To assess coordinated alterations and cross-site associations of oral and gut microbiota in post-stroke cognitive impairment (PSCI) and their significance in understanding PSCI.
Key Findings:
PSCI participants exhibited reduced oral richness and gut diversity/evenness.
Depletion of oral commensals (Leptotrichia, Neisseria) and enrichment of opportunistic taxa (Pseudomonas, Alloprevotella, Streptococcus).
Increased gut Gram-negative potential pathogens (Enterobacter, Pseudomonas, Klebsiella) and decreased SCFA-associated microbiota (Coprococcus, Faecalibacterium, Ruminococcus).
Stronger oral-gut association in PSCI indicated by lower dissimilarity and higher shared-genera fraction.
Combined oral-gut features showed favorable exploratory performance in predicting PSCI, highlighting the most impactful results.
Interpretation:
PSCI is associated with coordinated oral and gut dysbiosis, characterized by loss of commensals and enrichment of opportunistic taxa, alongside functional alterations related to lipopolysaccharide biosynthesis and tryptophan metabolism, emphasizing the clinical implications.
Limitations:
Findings require validation in larger longitudinal multi-omics cohorts, with specific examples of generalizability.
Single-center study may limit generalizability.
Conclusion:
PSCI is linked to significant alterations in oral and gut microbiota, suggesting a need for further investigation into the oral-gut-brain pathway and its clinical implications.
