Voigt Robin M, Engen Phillip A, Villanueva Michelle, Bambi Simona A, Green Stefan J, Naqib Ankur, Raeisi Shohreh, Shaikh Maliha, Hamaker Bruce R, Cantu-Jungles Thaisa M, Pridgen Sarah A, Held Philip, Keshavarzian Ali
Rush Center for Integrated Microbiome and Chronobiology Research, Rush University Medical Center, Chicago, IL, United States.
Department of Internal Medicine, Rush University Medical Center, Chicago, IL, United States.
Front Neurosci. 2025 Jan 7;18:1477519. doi: 10.3389/fnins.2024.1477519. eCollection 2024.
Posttraumatic stress disorder (PTSD) is a debilitating disorder characterized by intrusive memories, avoidance, negative thoughts and moods, and heightened arousal. Many patients also report gastrointestinal symptoms. Cognitive behavioral therapy (CBT) is an evidence-based treatment approach for PTSD that successfully reduces symptoms. However, many patients still meet criteria for PTSD after treatment or continue to have symptoms indicating the need for new treatment strategies for PTSD. Patients with PTSD have a disrupted intestinal microbiome (i.e., dysbiosis) which can promote neuroinflammation; thus, modulation of the microbiome could be an alternative or adjunct treatment approach for PTSD.
The current study was a 12-week, double-blind, placebo-controlled trial seeking to understand if CBT combined with a microbiota-modifying, prebiotic fiber intervention would beneficially impact clinical outcomes in veterans with PTSD ( = 70). This proof-of-concept, pilot trial was designed to assess: (1) the relationship between severity of PTSD symptoms and microbiota composition and SCFA levels (i.e., acetate, propionate, butyrate), (2) if CBT treatment with a concomitant prebiotic fiber intervention would beneficially impact clinical outcomes in veterans with PTSD, (3) evaluate the feasibility and acceptability of a prebiotic intervention as an adjunct treatment to CBT, and (4) assess the impact of treatment on the intestinal microbiota and stool SCFA (i.e., mechanism).
This study found that PTSD severity may be associated with reduced abundance of taxa capable of producing the SCFA propionate, and that a subset of individuals with PTSD may benefit from a microbiota-modifying prebiotic intervention.
This study suggests that targeting the intestinal microbiome through prebiotic supplementation could represent a promising avenue for enhancing treatment outcomes in some individuals with PTSD.
https://clinicaltrials.gov/, identifier NCT05424146.
创伤后应激障碍（PTSD）是一种使人衰弱的疾病，其特征为侵入性记忆、回避、消极思维和情绪以及过度警觉。许多患者还报告有胃肠道症状。认知行为疗法（CBT）是一种针对PTSD的循证治疗方法，可成功减轻症状。然而，许多患者在治疗后仍符合PTSD的标准，或持续出现症状，这表明需要新的PTSD治疗策略。PTSD患者的肠道微生物群受到破坏（即生态失调），这会促进神经炎症；因此，调节微生物群可能是PTSD的一种替代或辅助治疗方法。
本研究是一项为期12周的双盲、安慰剂对照试验，旨在了解CBT联合微生物群调节益生元纤维干预是否会对患有PTSD的退伍军人（n = 70）的临床结果产生有益影响。这项概念验证性试点试验旨在评估：（1）PTSD症状严重程度与微生物群组成和短链脂肪酸水平（即乙酸盐、丙酸盐、丁酸盐）之间的关系，（2）CBT治疗与益生元纤维干预同时进行是否会对患有PTSD的退伍军人的临床结果产生有益影响，（3）评估益生元干预作为CBT辅助治疗的可行性和可接受性，以及（4）评估治疗对肠道微生物群和粪便短链脂肪酸的影响（即作用机制）。
本研究发现，PTSD严重程度可能与能够产生丙酸盐的分类群丰度降低有关，并且一部分PTSD患者可能从微生物群调节益生元干预中获益。
本研究表明，通过补充益生元靶向肠道微生物群可能是改善某些PTSD患者治疗效果的一条有前景的途径。
