Data_Sheet_1_A preliminary study for the clinical effect of one combinational physiotherapy and its potential influence on gut microbial composition in children with Tourette syndrome.pdf

IntroductionTourette syndrome (TS) is a chronic neuropsychiatric disorder with unknown causes and inadequate therapies. Inspired by the important roles of gut microbiota in some mental illnesses, the interactions between gut microbiota and TS via the gut-brain axis have gained more and more attention. This study aimed to characterize the gut microbial profiles in children with TS, and explore the clinical effects of one combinational physiotherapy and its potential influence on gut microbial composition.MethodsThe gut microbial profiles were depicted based on the sequence data of 32 patients and 29 matched health children by 16S rDNA amplicon pyrosequencing. Thirty of thirty-two patients underwent uninterrupted two 10-day courses of combinational physiotherapy, which included a 60-minute cranial electrotherapy stimulation (CES) training followed by a 30-minute biofeedback training per session, 2 sessions a day.ResultsOur results indicated that the gut microbial composition in children with TS was different from that in healthy controls. Multiple GBM neurotransmitter modules obtained through Picrust2 functional predictive analysis were significantly increased in patients, including Histamine degradation, Dopamine degradation, and DOPAC synthesis. Moreover, this combinational physiotherapy could significantly diminish tic activity, whose positive effects were first reported in children with TS. Lastly, different gut microbial compositions and predictive metabolic pathways were also observed between patients before and after this treatment, with lower abundances of the genera (e.g., Dorea) and significant decreases of GBM neurotransmitter modules (e.g. dopamine degradation) in patients after this treatment, indicating that improved clinical symptoms might be accompanied by an improvement of intestinal microenvironment.DiscussionChildren with TS showed a cognizable gut microbial profile, and certain enriched bacteria with pro-inflammatory potential might induce neuroinflammatory responses. This combinational physiotherapy could significantly diminish tic activity, and the gut microbial compositions in patients after this treatment were different from those without any treatment, indicating the existence of bidirectional communication of the gut-brain axis in TS. But studies on the gut microbial characteristics in TS patients, the influences of gut microbiota on tic severity, the efficacy and safety of this treatment, and the bidirectional regulatory mechanism between brain signals and gut microbiota in TS still need to be explored.

Tourette 综合征（TS）是一种病因未明且治疗不足的慢性神经精神障碍。鉴于肠道微生物群在部分精神疾病中扮演的重要角色，肠道微生物群与 TS 通过肠-脑轴的相互作用日益受到关注。本研究旨在描述 TS 儿童的肠道微生物特征，并探讨一种组合物理治疗的临床效果及其对肠道微生物组成潜在的影响。方法：基于 32 名患者和 29 名健康儿童的 16S rDNA 扩增子焦磷酸测序数据描绘肠道微生物特征。32 名患者中的 30 人接受了不间断的两个 10 天疗程的组合物理治疗，包括每次 60 分钟的颅电刺激（CES）训练，随后进行 30 分钟的生物反馈训练，每日 2 次。结果：我们的研究结果表明，TS 儿童的肠道微生物组成与健康对照组存在差异。通过 Picrust2 功能预测分析获得的多个 GBM 神经递质模块在患者中显著增加，包括组胺降解、多巴胺降解和 DOPAC 合成。此外，这种组合物理治疗可以显著减少抽搐活动，这种积极影响首次在 TS 儿童中得到报道。最后，治疗前后的患者肠道微生物组成和预测代谢途径也存在差异，治疗后患者的属（例如，Dorea）丰度降低，GBM 神经递质模块（例如，多巴胺降解）显著减少，表明改善的临床症状可能伴随着肠道微环境的改善。讨论：TS 儿童表现出可识别的肠道微生物特征，某些富含促炎潜能的细菌可能诱导神经炎症反应。这种组合物理治疗可以显著减少抽搐活动，并且治疗后患者的肠道微生物组成与未经任何治疗的患者不同，这表明 TS 中存在肠-脑轴的双向沟通。然而，关于 TS 患者的肠道微生物特征研究、肠道微生物对抽搐严重程度的影响、该治疗的疗效和安全性以及 TS 中脑信号与肠道微生物群之间的双向调节机制仍需进一步探索。