Role of the gut microbiota in the development of various neurological diseases.

INTRODUCTION: In recent years, the scientific evidence supporting a relationship between the microbiota and various diseases has increased significantly; this trend has also been observed for neurological diseases. This has given rise to the concept of the gut-brain axis and the idea of a relationship between the gut microbiota and several neurological diseases whose aetiopathogenesis is yet to be clearly defined. DEVELOPMENT: We review the role of the gut microbiota in the gut-brain axis and analyse those neurological diseases in which alterations in the gut microbiota have been described as a result of human studies: specifically, Parkinson's disease, Alzheimer disease, amyotrophic lateral sclerosis, neuromyelitis optica, and multiple sclerosis. CONCLUSIONS: The body of evidence linking the gut microbiota to various neurological diseases has grown considerably. Several interesting studies show a relationship between the gut microbiota and Parkinson's disease, Alzheimer disease, neuromyelitis optica, and multiple sclerosis, whereas other controversial studies implicate it in amyotrophic lateral sclerosis. Many of these studies place considerable emphasis on modulation of inflammation, particularly by bacteria capable of producing short-chain fatty acids. Despite these encouraging results, many questions remain, and there is a need to demonstrate causality, determine the role of fungi or viruses, and research possible treatment through diet, probiotics, or faecal microbiota transplantation.

Papel de la microbiota intestinal en el desarrollo de diferentes enfermedades neurológicas / Role of the gut microbiota in the development of various neurological diseases

Introducción: En los últimos años la producción científica acerca de la microbiota y su relación con diversas enfermedades se ha disparado, hecho que se ha observado también entre las enfermedades neurológicas. Fruto de estas investigaciones ha surgido el concepto del eje intestino-cerebro, así como la existencia de una relación entre la microbiota intestinal y diversas enfermedades neurológicas, muchasde ellas sin etiopatogenia claramente definida. Desarrollo: Se revisa la implicación de la microbiota intestinal en el eje intestino-cerebro, así como en aquellas enfermedades neurológicas en que se ha descrito una alteración en la microbiota intestinal en estudios llevados a cabo en humanos; concretamente enfermedad de Parkinson, enfermedad de Alzheimer, esclerosis lateral amiotrófica, neuromielitis óptica y esclerosis múltiple. Conclusiones: En la actualidad el cuerpo de evidencia que relaciona la microbiota intestinal y diversas enfermedades neurológicas está creciendo notablemente. Existen interesantes estudios que relacionan la microbiota intestinal con la enfermedad de Parkinson, el Alzheimer, la neuromielitis óptica y la esclerosis múltiple, así como estudios controvertidos acerca del papel de las bacterias intestinales en la esclerosis lateral amiotrófica. En muchas de estas relaciones tiene un importante peso el papel de la modulación de la inflamación, especialmente de aquellas bacterias capaces de producir ácidos grasos de cadena corta. Aún quedan muchos interrogantes por dilucidar, como realizar estudios diseñados para demostrar causalidad, determinar el papel de hongos o virus y los posibles tratamientos con dieta, probióticos o trasplante de heces. (AU)

Introduction: In recent years, the scientific evidence supporting a relationship between the microbiota and various diseases has increased significantly; this trend has also been observed for neurological diseases. This has given rise to the concept of the gut-brain axis and the idea of a relationship between the gut microbiota and several neurological diseases whose aetiopathogenesis is yet to be clearly defined. Development: We review the role of the gut microbiota in the gut-brain axis and analyse those neurological diseases in which alterations in the gut microbiota have been described as a result of human studies: specifically, Parkinson's disease, Alzheimer disease, amyotrophic lateral sclerosis, neuromyelitis optica, and multiple sclerosis. Conclusions: The body of evidence linking the gut microbiota to various neurological diseases has grown considerably. Several interesting studies show a relationship between the gut microbiota and Parkinson's disease, Alzheimer disease, neuromyelitis optica, and multiple sclerosis, whereas other controversial studies implicate it in amyotrophic lateral sclerosis. Many of these studies place considerable emphasis on modulation of inflammation, particularly by bacteria capable of producing short-chain fatty acids. Despite these encouraging results, many questions remain, and there is a need to demonstrate causality, determine the role of fungi or viruses, and research possible treatment through diet, probiotics, or faecal microbiota transplantation. (AU)

Sintomatología neuropsiquiátrica en el síndrome post-COVID. Propuesta de manejo y derivación desde atención primaria / Neuropsychiatric symptomatology in post-COVID syndrome. Intervention proposal and referral from primary care

La infección por SARS-CoV-2 es una enfermedad multiorgánica. Tiene un amplio espectro de manifestaciones clínicas, entre ellas neurológicas y psiquiátricas, que se expresan en todos los estadios evolutivos de la enfermedad. En muchas ocasiones presenta sintomatología a largo plazo que se ha denominado síndrome post-COVID. Entre la sintomatología neuropsiquiátrica derivada del mencionado síndrome, nos centramos en este manuscrito, por su prevalencia, en la cefalea, el deterioro cognitivo, las alteraciones del gusto y olfato, la depresión, los trastornos de ansiedad y el insomnio. En este documento se revisa esta sintomatología y se proponen algoritmos de manejo y criterios de derivación de atención primaria (AP) a otros especialistas (AU)

SARS-CoV-2 infection is a multiorgan disease with a wide spectrum of clinical manifestations, including neurological and psychiatric, which are expressed in all stages of the disease and often has long-term symptoms, called post-COVID syndrome. Among the neuropsychiatric symptoms derived from this syndrome, in this article we focus on headache, cognitive impairment, taste and smell alterations, depression, anxiety and sleep disorders. Intervention algorithms for these symptoms in primary care establishing criteria for referral to specialized care are proposed (AU)

[Neuropsychiatric symptomatology in post-COVID syndrome. Intervention proposal and referral from primary care]. / Sintomatología neuropsiquiátrica en el síndrome post-COVID. Propuesta de manejo y derivación desde atención primaria.

SARS-CoV-2 infection is a multiorgan disease with a wide spectrum of clinical manifestations, including neurological and psychiatric, which are expressed in all stages of the disease and often has long-term symptoms, called post-COVID syndrome. Among the neuropsychiatric symptoms derived from this syndrome, in this article we focus on headache, cognitive impairment, taste and smell alterations, depression, anxiety and sleep disorders. Intervention algorithms for these symptoms in primary care establishing criteria for referral to specialized care are proposed.

[Mild encephalitis/encephalopathy syndrome with reversible splenial lesion associated with intraventricular bleeding secondary to cavernoma. Findings from the magnetic resonance brain scan]. / Síndrome de encefalitis/encefalopatía leve con lesión del esplenio reversible asociado a sangrado intraventricular secundario a cavernoma. Hallazgos en la resonancia magnética cerebral.

TITLE: Síndrome de encefalitis/encefalopatía leve con lesión del esplenio reversible asociado a sangrado intraventricular secundario a cavernoma. Hallazgos en la resonancia magnética cerebral.

The influence of interferon ß-1b on gut microbiota composition in patients with multiple sclerosis.

INTRODUCTION: The association between gut microbiota and animal models of multiple sclerosis has been well established; however, studies in humans are scarce. METHODS: We performed a descriptive, cross-sectional study comparing the relative composition of gut microbiota in 30 patients with multiple sclerosis (15 treated with interferon ß-1b, 15 not receiving this treatment) and 14 healthy controls using next generation sequencing. RESULTS: Patients with multiple sclerosis and controls showed differences in the proportion of Euryarchaeota, Firmicutes, Proteobacteria, Actinobacteria, and Lentisphaerae phyla and in 17 bacterial species. More specifically, we found significant differences in the proportion of Firmicutes, Actinobacteria, and Lentisphaerae and 6 bacteria species between controls and untreated patients; however, these differences disappeared when compared with treated patients. Untreated patients showed a significant reduction in the proportion of Prevotella copri compared to controls, while the bacteria was significantly more abundant in patients treated with interferon ß-1b than in untreated patients, with levels resembling those observed in the healthy control group. CONCLUSION: We observed differences in gut microbiota composition between patients with multiple sclerosis and controls, and between patients treated and not treated with interferon ß-1b. In most cases, no differences were observed between treated patients and healthy controls, particularly for P. copri levels. This suggests that the clinical improvements observed in patients with multiple sclerosis receiving interferon ß-1b may result from the effect of the drug on gut microbiota. Longitudinal and functional studies are necessary to establish a causal relationship.

Composición de la microbiota intestinal en pacientes con esclerosis múltiple. Influencia del tratamiento con interferón B-1b / The influence of interferon B–1b on gut microbiota composition in patients with multiple sclerosis

Introducción. El papel de la microbiota en los modelos animales de esclerosis múltiple está bien establecido; por el contrario, los estudios en humanos son escasos.MétodosEstudio transversal descriptivo que compara la composición relativa de la microbiota intestinal en 30 pacientes con esclerosis múltiple (15 tratados con interferón β-1b, 15 sin tratamiento) y 14 controles sanos utilizando la secuenciación de última generación.ResultadosLos sujetos control y los pacientes con esclerosis múltiple presentaron diferente abundancia de los filos Euryarchaeota, Firmicutes, Proteobacteria, Actinobacteria, y Lentisphaerae y 17 especies bacterianas. Concretamente, la abundancia en Firmicutes, Actinobacteria y Lentisphaerae y 6 especies mostró diferencias al comparar los grupos control y sin tratamiento, desapareciendo esta diferencia cuando se compararon con los pacientes tratados. Se observó reducción estadísticamente significativa en la abundancia de Prevotella copri en pacientes sin tratamiento en comparación con controles, mientras que los tratados con interferón β-1b presentaron un aumento significativo frente a pacientes sin tratamiento, asemejándose al grupo de pacientes sanos control.ConclusiónLa composición de la microbiota intestinal fue diferente entre los pacientes con esclerosis múltiple y los controles, y entre los pacientes sin tratamiento y los tratados con interferón β-1b. En la mayoría de los casos, no se encontraron diferencias entre los pacientes tratados y los controles sanos, siendo especialmente evidente con P. copri. Esto podría indicar que la influencia del interferón β-1b sobre la microbiota intestinal podría subyacer en los beneficios clínicos observados en pacientes con esclerosis múltiple que siguen este tratamiento. Serán necesarios estudios longitudinales y funcionales para poder mostrar causalidad. (AU)

Introduction: The association between gut microbiota and animal models of multiple sclerosis has been well established; however, studies in humans are scarce.MethodsWe performed a descriptive, cross-sectional study comparing the relative composition of gut microbiota in 30 patients with multiple sclerosis (15 treated with interferon β–1b, 15 not receiving this treatment) and 14 healthy controls using next generation sequencing.ResultsPatients with multiple sclerosis and controls showed differences in the proportion of Euryarchaeota, Firmicutes, Proteobacteria, Actinobacteria, and Lentisphaerae phyla and in 17 bacterial species. More specifically, we found significant differences in the proportion of Firmicutes, Actinobacteria, and Lentisphaerae and 6 bacteria species between controls and untreated patients; however, these differences disappeared when compared with treated patients. Untreated patients showed a significant reduction in the proportion of Prevotella copri compared to controls, while the bacteria was significantly more abundant in patients treated with interferon β–1b than in untreated patients, with levels resembling those observed in the healthy control group.ConclusionWe observed differences in gut microbiota composition between patients with multiple sclerosis and controls, and between patients treated and not treated with interferon β–1b. In most cases, no differences were observed between treated patients and healthy controls, particularly for P. copri levels. This suggests that the clinical improvements observed in patients with multiple sclerosis receiving interferon β–1b may result from the effect of the drug on gut microbiota. Longitudinal and functional studies are necessary to establish a causal relationship. (AU)

Cefalea secundaria farmacorresistente asociada a fármacos biológicos / Drug-resistant secondary headache associated with administration of biological drugs

No disponible

Role of the gut microbiota in the development of various neurological diseases. / Papel de la microbiota intestinal en el desarrollo de diferentes enfermedades neurológicas.

INTRODUCTION: In recent years, the scientific evidence supporting a relationship between the microbiota and various diseases has increased significantly; this trend has also been observed for neurological diseases. This has given rise to the concept of the gut-brain axis and the idea of a relationship between the gut microbiota and several neurological diseases whose aetiopathogenesis is yet to be clearly defined. DEVELOPMENT: We review the role of the gut microbiota in the gut-brain axis and analyse those neurological diseases in which alterations in the gut microbiota have been described as a result of human studies: specifically, Parkinson's disease, Alzheimer disease, amyotrophic lateral sclerosis, neuromyelitis optica, and multiple sclerosis. CONCLUSIONS: The body of evidence linking the gut microbiota to various neurological diseases has grown considerably. Several interesting studies show a relationship between the gut microbiota and Parkinson's disease, Alzheimer disease, neuromyelitis optica, and multiple sclerosis, whereas other controversial studies implicate it in amyotrophic lateral sclerosis. Many of these studies place considerable emphasis on modulation of inflammation, particularly by bacteria capable of producing short-chain fatty acids. Despite these encouraging results, many questions remain, and there is a need to demonstrate causality, determine the role of fungi or viruses, and research possible treatment through diet, probiotics, or faecal microbiota transplantation.

Papel de la microbiota intestinal en el desarrollo de la esclerosis múltiple / Role of intestinal microbiota in the development of multiple sclerosis

Introducción. La esclerosis múltiple (EM) es una enfermedad desmielinizante que afecta a adultos jóvenes, grupo en que supone la segunda causa de discapacidad en nuestro medio. Su etiología precisa no está dilucidada, pero se acepta que se presenta en pacientes predispuestos genéticamente que se ven expuestos a determinados factores ambientales. El descubrimiento del papel regulador de la microbiota intestinal en diversas enfermedades autoinmunes ha abierto una nueva línea de investigación en este campo, lo que se discute en esta revisión. Desarrollo. Revisamos los estudios publicados acerca del papel de la microbiota en el desarrollo de la EM y su modelo animal, la encefalomielitis autoinmune experimental (EAE). En ratones, se ha demostrado que los microorganismos intestinales regulan la polarización de las células T helper de Th1-Th17 hasta Th2, la función de las células T reguladoras y la actividad de las células B, participando en la génesis de la EAE, así como en su prevención y tratamiento. Por el contrario, en humanos la evidencia es aún escasa, fundamentalmente en base a estudios de casos control que apuntan a la existencia de diferencias en determinadas comunidades bacterianas. Conclusiones. Existe múltiple evidencia del papel de la microbiota en la EAE. La extrapolación de los resultados a la EM está en las primeras fases de investigación, y hacen falta estudios que definan qué poblaciones bacterianas se asocian a la EM, su papel en la patogenia y las posibilidades terapéuticas que esto nos ofrezca (AU)

Introduction. Multiple sclerosis (MS) is a demyelinating disease that affects young adults; in that age group, it represents the second leading cause of disability in our setting. Its precise aetiology has not been elucidated, but it is widely accepted to occur in genetically predisposed patients who are exposed to certain environmental factors. The discovery of the regulatory role played by intestinal microbiota in various autoimmune diseases has opened a new line of research in this field, which is discussed in this review. Development. We reviewed published studies on the role of the microbiota in the development of both MS and its animal model, experimental autoimmune encephalomyelitis (EAE). In mice, it has been shown that intestinal microorganisms regulate the polarisation of T helper cells from Th1-Th17 up to Th2, the function of regulatory T cells, and the activity of B cells; they participate in the pathogenesis of EAE and contribute to its prevention and treatment. In contrast, evidence in humans is still scarce and mainly based on case-control studies that point to the presence of differences in certain bacterial communities. Conclusions. Multiple evidence points to the role of microbiota in EAE. Extrapolation of these results to MS is still in the early stages of research, and studies are needed to define which bacterial populations are associated with MS, the role they play in pathogenesis, and the therapeutic possibilities this knowledge offers us (AU)

Role of intestinal microbiota in the development of multiple sclerosis. / Papel de la microbiota intestinal en el desarrollo de la esclerosis múltiple.

INTRODUCTION: Multiple sclerosis (MS) is a demyelinating disease that affects young adults; in that age group, it represents the second leading cause of disability in our setting. Its precise aetiology has not been elucidated, but it is widely accepted to occur in genetically predisposed patients who are exposed to certain environmental factors. The discovery of the regulatory role played by intestinal microbiota in various autoimmune diseases has opened a new line of research in this field, which is discussed in this review. DEVELOPMENT: We reviewed published studies on the role of the microbiota in the development of both MS and its animal model, experimental autoimmune encephalomyelitis (EAE). In mice, it has been shown that intestinal microorganisms regulate the polarisation of T helper cells from Th1-Th17 up to Th2, the function of regulatory T cells, and the activity of B cells; they participate in the pathogenesis of EAE and contribute to its prevention and treatment. In contrast, evidence in humans is still scarce and mainly based on case-control studies that point to the presence of differences in certain bacterial communities. CONCLUSIONS: Multiple evidence points to the role of microbiota in EAE. Extrapolation of these results to MS is still in the early stages of research, and studies are needed to define which bacterial populations are associated with MS, the role they play in pathogenesis, and the therapeutic possibilities this knowledge offers us.