If therapeutic manipulation of gut microbiota proves effective to treat some pathogenic aspects of PD, an important inquiry would be at which point of the disease evolution these therapies should be implemented. It is accepted that microbiota conformation is shaped early in life with relative minor changes later on. However, patients with rapid eye movement-sleep behavior disorder (a condition that may precede the motor manifestations of PD) have shown gut microbiomes similar to those seen in patients with PD, but different to healthy controls (Heintz-Buschart et al., 2018), suggesting that dysbiosis may start very early within the evolution of PD; leading to the idea that interventions to modify gut microbiota may be implemented even in the pre-motor phase of the disease. CLICK TO REVIEW