gut bacteria and can influence immune function.

Plant-Rich, Fiber-Driven Meals Matter

A Mediterranean-style diet is associated with lower risks of developing Parkinson’s, higher microbial diversity and improved heart and cognitive health. Studies also show incorporating this whole-food based diet, along with healthy fats, such as extra virgin olive, oil, nuts and seeds can ease PD symptoms.

To boost gut health experts recommend:

  • Eating at least 14 grams of fiber for every 1,000 calories — about 28 grams for someone eating 2,000 calories a day. The average American only consumes half of the recommended daily fiber.
  • Filling half your plate with vegetables and fruit.
  • Eating prebiotic fibers such as bananas, onions, garlic, chicory root, artichokes, beans, grapes and cranberries.

For some people with Parkinson’s, taking certain PD medications with a protein-rich meal — like meat, fish, eggs, dairy products, nuts and beans — may interfere with absorption, slowing medication effectiveness. Talk to your doctor about whether a protein-redistribution diet, a popular solution for motor fluctuations, might be right for you. This means eating most of your daily protein during your last meal of the day.

On the Horizon

The research on dietary interventions to alter gut microbiota is entering a new era. Scientists are currently exploring:

  • Probiotics: benefits specific to probiotic species and strain. Healthcare experts use the Clinical Guide to Probiotic Products Available in USA to inform research-based recommendations. There is no recommended consumption of probiotics in PD but bring up this topic with your doctor.
  • Postbiotics: “a preparation of inanimate microorganisms and/or their components that confers a health benefit on the host,” according to the International Scientific Association for Probiotics and Prebiotics (ISAPP). Studies show potential for using postbiotics to ease symptoms of irritable bowel syndrome, treat infections and more.
  • Synbiotics: prebiotics combined with probiotics, defined by ISAPP as “a mixture comprising live microorganisms and substrate(s) selectively utilized by host microorganisms that confers a health benefit on the host.” These are being investigated to potentially improve PD symptoms and more.

Researchers are also investigating how machine learning and artificial intelligence might aid in modifying gut bacteria. Entering information from an individual’s stool sample, diet, genetics and other medical data into a machine-learning model could identify precision nutrition to modify a person’s microbiome.

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Explore our resources about the gut-brain connection in Parkinson’s:

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