Gut Microbiome in Sporadic Cerebral Small Vessel Disease: MRI-Defined Phenotypes, Mechanistic Evidence, and Nutritional Implications for Brain Aging
7 affiliations
- 1Department of Neurology and Stroke, Saint John’s Central Hospital of North Buda, 1125 Budapest, Hungary
- 2Health Sciences Division, Doctoral College, Semmelweis University, 1085 Budapest, Hungary
- 3MiND Brain-Gut Center, 1125 Budapest, Hungary
- 4Department of Pulmonology, Semmelweis University, 1083 Budapest, Hungary
- 5Institute of Preventive Medicine and Public Health, Faculty of Medicine, Semmelweis University, 1089 Budapest, Hungary
- 6Fodor Center for Prevention and Healthy Aging, Semmelweis University, 1085 Budapest, Hungary
- 7Faculty of International Business Economics, Budapest University of Economics and Business, 1054 Budapest, Hungary
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.
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BibTeX
@article{jarecsny2026microbiome,
title = {{Gut Microbiome in Sporadic Cerebral Small Vessel Disease: MRI-Defined Phenotypes, Mechanistic Evidence, and Nutritional Implications for Brain Aging}},
author = {Tamas Jarecsny and Ferenc Fazekas and Nadim Al-Muhanna and Richard Schwab and Viktoria Hadnagy and Sara Laki and Janos Tamas Varga and Andrea Lehoczki and Virag Zabo and Diana Gorog and Monika Fekete},
journal = {Nutrients},
year = {2026},
month = oct,
doi = {10.3390/nu18203421},
url = {https://www.mdpi.com/2072-6643/18/20/3421},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Gut Microbiome in Sporadic Cerebral Small Vessel Disease: MRI-Defined Phenotypes, Mechanistic Evidence, and Nutritional Implications for Brain Aging
AU - Tamas Jarecsny
AU - Ferenc Fazekas
AU - Nadim Al-Muhanna
AU - Richard Schwab
AU - Viktoria Hadnagy
AU - Sara Laki
AU - Janos Tamas Varga
AU - Andrea Lehoczki
AU - Virag Zabo
AU - Diana Gorog
AU - Monika Fekete
PY - 2026
DA - 2026/10/01
JO - Nutrients
DO - 10.3390/nu18203421
UR - https://www.mdpi.com/2072-6643/18/20/3421
AB - 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.
SN - 2072-6643
ER -