Gut Microbiota Relationship with Lewy Body Dementia

Background and Aim : One of the most challenging issues among psychiatrists is differentiating between neurological diseases and psychiatric disorders. Side effects of even a low dose of antipsychotic drugs may aggravate the patient’s mental disease. The subject in this study has shown jealousy delusions, which may suggest primary delusional disorder. The disease is associated with the destruction and death of nerve cells. Lewy body disease is similar to Alzheimer's and Parkinson's disease (PD) in many ways and this disease is sometimes difficult to distinguish from PD. Many studies of neurological disorders have examined patients' Gut microbiota, but we have no evidence of Lewy body. Since PD is similar to Lewy body and we have evidence of Gut microbiota in these patients, can we hypothesize the study of Gut microbiota in Lewy body patients?Methods : A ۵۸-year-old married woman without the previous medical illness and no vascular risk factors referred to a neuropsychiatry clinic. She was examined comprehensively by neuropsychiatrists in examining with dementia; also she underwent laboratory tests and standard neuropsychological examination such as Mini-Mental State Examination (MMSE). Brain magnetic resonance imaging (MRI) was also performed. Results : She presented behavioral symptoms including persecutory and jealousy delusions. Additionally, the patient had become cognitive decline with visuo-spatial deficit, psychomotor retardation, and cogwheel rigidity. In neurological examination, she had bradykinesia, bradyphrenia with left hemiparkinsonism and rigidity exaggerated elevated reflexes. In brain MRI findings, it was shown atrophy of insular, frontal and medial temporal lobe. Gut microbiota (GM) and short-chain fatty acids (SCFA), resulting in anti-inflammatory effects, are significantly reduced in the fecal samples of PD patients. However, the genes that synthesize lipopolysaccharide and the type III bacterial secretion system are more in the fecal samples of PD patients than healthy patients. Therefore, the microbiome can be a potential diagnostic and therapeutic target for dementiaConclusion : There are currently various methods for recovering and modulating GM, including the use of antibiotics, probiotics, prebiotics, and FMT. Many studies show that FMT is useful in improving non-GI symptoms in patients with neurological disorders

Keywords:

Lewy body , dementia , Gut Microbiome