Page 9 - Introduction to FMT

FMT Introduction

Neuropsychiatric disorderseuropsychiatric disorders
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A high incidence rate of constipation is found in Parkinson’s disease (PD) patients. Constipation can
precede the onset of motor symptoms by more than 10 years[50], indicating the disease may start in the
intestine. A man suffered from PD and characterized with the motor symptoms of marked pill-rolling
hand tremors, micrographia, cogwheel rigidity, and chronic constipation[74]. He received antibiotic
therapy (vancomycin, colchicine, and metronidazole) for his constipation and reported an improvement in
gastrointestinal symptoms. After consistent therapy for 10 mo, his neurologic symptoms disappeared.
This case cured by antibiotics suggests that the gut microbiota are involved in the pathogenesis of
PD[74]. The results of symptomatic improvement in PD patients by FMT indicate a new way of thinking for
clinicians[75].

Both animal and clinical studies have shown that the pathogenesis of multiple sclerosis (MS) is associated
with the intestinal microbiota[76,77]. Three patients with MS who underwent FMT for constipation achieved
normal defecation and virtually complete normalization of neurological symptoms, thereby improving
their quality of life[76]. Borody et al[78] reported a case of a young female patient with myoclonic
dystonia and chronic diarrhea. The symptoms had co-developed since she was 6 years old and
progressed in severity to a plateau. FMT resulted in a rapid improvement in diarrhea symptoms, a 90%
improvement in her myoclonus dystonia symptoms, and, as a consequence of restoring her fine motor
function, improving her ability to perform tasks that require dexterity, such as holding cups and fastening
buttons[78].

Autism is another condition in which intestinal microbiota is implicated. The onset of autism is often
accompanied by intestinal dysfunction[79-81]. The first description of an association between autism and
gastrointestinal syndrome began in 1971, with a report that 6 out of 15 autism patients had changed fecal
character and defecation frequency[81]. Finegold et al[79] performed an intestinal flora study in
regressive autism. It is compelling to observe that there were higher counts of Clostridium and
Ruminococcus spp. in the stools of autistic children when compared to those in the control group. Nine
clostridial species were found in autistic children, while only three were found in healthy children. The
authors further observed histologic changes in the gastric and duodenal specimens. Moreover, significant
higher numbers of non-spore- forming anaerobes and microaerophilic bacteria were found

In autistic children. Based on the hypothesis that autism involves intestinal microbiota, Song et al[82]
characterized Clostridia from the feces of autistic and control children. The data indicate that counts of
Clostridium bolteae and clusters I and XI in autistic group are largely greater than those in control
children. There was evidence of autistic symptom remission in two children after FMT[49]. Parallel results
were also presented in five children who received daily cultured Bacteroidetes and Clostridia for several
weeks.

FMT Introduction