{
  "abstract": "Background/Objectives: Cerebral small vessel disease (CSVD) is a major vascular component of brain aging, yet potentially modifiable systemic contributors remain incompletely understood. Growing evidence links the gut microbiome to magnetic resonance imaging (MRI)-defined CSVD, but interpretation is complicated by heterogeneity in microbiome profiling, clinical populations, analytical methods, and neuroimaging phenotypes. This review critically integrates the available human evidence with complementary multi-omics, ex vivo, and experimental findings. Methods: PubMed, Embase, Scopus, and Web of Science were searched through 4 August 2026; 12 eligible reports representing eight cohort families were included and evaluated using a structured study-level methodological appraisal. Results: Across the available literature, ecological and host-related biological processes show greater qualitative convergence than individual taxa, although this pattern has not been formally quantified across independent cohorts. Among reported alpha diversity measures, Chao/Chao1 showed the same numerical disease-versus-control direction across four cohort families, with statistical significance in two, suggesting a recurrent but still preliminary richness-related signal; Shannon and Simpson indices were less consistent. No single genus or species has been consistently replicated across the available, largely cross-sectional cohorts. Complementary studies implicate intestinal barrier, immune–metabolic, neurovascular, and perivascular clearance pathways but do not establish a unified causal pathway in human sporadic CSVD. Conclusions: These observations support a hypothesis-generating ecosystem-level framework. Because diet is an important modifiable determinant of the gut microbial ecosystem, these findings may have relevance for nutrition-based strategies targeting vascular brain aging. However, no CSVD-specific dietary or microbiome-directed intervention has yet been shown to modify disease progression or related MRI outcomes.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Neurology and Stroke, Saint John’s Central Hospital of North Buda, 1125 Budapest, Hungary",
    "Health Sciences Division, Doctoral College, Semmelweis University, 1085 Budapest, Hungary",
    "MiND Brain-Gut Center, 1125 Budapest, Hungary",
    "Department of Pulmonology, Semmelweis University, 1083 Budapest, Hungary",
    "Institute of Preventive Medicine and Public Health, Faculty of Medicine, Semmelweis University, 1089 Budapest, Hungary",
    "Fodor Center for Prevention and Healthy Aging, Semmelweis University, 1085 Budapest, Hungary",
    "Faculty of International Business Economics, Budapest University of Economics and Business, 1054 Budapest, Hungary"
  ],
  "article_type": "review article",
  "arxiv": null,
  "author_total": 11,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Tamas Jarecsny",
      "orcid": "0000-0002-8419-5292"
    },
    {
      "affs": [
        0
      ],
      "name": "Ferenc Fazekas"
    },
    {
      "affs": [
        0
      ],
      "name": "Nadim Al-Muhanna"
    },
    {
      "affs": [
        2
      ],
      "name": "Richard Schwab",
      "orcid": "0009-0000-7014-1667"
    },
    {
      "affs": [
        2
      ],
      "name": "Viktoria Hadnagy"
    },
    {
      "affs": [
        2
      ],
      "name": "Sara Laki"
    },
    {
      "affs": [
        3
      ],
      "name": "Janos Tamas Varga",
      "orcid": "0000-0002-8552-1336"
    },
    {
      "affs": [
        1,
        4,
        5
      ],
      "name": "Andrea Lehoczki"
    },
    {
      "affs": [
        1,
        4,
        5
      ],
      "name": "Virag Zabo"
    },
    {
      "affs": [
        6
      ],
      "name": "Diana Gorog"
    },
    {
      "affs": [
        1,
        4,
        5
      ],
      "name": "Monika Fekete",
      "orcid": "0000-0001-8632-2120"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/dn20y41np8vck.bib",
  "cited_by": 0,
  "doi": "10.3390/nu18203421",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13708570/?tool=EBI",
  "id": "dn20y41np8vck",
  "issns": [
    "2072-6643"
  ],
  "landing_url": "https://www.mdpi.com/2072-6643/18/20/3421",
  "language": "eng",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "1312|Gut microbiota and health"
    ]
  ],
  "openalex": "W7222944172",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13708570/pdf/?tool=EBI",
  "pmcid": "PMC13708570",
  "pmid": null,
  "published": "2026-10-01",
  "publisher": "MDPI AG",
  "ris": "https://research.draconitic.com/paper/dn20y41np8vck.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:56Z",
      "native_id": "10.3390/nu18203421",
      "source": "crossref",
      "url": "https://www.mdpi.com/2072-6643/18/20/3421"
    },
    {
      "first_seen": "2026-10-30T12:21:49Z",
      "native_id": "PMC:PMC13708570",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13708570"
    }
  ],
  "subjects": [
    {
      "field": "biochemistry",
      "origin": "openalex:1312|Gut microbiota and health",
      "subfield": "molecular-biology"
    }
  ],
  "title": "Gut Microbiome in Sporadic Cerebral Small Vessel Disease: MRI-Defined Phenotypes, Mechanistic Evidence, and Nutritional Implications for Brain Aging",
  "title_text": "Gut Microbiome in Sporadic Cerebral Small Vessel Disease: MRI-Defined Phenotypes, Mechanistic Evidence, and Nutritional Implications for Brain Aging",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:21:49Z",
  "url": "https://research.draconitic.com/paper/dn20y41np8vck",
  "venue": "Nutrients",
  "versions": []
}