Fecal microbiota transplant can improve cognition in patients with cognitive decline and Clostridioides difficile infection

Abstract

AbstractBackgroundAfter fecal microbiota transplantation (FMT) to treat Clostridioides difficile infection (CDI), cognitive improvement is noticeable, suggesting an essential association between the gut microbiome and neural function. Although the gut microbiome has been associated with cognitive function, it remains to be elucidated whether fecal microbiota transplantation can improve cognition in patients with cognitive decline.MethodThe study included 10 patients (age range, 63‐90 years; female, 80%) with dementia and severe CDI who were evaluated using cognitive function tests (Mini‐Mental State Examination [MMSE] and Clinical Dementia Rating scale Sum of Boxes [CDR‐SB] score) and stool PCR before and after FMT. Cognitive function test was performed one month before FMT and one month after FMT. The patients’ fecal samples were analyzed to determine the composition of their gut microbiota before FMT and 3 weeks after FMT to compare the microbiota composition.ResultTen patients receiving FMT showed improvements in clinical symptoms and cognitive functions. The MMSE score pre‐FMT was 10.00 (Median, 7.00 – 14.00 interquartile range [IQR]), and the MMSE score post‐FMT was 16.00 (Median, 13.00 – 18.00 [IQR]). The CDR‐SB score pre‐FMT was 10.00 (Median, 5.00 – 12.00 IQR), and post‐FMT was 5.50 (Median, 4.00 – 8.00, IQR). FMT led to changes in the recipient’s gut microbiota composition, with enriched Proteobacteria in pre‐FMT and Bacteroidetes in post‐FMT most pronounced. We found that the genera were reported to be associated with cognitive function. In addition, alanine, aspartate, and glutamate metabolism pathway was found to be significantly different between before and after FMTConclusionThis study highlight the important interaction between the gut microbiome and cognitive function. Moreover, this study suggest that FMT may effectively delay cognitive decline in patients with dementia.