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REVIEW article

Front. Neurol.

Sec. Neurorehabilitation

Volume 16 - 2025 | doi: 10.3389/fneur.2025.1644490

Gut-Brain Axis Modulation in Remote Rehabilitation of Parkinson's Disease: Reconstructing the Fecal Metabolome and Nigral Network Connectivity

Provisionally accepted
Yuting  JinYuting JinHuan  WangHuan WangJinan  SongJinan Song*
  • Department of Rehabilitation, Sheng Jing Hospital Affiliated, China Medical University, Shenyang, China

The final, formatted version of the article will be published soon.

The pathogenesis of Parkinson's disease (PD) is gradually evolving from a central neurodegeneration-centered concept to a multi-pathway pathological model at the gut-brain system level. Studies have shown that PD patients commonly exhibit dysbiosis, reduced short-chain fatty acids (SCFAs; microbial fermentation products of dietary fiber that play key roles in host metabolism and immune regulation), abnormal tryptophan metabolism, and impaired gut barrier function. These alterations may contribute to dopaminergic neuronal damage through mechanisms including neuroinflammation, oxidative stress, and α-synuclein (α-syn) aggregation. The vagus nerve plays a critical role in bidirectional gut-brain signaling, and its dysfunction may represent a key route for pathological protein transmission from the periphery to the brain. In response, remote rehabilitation and gut-targeted interventions-including probiotics, prebiotics, dietary modulation, fecal microbiota transplantation (FMT), and transcutaneous vagus nerve stimulation (tVNS)-have shown potential in improving neurological function and inflammation in both animal and clinical studies. Multimodal data analyses have revealed significant associations between SCFA levels in fecal metabolomics and brain imaging features. Despite ongoing challenges in mechanistic extrapolation, biomarker sensitivity, and translational implementation, the integration of metagenomics, metabolomics, neuroimaging, and digital therapeutics-collectively referred to as multi-omics and digital profiling techniques-represents an emerging research direction with the potential to inform future clinical paradigms for precision remote management of PD.

Keywords: Parkinson's disease1, Gut-brain axis2, Short-chain fatty acids (SCFAs)3, α-synuclein4, neuroinflammation5, Remote rehabilitation6, Vagus nerve stimulation7

Received: 10 Jun 2025; Accepted: 28 Jul 2025.

Copyright: © 2025 Jin, Wang and Song. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Jinan Song, Department of Rehabilitation, Sheng Jing Hospital Affiliated, China Medical University, Shenyang, China

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