Neuroscience and biobehavioral reviews · 2026
Gut microbiome variability and brain alterations in schizophrenia: A scoping review of structural and functional MRI studies.
СтатьяScoping ReviewНазвание и аннотация: Перевод в очереди
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Bottaro Federico, Enrico Paolo, Ratti Giorgio, Brambilla Paolo, Delvecchio Giuseppe
Аннотация
INTRODUCTION: Schizophrenia (SCZ) is increasingly considered a multifactorial disorder involving gut-brain interactions. Current evidence supports gut microbiome alterations in SCZ, along with well-established structural and functional brain abnormalities. However, findings linking gut microbiome variability to neuroimaging alterations in SCZ have not yet been comprehensively integrated.
METHODS: Following the Joanna Briggs Institute methodology for scoping reviews and the PRISMA-ScR checklist, a literature search was performed in PubMed, Scopus, and Web of Science, selecting structural magnetic resonance imaging (sMRI) and resting-state functional MRI (fMRI) studies examining the associations between gut microbiome variability and brain alterations in first-episode and chronic SCZ.
RESULTS: Eight studies (one sMRI-only, one fMRI-only, and six combining sMRI and fMRI) met the inclusion criteria. The sMRI studies primarily showed associations between gut microbiome composition and gray matter volume in frontal, temporal, and limbic regions, while the fMRI studies found microbial variations associated with resting-state activity and functional connectivity across cortico-subcortical and large-scale brain networks. Notably, gut microbiome-neuroimaging associations differed between early and chronic stages of the disorder, suggesting stage-dependent gut-brain relationships.
CONCLUSIONS: Available evidence supports an association between gut microbiome variability and neuroimaging alterations in SCZ, with emerging differences between first-episode and chronic patients. Despite methodological heterogeneity and predominantly cross-sectional designs, these findings highlight the relevance of a multimodal gut-brain framework. Future longitudinal, multimodal studies integrating gut microbiome, neuroimaging, and clinical features may help disentangle biological heterogeneity and improve patient stratification in SCZ.
METHODS: Following the Joanna Briggs Institute methodology for scoping reviews and the PRISMA-ScR checklist, a literature search was performed in PubMed, Scopus, and Web of Science, selecting structural magnetic resonance imaging (sMRI) and resting-state functional MRI (fMRI) studies examining the associations between gut microbiome variability and brain alterations in first-episode and chronic SCZ.
RESULTS: Eight studies (one sMRI-only, one fMRI-only, and six combining sMRI and fMRI) met the inclusion criteria. The sMRI studies primarily showed associations between gut microbiome composition and gray matter volume in frontal, temporal, and limbic regions, while the fMRI studies found microbial variations associated with resting-state activity and functional connectivity across cortico-subcortical and large-scale brain networks. Notably, gut microbiome-neuroimaging associations differed between early and chronic stages of the disorder, suggesting stage-dependent gut-brain relationships.
CONCLUSIONS: Available evidence supports an association between gut microbiome variability and neuroimaging alterations in SCZ, with emerging differences between first-episode and chronic patients. Despite methodological heterogeneity and predominantly cross-sectional designs, these findings highlight the relevance of a multimodal gut-brain framework. Future longitudinal, multimodal studies integrating gut microbiome, neuroimaging, and clinical features may help disentangle biological heterogeneity and improve patient stratification in SCZ.