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. 2023 Aug;13(8):e3115.
doi: 10.1002/brb3.3115. Epub 2023 Jun 5.

Longitudinal study of gut microbiome in obsessive-compulsive disorder

Long Long Chen  1 , Afrouz Abbaspour  2 , Kristina Aspvall  1 , Christian Rück  1 , Cynthia M Bulik  2   3 , Diana Pascal  1
Affiliations

Longitudinal study of gut microbiome in obsessive-compulsive disorder

Long Long Chen et al. Brain Behav. 2023 Aug.

Abstract

Introduction: Patients with obsessive-compulsive disorder (OCD) often have limited exposure to a diverse environment and perform repetitive compulsions such as excessive cleaning and washing, which could lead to altered gut microbiome. Therefore, longitudinal studies that investigate changes in gut microbiome before and after cognitive behavioral therapy based on exposure and response prevention (ERP) are warranted.

Methods: All study participants (N = 64) underwent a structured psychiatric diagnostic interview prior to inclusion. Nutritional intake was assessed with a comprehensive food frequency questionnaire. Stool samples were collected from OCD patients before ERP (n = 32) and 1 month after completion of ERP (n = 15), as well as from healthy controls (HCs; n = 32). Taxonomic and functional analyses were performed using data from microbiome whole genome sequencing.

Results: Patients with OCD at baseline reported consuming significantly less fiber than HCs (R2 = .12, F(2, 59) = 5.2, p ≤ .01). There were no significant differences in α- and β-diversity indices, or taxonomic dissimilarities at the species level between patients with OCD and HCs, or within patients before and after ERP. Functional profiling based on gut microbial gene expression was grouped into 56 gut-brain modules with neuroactive potential. None of the gut-brain modules differed significantly in expression between patients with OCD at baseline and HCs or within patients before and after ERP.

Conclusions: The diversity, composition, and functional profile of the gut microbiome in patients with OCD did not differ significantly from HCs and remained stable over time, despite behavioral changes.

Keywords: cognitive behavior therapy; diet; gastrointestinal microbiome; gut-brain axis; metagenomics; obsessive-compulsive disorder.

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Conflict of interest statement

C. M. Bulik: Shire (grant recipient, Scientific Advisory Board member); Lundbeckfonden (grant recipient); Pearson (author, royalty recipient); and Equip Health Inc. (Stakeholder Advisory Board). The other authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Principal coordinate analysis illustrating β‐diversity indices, (A) Bray–Curtis, (B) unweighted UniFrac distances, and (C) weighted UniFrac distances. Samples from HC are in red (n = 32), samples from patients with OCD are in green (n = 32), and samples from patients who have completed ERP treatment 1 month prior are in blue (n = 15). Multivariate analysis (PERMANOVA) for β‐diversity indices between the three groups were Bray–Curtis (F (2) = 0.02, p‐value = .97), unweighted UniFrac (F (2) = 0.02, p‐value = .96), and weighted UniFrac (F (2) = 0.02, p‐value = .50).
FIGURE 2
FIGURE 2
Differences in abundance at species level between patients with OCD and HC. (A) The left panel is a Bland–Altman plot that shows the relative abundance of species between OCD and HC. The log‐ratio abundance axis is the center‐log‐ratio value for the feature. (B) The right panel is an effect plot that shows the difference in effect size (dispersion) between OCD and HC. In both plots, each feature is represented with a dot (gray dots are abundant, while black dots are rare, neither are significantly differentially abundant).
FIGURE 3
FIGURE 3
Differences in expression of neuroactive GBM between patients with OCD and HC as mean percentage. None of the GBMs reached statistical significance after correcting for multiple comparisons using FDR‐adjusted p‐value (q < .05).
See this image and copyright information in PMC

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