精神分裂症肠道微生物与脑影像和临床表征的关系 postprint

Abstract: The microbiota-gut-brain axis hypothesis has attracted more and more attention in the research of the pathogenesis of schizophrenia. This hypothesis stated that gut microbiota can cause inflammation in the brain of patients with schizophrenia and cause abnormalities of brain function through the intestinal immune system, and that early colonization of gut microbiota will affect the development of the central nervous system in patients with schizophrenia and thus cause abnormalities of brain structure. Previous research has preliminarily investigated the relationship between the composition of gut microbiota and the brain imaging and clinical manifestation of patients with schizophrenia, but the specific action path is still unclear. In the current research, we have summarized the latest research progress and found that the gut microbiota diversity of patients with schizophrenia is significantly lower than that of the normal control, and the relative abundance of gut microbiota is also significantly different from that of the normal control at different biological levels, which is mainly manifested as the increase in the relative abundance of Actinomycetes and Proteus as well as the decrease in the relative abundance of Bacteroides and Sclerotinia. Based on the brain imaging results of patients with schizophrenia, we found that there was a significant correlation between the diversity of gut microbiota and the relative abundance of certain microbiota and the gray volume of specific areas of the patient's brain, including the right middle frontal gyrus, the right postcentral gyrus and insula, as well as the Amplitude of Low Frequency Fluctuation index (ALFF) and Regional Homogeneity index (ReHo) in certain brain functional areas, which were mainly reflected in the functional signals of the frontal and temporal lobes. Further combined with the clinical manifestation analysis of patients with schizophrenia, the results showed that there was a significant correlation between the composition of gut microbiota and the cognitive function scores as well as the clinical symptom score (PANSS). The α diversity of gut microbiota was related to visual hallucination, and the relative abundance of Sclerotinia sclerotiorum was significantly and positively correlated with the negative symptom score. These evidences indicate that the potential role of gut microbiota in schizophrenia is related to the changes of brain structure and function. Based on the ability of gut microbiota to identify and produce chemicals and the evidence of severe neurotransmitter imbalance in patients with schizophrenia, we proposed the mechanism hypothesis of gut microbiota affecting the brain structure and function of patients with schizophrenia, believing that gut microbiota may affect the brain structure and function of patients with schizophrenia through immune mediated pathway, short-chain fatty acid pathway, kynurenine pathway and brain-derived neurotrophic factor pathway. The related contents will provide new insights for further elucidation of the pathological mechanism of schizophrenia, clarify how gut microbiota affect the potential pathophysiological process of schizophrenia through the microbiota-gut-brain axis, and provide a theoretical basis for the inclusion of gut microbiota in the diagnosis, evaluation and intervention of schizophrenia.