Assad Annabelle, Johnson Samuel L, Reichard Rhett A
Medicine, Saba University School of Medicine, The Bottom, BES.
Medical Education and Simulation, Saba University School of Medicine, The Bottom, BES.
Cureus. 2025 Aug 3;17(8):e89302. doi: 10.7759/cureus.89302. eCollection 2025 Aug.
Mild cognitive impairment progresses slowly and may be reversible, providing a window of opportunity for intervention before it progresses to Alzheimer's disease, at which point treatments, at best, ameliorate symptoms with little efficacy towards delaying disease progression. The gut and brain communicate through the gut-brain axis, and derangement of the gut microbiome has been shown to promote neuroinflammation, a process intricately linked to pathological progression to mild cognitive impairment and subsequent neurocognitive diseases. In preclinical trials, probiotics modulated the gut microbiome in a way that was neuroprotective. We aim to test our hypothesis that probiotic supplementation can improve cognition in those with mild cognitive impairment. A literature search of electronic databases PubMed/MEDLINE using terms such as "Probiotics" and "Cognitive dysfunction" or "Alzheimer's disease" or "Mild Cognitive Impairment" was done to identify all randomized controlled trials that tested our hypothesis. The effects of daily doses of , , or a mixture of both on clinical cognitive tests were assessed in five trials. All studies but one demonstrated a statistically significant improvement in total cognitive test scores, while all studies showed a significant improvement over the placebo in at least one cognitive subdomain. An overall trend suggested greater improvement in those more severely impaired at baseline. Thus, probiotics may be effective in improving cognition in those with mild cognitive impairment. However, larger-scale multicenter clinical trials should confirm the present findings using a standardized approach.
轻度认知障碍进展缓慢且可能可逆，这为在其发展为阿尔茨海默病之前进行干预提供了机会窗口，而在阿尔茨海默病阶段，治疗充其量只能缓解症状，对延缓疾病进展效果甚微。肠道与大脑通过肠脑轴进行沟通，肠道微生物群的紊乱已被证明会促进神经炎症，这一过程与轻度认知障碍及后续神经认知疾病的病理进展密切相关。在临床前试验中，益生菌以一种具有神经保护作用的方式调节肠道微生物群。我们旨在检验我们的假设，即补充益生菌可以改善轻度认知障碍患者的认知能力。通过在电子数据库PubMed/MEDLINE中进行文献检索，使用“益生菌”和“认知功能障碍”或“阿尔茨海默病”或“轻度认知障碍”等术语，以识别所有检验我们假设的随机对照试验。在五项试验中评估了每日剂量的 、 或两者混合物对临床认知测试的影响。除一项研究外，所有研究均显示总认知测试分数有统计学意义的改善，而所有研究均显示在至少一个认知子领域中比安慰剂有显著改善。总体趋势表明，基线时受损更严重的患者改善更大。因此，益生菌可能对改善轻度认知障碍患者的认知有效。然而，大规模多中心临床试验应以标准化方法证实目前的研究结果。
