Alteration of gut microbiota in post-stroke depression patients with Helicobacter pylori infection

Abstract Several studies have identified an association between the gut microbiome and post-stroke depression (PSD). As a common gastric infection bacteria, Helicobacter pylori ( H. pylori ) infection cause significant alterations in the composition of the gastrointestinal microbiome, but relationship between H. pylori infection and PSD is still limited. Here, we conducted a retrospective study to assess risk factors associated with PSD. A total of 183 patients with ischemic stroke were enrolled and their depression scores, imaging features and clinical data were analyzed. Multivariate logistic regression analysis showed that deep white matter lesions (DWMLs) and H. pylori infection were the independent risk factors for PSD. Further analysis indicated that patients with H. pylori- positive infection [ H. pylori (+)] had more severe depressive symptoms than those with negative infection [ H. pylori (-)]. Fecal 16S rRNA gene sequencing analysis revealed statistically differences in intestinal flora between H. pylori (+) patients and H. pylori (-) patients. The DESeq2 analysis indicated that Akkermansia muciniphila, Bacteroides dorei, and Fusobacterium ulcerans levels were significantly decreased, while Megamonas funiformis and Bifidobacterium adolescentis were more abundant in the H. pylori (+) group. GC-MS revealed that short-chain fatty acids (SCFAs) concentrations were significantly different between the two groups, and fecal SCFAs concentrations reduced in the H. pylori (+) group. In conclusion, DWMLs and H. pylori infection may play important roles in the development of PSD. H. pylori infection is likely to be involved in the pathogenesis of PSD by altering the intestinal flora.