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Abnormal gut bugs tied to worse cognitive performance in vets with PTSD and cirrhosis: Study involved more than 90 combat veterans

The study appeared Aug. 28, 2019, in the American Journal of Physiology.

Lead author Dr. Jasmohan Bajaj says the findings add to the substantial evidence linking gut health and brain function. He says they offer particular hope for people with PTSD and cirrhosis -- a common combination in the VA patient population.

"There is room for improvement in terms of the response to current therapies for PTSD," he says. "Targeting the gut microbiota might be an effective way to address the altered gut-brain axis in these patients and improve cognitive function, as well as other parameters of mental and physical health."

Bajaj is a physician-researcher with the McGuire Veterans Affairs Medical Center and Virginia Commonwealth University in Richmond.

Cirrhosis, or scarring of the liver, is prevalent in veterans with PTSD. Common causes include alcohol use disorder, obesity, and hepatitis C. Some patients with cirrhosis develop a complication called hepatic encephalopathy, which affects brain function. They become mentally sluggish and confused, and in severe cases can even lose consciousness.

PTSD, for its part, can also impair cognition. This can occur whether or not patients are taking drugs, such as antidepressants or sedatives, that act on the brain.

The researchers wanted to tease out the impact of abnormal gut microbiota in these conditions, and see whether those with cirrhosis and PTSD had different gut profiles than those with cirrhosis but no PTSD.

Bajaj's team took stool samples from 93 male veterans with cirrhosis, about a third of whom had combat-related PTSD. The other men had been exposed to combat during their military service but had not developed PTSD.

All the veterans completed a battery of cognitive exams. The tests covered areas such as reaction time, spatial ability, memory, and problem-solving.

Compared with the non-PTSD group, the men with PTSD had poorer cognitive performance.

Those with PTSD had microbiota that were less diverse, meaning they had fewer types of bacteria overall. This was true even after the researchers controlled for severity of cirrhosis, prior episodes of hepatic encephalopathy, alcohol use, and psychotropic medication use.

Journal Reference:
Jasmohan Singh Bajaj, et. al.. Post-Traumatic Stress Disorder is Associated with Altered Gut Microbiota that Modulates Cognitive Performance in Veterans with Cirrhosis. American Journal of Physiology-Gastrointestinal and Liver Physiology, 2019; DOI: 10.1152/ajpgi.00194.2019

Original Submission