Global Symposium: Does Parkinson’s Begin in the Gut? (2025)

In this webinar, Dr. Per Borghammer, Clinical Professor in the Department of Nuclear Medicine and PET-Centre at Aarhus University (Denmark), presented research supporting a dual-subtype model of Parkinson’s disease, proposing “body first” and “brain first” pathways of disease initiation and progression.

He challenged the traditional Braak hypothesis by showing that some Parkinson's cases begin in the peripheral nervous system, often the gut, while others start in the brain, particularly near the olfactory system. Clinical symptoms, post-mortem findings, and imaging data revealed distinct trajectories, with “body first” patients typically experiencing early non-motor symptoms and autonomic dysfunction, and “brain first” patients showing early sensory and motor brain-related signs.

Imaging studies confirmed these differences, with sympathetic heart nerve damage appearing earlier in “body first” cases. Dr. Borghammer also highlighted the potential role of environmental factors such as microbiome changes, infections, and leaky gut in triggering “body first” pathology. Animal models were shown to replicate both pathways, providing tools for therapeutic research.

He concluded by emphasizing the need for early detection, personalized treatment approaches, and continued investigation into environmental and biological triggers.

**Disclaimer: These sessions are designed to provide general education and are not intended for individual advice and/or clinical care. The information conveyed in this recording was accurate at the time of presentation.**