ReviewNutrients2026
Gut Microbiome in Sporadic Cerebral Small Vessel Disease: MRI-Defined Phenotypes, Mechanistic Evidence, and Nutritional Implications for Brain Aging.
Review in Nutrients, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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11 authors.
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Abstract
BACKGROUND/
objectivesCerebral 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.
methodsPubMed, 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.
resultsAcross 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.
conclusionsThese 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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