An integrative study of the microbiome gut-brain-axis and hippocampal inflammation in psychosis: Persistent effects from mode of birth

Peter Joe, Jose C. Clemente, Enrica Piras, David S. Wallach, Jessica Robinson-Papp, Emeka Boka, Brooke Remsen, Mharisi Bonner, David Kimhy, Deborah Goetz, Kevin Hoffman, Jakleen Lee, Eugene Ruby, Sarah Fendrich, Oded Gonen, Dolores Malaspina

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


The mechanism producing psychosis appears to include hippocampal inflammation, which could be associated with the microbiome-gut-brain-axis (MGBS). To test this hypothesis we are conducting a multidisciplinary study, herein described. The procedures are illustrated with testing of a single subject and group level information on the impact of C-section birth are presented. Method: Study subjects undergo research diagnostic interviews and symptom assessments to be categorized into one of 3 study groups: psychosis, nonpsychotic affective disorder or healthy control. Hippocampal volume and metabolite concentrations are assessed using 3-dimensional, multi-voxel H1 Magnetic Resonance Imaging (MRSI) encompassing all gray matter in the entire hippocampal volume. Rich self-report information is obtained with the PROMIS interview, which was developed by the NIH Commons for research in chronic conditions. Early trauma is assessed and cognition is quantitated using the MATRICS. The method also includes the most comprehensive autonomic nervous system (ANS) battery used to date in psychiatric research. Stool and oral samples are obtained for microbiome assessments and cytokines and other substances are measured in blood samples. Results: Group level preliminary data shows that C-section birth is associated with higher concentrations of GLX, a glutamate related hippocampal neurotransmitter in psychotic cases, worse symptoms in affective disorder cases and smaller hippocampal volume in controls. Conclusion: Mode of birth appears to have persistent influences through adulthood. The methodology described for this study will define pathways through which the MGBA may influence the risk for psychiatric disorders.

Original languageEnglish
Pages (from-to)101-115
Number of pages15
JournalSchizophrenia Research
StatePublished - Sep 2022


  • Autonomic nervous system
  • Inflammation
  • Magnetic resonance spectroscopy
  • Microbiome
  • Psychosis
  • Schizophrenia


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