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. 2025 Mar;130(3):327-358.
doi: 10.1007/s11547-024-01938-0. Epub 2024 Dec 24.

Gut-brain axis and neuroplasticity in health and disease: a systematic review

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Gut-brain axis and neuroplasticity in health and disease: a systematic review

Alberto Di Napoli et al. Radiol Med. 2025 Mar.

Abstract

The gut microbiota emerged as a potential modulator of brain connectivity in health and disease. This systematic review details current evidence on the gut-brain axis and its influence on brain connectivity. The initial set of studies included 532 papers, updated to January 2024. Studies were selected based on employed techniques. We excluded reviews, studies without connectivity focus, studies on non-human subjects. Forty-nine papers were selected. Employed techniques in healthy subjects included 15 functional magnetic resonance imaging studies (fMRI), 5 diffusion tensor imaging, (DTI) 1 electroencephalography (EEG), 6 structural magnetic resonance imaging, 2 magnetoencephalography, 1 spectroscopy, 2 arterial spin labeling (ASL); in patients 17 fMRI, 6 DTI, 2 EEG, 9 structural MRI, 1 transcranial magnetic stimulation, 1 spectroscopy, 2 R2*MRI. In healthy subjects, the gut microbiota was associated with connectivity of areas implied in cognition, memory, attention and emotions. Among the tested areas, amygdala and temporal cortex showed functional and structural differences based on bacteria abundance, as well as frontal and somatosensory cortices, especially in patients with inflammatory bowel syndrome. Several studies confirmed the connection between microbiota and brain functions in healthy subjects and patients affected by gastrointestinal to renal and psychiatric diseases.

Keywords: EEG; Gut-Brain axis; MEG; MRI; Neuroplasticity; Resting state; TMS; fMRI.

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Conflict of interest statement

Declarations. Conflict of interest: The study was reviewed by the local ethics committee, and consent was waived. The authors declare no conflict of interest concerning the study.

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