This study aimed to evaluate the clinical efficacy and safety of probiotics supplementation in the treatment of Parkinson's disease (PD). We searched China National Knowledge Infrastructure (CNKI), Weipu (VIP) database, Wanfang Database, Sinomed (CBM), PubMed, Embase, Cochrane library and Web of Science databases for eligible studies from inception to January 4th, 2024. Randomized controlled trials (RCTS) comparing the effects of probiotic supplements and placebo in patients with PD. Meta-analysis was conducted with the software Review Manager 5.4. The quality assessment was performed according to Cochrane risk of bias tool. A total of 11 RCTs with 756 PD patients were included in this study. We found that probiotics could increase the number of complete bowel movements (CBMs) per week and improved the scores of Patient Assessment of Constipation Quality of Life Questionnaire (PAC-QOL) (SMD = 0.73, 95% CI: 0.54 - 0.92, P < 0.00001, I² = 45%; SMD = -0.79, 95% CI: -1.19 - -0.39, P < 0.001, I² = 55%, respectively) compared with the placebo group. However, there was no significant difference between the two groups in improving fecal traits and defecation efforts in PD patients (SMD = 0.87, 95% CI: 0.01 - 1.74, P = 0.05, I² = 94%; SMD = 1.24, 95% CI: -1.58 - 4.06, P > 0.05, I² = 98%, respectively). In terms of PD composite scale scores: after treatment, there was no significant difference in Movement Disorder Society-Unified-Parkinson Disease Rating Scale Ⅲ score (MDS-UPDRSⅢ) between the probiotic group and the placebo group (SMD = -0.09, 95% CI: -0.35 - 0.16, P > 0.05, I² = 0%). In conclusion, based on the overall results of the available RCTs studies, our results suggested the potential value of probiotics in improving constipation symptoms in PD patients. Therefore, probiotics may be one of the adjuvant therapy for PD-related constipation patients. The findings of this study provide more proof supporting the effectiveness of probiotics, encouraging probiotics to be utilized alone or in combination with other therapies in clinical practice for PD patients. However, more well-designed RCTs with large sample sizes are required.

Background. The neurotrophic pathway regulated by the brain‐derived neurotrophic factor (BDNF) plays a crucial role in the pathogenesis of poststroke depression (PSD). How the traditional Chinese medicine compound preparation Xingnao Jieyu (XNJY) decoction regulates the neurotrophic pathway to treat PSD is unclear. Objective. This study aimed to investigate the antidepressant effect of XNJY decoction on a rat model of PSD and the molecular mechanism intervening in the neurotrophic pathway. Methods. After a middle cerebral artery occlusion model was established, chronic unpredictable mild stress was applied for 21 days to prepare a PSD model. XNJY groups and a fluoxetine (Flu) group of rats were intragastrically administered with XNJY and Flu, respectively, for 21 consecutive days. Depressive‐like behaviors, including sucrose preference, open field test, and forced swimming test, were assessed. The survival and apoptosis of cortical and hippocampal neurons were evaluated by immunofluorescence assay and TUNEL staining. The contents of serotonin (5‐HT), norepinephrine (NE), and BDNF in the cortex and hippocampus were determined by ELISA. The protein levels of BDNF, p‐ERK/ERK, and p‐CREB/CREB in the cortical and hippocampal regions were tested by Western blot. Results. The depressive‐like behaviors markedly improved after XNJY and Flu treatment. XNJY and Flu promoted neuronal survival and protected cortical and hippocampal neurons from apoptosis. XNJY also increased the contents of 5‐HT, NE, and BDNF and recovered the protein levels of p‐ERK/ERK, p‐CREB/CREB, and BDNF in the cortical and hippocampal regions. Conclusion. These results indicated that the XNJY decoction exerts an obvious antidepressant effect, which may be due to the regulation of the BDNF/ERK/CREB signaling pathway.

Objective: To explore the bidirectional association between dyslipidemia and depression, and the potential predictive role of lipid level changes for depression onset. Methods: A systematic search of the Cochrane Library, Web of Science, Embase, and PubMed databases was conducted to identify cohort studies on blood lipids and 5-hydroxytryptamine (5-HT) parameters related to depression, from database inception to May 2024. Data were analyzed using Stata 14.0 software. Results: Seven studies were included in the analysis. Serum high-density lipoprotein (HDL) and triglyceride levels are significantly associated with an increased risk of depression (OR = 1.28, 95% CI: 1.07 - 1.53; OR = 1.41, 95% CI: 1.20 - 1.66, P < 0.05). However, depressive symptoms do significantly affect serum HDL, LDL, triglyceride, or total cholesterol levels (ORs = 0.88, 1.05, 1.05, 1.11; 95% CIs: 0.58 - 1.35, 0.88 - 1.24, 0.91 - 1.21, 0.9 - 1.32, P > 0.05). Conclusion: Based on the present findings, changes in serum HDL and triglyceride levels are significantly linked to depression incidence. Monitoring these two lipid parameters may aid in early identification of at-risk individuals and enhance the prognosis and quality of life for depressed patients through timely interventions. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/ , identifier CRD42024542833.

Background. Poststroke depression (PSD) is a common neuropsychiatric disorder that affects the disability, mortality, functional recovery, and quality of daily life of patients. Xiaoyao Recipe (XYR) is often used to treat PSD and has achieved good clinical effects, but it lacks reliable evidence. Objective. This study aims to evaluate the effectiveness and safety of XYR on PSD through meta-analysis. Methods. A comprehensive literature search was carried out in multiple databases, including PubMed, the Cochrane Library, Chinese Biomedical Literature Service System, China National Knowledge Infrastructure, Wanfang Database, VIP Database, and ClinicalTrials, from inception to July 1, 2021, to collect randomized controlled trials that applied XYR for patients with PSD. For a controlled trial, the search time limit was set from the time of the database’s establishment to July 2021. Two experienced researchers independently screened the literature according to the inclusion and exclusion criteria, extracted data, evaluated the quality of the literature, and used RevMan 5.3 software for meta-analysis. Results. A total of 12 studies were included in this study, involving 882 patients with PSD who were hospitalized or outpatients. The meta-analysis results showed that the total effective rate ( ) of the test group (XYR or XYR combined with antidepressants) after treatment was high; Hamilton’s Depression Scale score ( ), Scandinavian Stroke Scale score ( ), and Barthel index ( ) were improved; the incidence of adverse reactions ( ) was low; and the serum serotonin content ( ) was high. Conclusion. Compared with antidepressant drugs, XYR is more effective and safer in the treatment of PSD patients. However, more high-quality studies are needed to further support the above conclusions.