Experimental Cohort
Inclusion Criteria
- Age 45-75 years old
- Idiopathic Parkinson’s Disease defined by the modified UK Parkinson’s Disease Society Brain Bank criteria
- Baseline Hoehn & Yahr score 1-4
- Able to give informed consent for study participation
Exclusion Criteria
- Clinical features suggestive of a neurodegenerative diagnosis other than Parkinson’s disease
- Diagnosis of primary mitochondrial disorder, epilepsy, stroke, multiple sclerosis or other neurodegenerative diseases
- Significant concomitant medical disease limiting life expectancy to less than 24 months from study inclusion, or significant and serious concomitant medical disease that is poorly controlled
- Active or untreated gastrointestinal disease
Control Cohort
Inclusion Criteria
- Age 45-75 years old
- No contraindications to undergoing screening colonoscopy
- Able to give informed consent for study participation
Exclusion Criteria
- Clinical features suggestive of a Parkinson’s disease or another neurodegenerative diagnosis
- Significant concomitant medical disease limiting life expectancy to less than 24 months from study inclusion, or significant and serious concomitant medical disease that is poorly controlled
- Signs of active malignant disease or other clinically relevant abnormality on chest x-ray
- Active or untreated gastrointestinal disease
Parkinson's disease affects 1 in 100 people over the age of 65, but the time between Parkinson's disease onset and diagnosis can be many months or years. Interestingly, pathological hallmarks of Parkinson's in the brain can also be seen in the neurons in the gut and symptoms like constipation often precede the onset of tremor and incoordination by many years. It is now believed that Parkinson's disease may begin in the gut, at least in some people. Unlike the neurons in the brain, the neurons in the gut are accessible through routine colonoscopy, and so can be obtained by biopsy to study in the laboratory. In addition, there are links between gut microbes, including bacteria, and the diagnosis of Parkinson's disease. This research study is therefore being done to discover whether the pathology and types of bacteria in the gut can serve as an indicator of Parkinson's disease in subjects aged 45-75 that could eventually help in earlier diagnosis. It will also strengthen our understanding of the link between the gut and brain in Parkinson's disease.