Jeng Tsung-Min, Hsieh Yi-Chen, Chang Po-Ya, Li Yu-Ling, Tang Sung-Chun, Jeng Jiann-Shing, Hu Chaur-Jong, Chiou Hung-Yi
Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
Ph.D. Program in Medical Neuroscience, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.
Sci Rep. 2025 May 29;15(1):18849. doi: 10.1038/s41598-025-03068-7.
More than half of stroke survivors have post-stroke cognitive impairment (PSCI). The role of gut microbiota, which can communicate with the brain through the gut-brain axis and affect inflammation, has been receiving increased attention. This cross-sectional study aimed to investigate the association of PSCI, gut microbiota, and inflammatory markers. Patients with first ischemic stroke and complete 3-month and 1-year follow-up data were included and divided into PSCI and non-PSCI groups according to the Montreal Cognitive Assessment (MoCA) score at the above time points. PSCI was defined as having a MoCA less than 23 at either 3 months or 1 year, or a decrease of more than 2 points at both time points. Gut microbiota was assessed by 16 S rRNA gene sequencing and Next Generation Sequencing analysis. The inflammatory markers included interleukins (ILs), eotaxin, G-CSF, TNF-α, IFNγ, sCD40L, and MCP-1. There were 95 ischemic stroke patients (mean age, 60.5 ± 12.1 years; male, 68.4%), including 30 with PSCI and 65 with non-PSCI. In gut microbiota analysis, the PSCI group had a higher abundance of Bacteroidaceae and Clostridiaceae, and the non-PSCI group had a higher abundance of Prevotellaceae, Ruminococcaceae, Oscillibacter, and Faecalibacterium. Ruminococcaceae family under the Oscillospirales order remains significantly different in the two groups in logistic regression model adjusting confounding variables (p = 0.044). In an analysis of inflammatory markers, the plasma levels of eotaxin (p = 0.041) and IL-12p40 (p = 0.031) were significantly higher in the PSCI group than those in the non-PSCI group, and the plasma level of eotaxin was significantly positively correlated with the amount of Clostridiaceae (rho = 0.389, p = 0.045). The study found that PSCI was associated with certain gut microbiota, and these gut microbiotas correlated with the pro-inflammatory marker eotaxin. This suggests that gut microbiota might play a role in the development of cognitive impairment after ischemic stroke.
超过半数的中风幸存者患有中风后认知障碍（PSCI）。肠道微生物群可通过肠-脑轴与大脑进行交流并影响炎症反应，其作用日益受到关注。这项横断面研究旨在调查PSCI、肠道微生物群和炎症标志物之间的关联。纳入首次发生缺血性中风且有完整3个月和1年随访数据的患者，并根据上述时间点的蒙特利尔认知评估（MoCA）评分分为PSCI组和非PSCI组。PSCI的定义为在3个月或1年时MoCA评分低于23分，或在两个时间点评分下降超过2分。通过16S rRNA基因测序和下一代测序分析评估肠道微生物群。炎症标志物包括白细胞介素（ILs）、嗜酸性粒细胞趋化因子、粒细胞集落刺激因子、肿瘤坏死因子-α、干扰素γ、可溶性CD40配体和单核细胞趋化蛋白-1。共有95例缺血性中风患者（平均年龄60.5±12.1岁；男性占68.4%），其中30例患有PSCI，65例未患PSCI。在肠道微生物群分析中，PSCI组拟杆菌科和梭菌科的丰度较高，非PSCI组普雷沃氏菌科、瘤胃球菌科、颤螺菌属和粪杆菌属的丰度较高。在调整混杂变量的逻辑回归模型中，颤螺菌目下的瘤胃球菌科在两组中仍存在显著差异（p = 0.044）。在炎症标志物分析中，PSCI组的血浆嗜酸性粒细胞趋化因子水平（p = 0.041）和IL-12p40水平（p = 0.031）显著高于非PSCI组，且血浆嗜酸性粒细胞趋化因子水平与梭菌科数量显著正相关（rho = 0.389，p = 0.045）。该研究发现，PSCI与某些肠道微生物群有关，且这些肠道微生物群与促炎标志物嗜酸性粒细胞趋化因子相关。这表明肠道微生物群可能在缺血性中风后认知障碍的发生中起作用。
