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Motor and non\u2010motor symptoms were tracked using Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS\u2010UPDRS) and levodopa equivalent dose across \u22645 yearly study visits. Stool samples were collected at baseline for metagenomic sequencing (176 PD, 100 controls).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      PD\u2010derived stool samples had reduced intermicrobial connectivity and seven differentially abundant species compared to controls. A suite of bacterial functions differed between PD and controls, including depletion of carbohydrate degradation pathways and enrichment of ribosomal genes.\n                      <jats:italic>Faecalibacterium prausnitzii<\/jats:italic>\n                      \u2010specific reads contributed significantly to more than half of all differentially abundant functional terms. A subset of disease\u2010associated functional terms correlated with faster progression of MDS\u2010UPDRS part IV and separated those with slow and fast progression with moderate accuracy within a random forest model (area under curve\u2009=\u20090.70). Most PD\u2010associated microbial trends were stronger in those with symmetric motor symptoms.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      We provide further evidence that the PD microbiome is characterized by reduced intermicrobial communication and a shift to proteolytic metabolism in lieu of short\u2010chain fatty acid production, and suggest that these microbial alterations may be relevant to disease progression. We also describe how our results support the existence of gut\u2010first versus brain\u2010first PD subtypes. \u00a9 2024 The Author(s).\n                      <jats:italic>Movement Disorders<\/jats:italic>\n                      published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mds.29959","type":"journal-article","created":{"date-parts":[[2024,8,28]],"date-time":"2024-08-28T03:05:10Z","timestamp":1724814310000},"page":"1740-1751","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Metagenomic Analysis Reveals Large\u2010Scale Disruptions of the Gut Microbiome in Parkinson's Disease"],"prefix":"10.1002","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1016-3765","authenticated-orcid":false,"given":"Avril","family":"Metcalfe\u2010Roach","sequence":"first","affiliation":[{"name":"Department of Microbiology and Immunology University of British Columbia  Vancouver British Columbia Canada"},{"name":"Michael Smith Laboratories University of British Columbia  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4900-6385","authenticated-orcid":false,"given":"Mihai S.","family":"Cirstea","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology University of British Columbia  Vancouver British Columbia Canada"},{"name":"Michael Smith Laboratories University of British Columbia  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam C.","family":"Yu","sequence":"additional","affiliation":[{"name":"Pacific Parkinson's Research Centre Djavad Mowafaghian Centre for Brain Health University of British Columbia  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hena R.","family":"Ramay","sequence":"additional","affiliation":[{"name":"International Microbiome Centre Cumming School of Medicine University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olabisi","family":"Coker","sequence":"additional","affiliation":[{"name":"International Microbiome Centre Cumming School of Medicine University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seti","family":"Boroomand","sequence":"additional","affiliation":[{"name":"Borgland Family Brain Tissue and DNA Bank Djavad Mowafaghian Centre for Brain Health University of British Columbia  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faezeh","family":"Kharazyan","sequence":"additional","affiliation":[{"name":"Borgland Family Brain Tissue and DNA Bank Djavad Mowafaghian Centre for Brain Health University of British Columbia  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2217-0487","authenticated-orcid":false,"given":"Davide","family":"Martino","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences Hotchkiss Brain Institute University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura K.","family":"Sycuro","sequence":"additional","affiliation":[{"name":"International Microbiome Centre Cumming School of Medicine University of Calgary  Calgary Alberta Canada"},{"name":"Department of Microbiology, Immunology, and Infectious Diseases University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silke","family":"Appel\u2010Cresswell","sequence":"additional","affiliation":[{"name":"Pacific Parkinson's Research Centre Djavad Mowafaghian Centre for Brain Health University of British Columbia  Vancouver British Columbia Canada"},{"name":"Division of Neurology Faculty of Medicine University of British Columbia  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B. 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