Association between gut microbiota and post-stroke depression in Chinese population: A meta-analysis

BACKGROUND: Post-stroke depression (PSD) is a common neuropsychological complication after a stroke with a range of poor outcomes. Evidence of gut microbiota disorder for PSD has recently accumulated. This study aimed to systematically evaluate the association between PSD and gut microbiota. METHODS: We searched PubMed, Web of Science, Embase, and VIP, CNKI, Wangfang without language restrictions for eligible studies and performed a meta-analysis and systematic review to assess the pooled differences in gut microbiota compositions between PSD and healthy individuals. RESULTS: We included nine eligible studies reporting the differences in the intestinal microbiome between PSD and healthy control. The pooled results demonstrated that the sequencing depth index (Good's coverage), richness indexes (Chao1 and ACE), evenness, and alpha diversity (Shannon and Simpson) were not significantly changed in PSD patients as compared to healthy controls. The observed species (operational taxonomic unit, OUT) in PSD was significantly higher than that in healthy individuals (SMD, 1.86, 95%CI: 1.47 to 2.25). Furthermore, we observed significant differences between PSD and healthy individuals at the phylum level. The pooled estimation of relative abundance of Proteobacteria (SMD, 0.37, 95%CI: 0.19 to 0.55), Bacteroidetes (SMD, 1.87, 95%CI: 1.25 to 2.48), and Fusobacteria (SMD, 1.06, 95%CI: 0.76 to 1.37) in patients with PSD significantly was increased as compared to controls, while the pooled relative abundance of Firmicutes (SMD, -0.84, 95%CI: -1.21 to -0.47) was significantly decreased in PSD as compared to healthy controls. Moreover, significant differences in intestinal microbiota were observed between PSD patients and healthy controls at the family and genus levels. CONCLUSIONS: This meta-analysis indicates a significant alteration of observed species and microbiota composition at the phylum, family and genus levels in PSD as compared to healthy individuals.