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It is a hypometabolic state with impairment in multiple metabolic pathways linked to m -Dys with impaired OXPHOS and reduced ATP production 207

However, when we consulted Prof

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Use of COMT inhibitors, especially entacapone, was associated with reduction in abundance of Firmicutes , species Faecalibacterium prausnitzii [68, 69] and Lachnospiraceae [68, 70], and increased abundance of Actinobacteria , Lactobacillaceae , Porphyromonadaceae and Proteobacteria [68]