Exploring the role of gut microbiota in potential mechanism of ketogenic diet in alleviating Parkinson’s disease symptoms

Background Current clinical research suggests that the ketogenic diet (KD) intervention can alleviate Parkinson’s disease (PD) symptoms. However, the underlying mechanisms remain unclear. This pilot study explored the potential link between KD-induced clinical improvements and gut microbiota alterations. Methods We engaged 27 PD patients in a 12-week ketogenic dietary trial (16 completed) and employed 16S rRNA sequencing to analyze gut microbiota differences compared to 27 healthy controls. Results Baseline analysis revealed distinct dysbiosis in PD patients, characterized by increased abundance of Enterobacteriaceae. Following the 12-week intervention, patients exhibited significant improvements in both motor (MDS-UPDRS Part III, p < 0.001) and non-motor symptoms (NMSS, p < 0.0001). These clinical improvements were accompanied by specific microbial shifts: a significant increase in Enterococcus and Synergistota, and a decrease in Alloprevotella . Conclusion These findings suggest that the therapeutic effects of the ketogenic diet in PD are associated with specific remodeling of the gut microbiota, particularly the enrichment of potential beneficial taxa and reduction of pro-inflammatory genera. Clinical trial registration https://www.chictr.org.cn/index.html , Unique Identifier: ChiCTR2100045394.