Association between gut microbiota and imaging biomarkers in arteriosclerotic cerebral small vessel disease with idiopathic normal pressure hydrocephalus.

OBJECTIVES

This study aims to characterize the gut microbiota in arteriosclerotic cerebral small vessel disease and idiopathic normal pressure hydrocephalus (aCSVD-iNPH) patients, investigate its correlation with cerebral small vessel disease imaging markers, and develop a diagnostic model based on differential microbial profiles.

METHODS

This study enrolled 95 subjects. Fresh fecal samples were collected for microbial DNA extraction. Gut microbiota composition was analyzed using 16S rDNA sequencing, and Spearman's correlation analysis was performed to investigate the association between microbial abundance and imaging indicators.

RESULTS

An analysis of gut microbiota diversity revealed no statistically significant differences in α-diversity among the three groups, but there were significant differences in β-diversity. Compared to the aCSVD group, the relative abundances of Clostridium_Innocuum_group, Dietzia, Lachnospira, Pedobacter, Romboutsia, Saccharomyces, Solobacterium, Thermus, and TM7x were significantly higher in the aCSVD-iNPH group (all p < 0.05). Among these, the relative abundance of Solobacterium was negatively correlated with the number of cerebral microbleeds (CMBs) in the basal ganglia (r = -0.292, FDR-adjusted p = 0.019) and deep regions (r = -0.296, FDR-adjusted p = 0.018). Additionally, the relative abundance of Thermus was positively correlated with the deep medullary vein (DMV) score (r = 0.271, FDR-adjusted p = 0.031). The ROC analysis yielded AUC values ranging from 0.666 to 0.716, indicating limited discriminative ability between aCSVD-iNPH and aCSVD (Thermus, AUC = 0.716, 95% CI 0.569-0.864, p = 0.006; Saccharomyces, AUC = 0.688, 95% CI 0.535-0.842, p = 0.017; Dietzia, AUC = 0.666, 95% CI 0.512-0.821, p = 0.034).

CONCLUSION

This study identifies distinct changes in gut microbiota among patients with aCSVD-iNPH and their associations with aCSVD imaging markers, suggesting that certain microbial taxa may serve as potential diagnostic biomarkers to distinguish aCSVD-iNPH from aCSVD, although these preliminary findings require validation in independent cohorts.