Cognitive behavioral therapy for irritable bowel syndrome induces bidirectional alterations in the brain-gut-microbiome axis associated with gastrointestinal symptom improvement

Autor: Kan Gao, Gregory D. Gudleski, Arpana Gupta, Bruce D. Naliboff, Ravi Bhatt, Jonathan P. Jacobs, Jennifer S. Labus, Jacob Brawer, Rebecca Firth, Kirsten Tillisch, Benjamin M. Ellingson, Venu Lagishetty, Emeran A. Mayer, Jeffrey M. Lackner
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Microbiology (medical)
Oncology
medicine.medical_specialty
16S
medicine.medical_treatment
Clinical Trials and Supportive Activities
Neuroimaging
Biology
Microbiology
behavioral disciplines and activities
Oral and gastrointestinal
law.invention
White matter
Irritable Bowel Syndrome
Microbial ecology
Randomized controlled trial
law
Clinical Research
Internal medicine
RNA
Ribosomal
16S
Basal ganglia
Brain-Gut Axis
medicine
Humans
Microbiome
Irritable bowel syndrome
Default mode network
Nutrition
Ribosomal
Cognitive Behavioral Therapy
Ecology
Research
QR100-130
Neurosciences
Outcome prediction
medicine.disease
Gastrointestinal Microbiome
Cognitive behavioral therapy
medicine.anatomical_structure
Mental Health
Medical Microbiology
RNA
Brain-gut-microbiome axis
Digestive Diseases
Mind and Body
Biomarkers
Zdroj: Microbiome, Vol 9, Iss 1, Pp 1-14 (2021)
Microbiome
Microbiome, vol 9, iss 1
ISSN: 2049-2618
Popis: Background There is growing recognition that bidirectional signaling between the digestive tract and the brain contributes to irritable bowel syndrome (IBS). We recently showed in a large randomized controlled trial that cognitive behavioral therapy (CBT) reduces IBS symptom severity. This study investigated whether baseline brain and gut microbiome parameters predict CBT response and whether response is associated with changes in the brain-gut-microbiome (BGM) axis. Methods Eighty-four Rome III-diagnosed IBS patients receiving CBT were drawn from the Irritable Bowel Syndrome Outcome Study (IBSOS; ClinicalTrials.gov NCT00738920) for multimodal brain imaging and psychological assessments at baseline and after study completion. Fecal samples were collected at baseline and post-treatment from 34 CBT recipients for 16S rRNA gene sequencing, untargeted metabolomics, and measurement of short-chain fatty acids. Clinical measures, brain functional connectivity and microstructure, and microbiome features associated with CBT response were identified by multivariate linear and negative binomial models. Results At baseline, CBT responders had increased fecal serotonin levels, and increased Clostridiales and decreased Bacteroides compared to non-responders. A random forests classifier containing 11 microbial genera predicted CBT response with high accuracy (AUROC 0.96). Following treatment, CBT responders demonstrated reduced functional connectivity in regions of the sensorimotor, brainstem, salience, and default mode networks and changes in white matter in the basal ganglia and other structures. Brain changes correlated with microbiome shifts including Bacteroides expansion in responders. Conclusions Pre-treatment intestinal microbiota and serotonin levels were associated with CBT response, suggesting that peripheral signals from the microbiota can modulate central processes affected by CBT that generate abdominal symptoms in IBS. CBT response is characterized by co-correlated shifts in brain networks and gut microbiome that may reflect top-down effects of the brain on the microbiome during CBT.
Databáze: OpenAIRE
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