Evaluation of an Immunomodulatory Probiotic Intervention for Veterans With Co-occurring Mild Traumatic Brain Injury and Posttraumatic Stress Disorder: A Pilot Study
Background: US military Veterans returned from Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn (OEF/OIF/OND) with symptoms associated with mild traumatic brain injury [mTBI; i.e., persistent post-concussive (PPC) symptoms] and posttraumatic stress disorder (PTSD). Interventions...
Main Authors: | , , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Frontiers Media S.A.
2020-10-01
|
Series: | Frontiers in Neurology |
Subjects: | |
Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2020.01015/full |
id |
doaj-c6095579cf494755988d2fbdfabeac60 |
---|---|
record_format |
Article |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Lisa A. Brenner Lisa A. Brenner Lisa A. Brenner Lisa A. Brenner Jeri E. Forster Jeri E. Forster Jeri E. Forster Kelly A. Stearns-Yoder Kelly A. Stearns-Yoder Kelly A. Stearns-Yoder Christopher E. Stamper Christopher E. Stamper Christopher E. Stamper Andrew J. Hoisington Andrew J. Hoisington Andrew J. Hoisington Andrew J. Hoisington Diana P. Brostow Diana P. Brostow Diana P. Brostow Meredith Mealer Meredith Mealer Hal S. Wortzel Hal S. Wortzel Teodor T. Postolache Teodor T. Postolache Teodor T. Postolache Teodor T. Postolache Christopher A. Lowry Christopher A. Lowry Christopher A. Lowry Christopher A. Lowry Christopher A. Lowry Christopher A. Lowry |
spellingShingle |
Lisa A. Brenner Lisa A. Brenner Lisa A. Brenner Lisa A. Brenner Jeri E. Forster Jeri E. Forster Jeri E. Forster Kelly A. Stearns-Yoder Kelly A. Stearns-Yoder Kelly A. Stearns-Yoder Christopher E. Stamper Christopher E. Stamper Christopher E. Stamper Andrew J. Hoisington Andrew J. Hoisington Andrew J. Hoisington Andrew J. Hoisington Diana P. Brostow Diana P. Brostow Diana P. Brostow Meredith Mealer Meredith Mealer Hal S. Wortzel Hal S. Wortzel Teodor T. Postolache Teodor T. Postolache Teodor T. Postolache Teodor T. Postolache Christopher A. Lowry Christopher A. Lowry Christopher A. Lowry Christopher A. Lowry Christopher A. Lowry Christopher A. Lowry Evaluation of an Immunomodulatory Probiotic Intervention for Veterans With Co-occurring Mild Traumatic Brain Injury and Posttraumatic Stress Disorder: A Pilot Study Frontiers in Neurology traumatic brain injury posttraumatic stress disorder (PTSD) probiotic Veteran gut-brain axis Lactobacillus reuteri DSM 17938 |
author_facet |
Lisa A. Brenner Lisa A. Brenner Lisa A. Brenner Lisa A. Brenner Jeri E. Forster Jeri E. Forster Jeri E. Forster Kelly A. Stearns-Yoder Kelly A. Stearns-Yoder Kelly A. Stearns-Yoder Christopher E. Stamper Christopher E. Stamper Christopher E. Stamper Andrew J. Hoisington Andrew J. Hoisington Andrew J. Hoisington Andrew J. Hoisington Diana P. Brostow Diana P. Brostow Diana P. Brostow Meredith Mealer Meredith Mealer Hal S. Wortzel Hal S. Wortzel Teodor T. Postolache Teodor T. Postolache Teodor T. Postolache Teodor T. Postolache Christopher A. Lowry Christopher A. Lowry Christopher A. Lowry Christopher A. Lowry Christopher A. Lowry Christopher A. Lowry |
author_sort |
Lisa A. Brenner |
title |
Evaluation of an Immunomodulatory Probiotic Intervention for Veterans With Co-occurring Mild Traumatic Brain Injury and Posttraumatic Stress Disorder: A Pilot Study |
title_short |
Evaluation of an Immunomodulatory Probiotic Intervention for Veterans With Co-occurring Mild Traumatic Brain Injury and Posttraumatic Stress Disorder: A Pilot Study |
title_full |
Evaluation of an Immunomodulatory Probiotic Intervention for Veterans With Co-occurring Mild Traumatic Brain Injury and Posttraumatic Stress Disorder: A Pilot Study |
title_fullStr |
Evaluation of an Immunomodulatory Probiotic Intervention for Veterans With Co-occurring Mild Traumatic Brain Injury and Posttraumatic Stress Disorder: A Pilot Study |
title_full_unstemmed |
Evaluation of an Immunomodulatory Probiotic Intervention for Veterans With Co-occurring Mild Traumatic Brain Injury and Posttraumatic Stress Disorder: A Pilot Study |
title_sort |
evaluation of an immunomodulatory probiotic intervention for veterans with co-occurring mild traumatic brain injury and posttraumatic stress disorder: a pilot study |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Neurology |
issn |
1664-2295 |
publishDate |
2020-10-01 |
description |
Background: US military Veterans returned from Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn (OEF/OIF/OND) with symptoms associated with mild traumatic brain injury [mTBI; i.e., persistent post-concussive (PPC) symptoms] and posttraumatic stress disorder (PTSD). Interventions aimed at addressing symptoms associated with both physical and psychological stressors (e.g., PPC and PTSD symptoms) are needed. This study was conducted to assess the feasibility, acceptability, and safety of a probiotic intervention, as well as to begin the process of evaluating potential biological outcomes.Methods: A pilot randomized controlled trial was implemented among US military Veterans from recent conflicts in Iraq and Afghanistan. Those enrolled had clinically significant PPC and PTSD symptoms. Participants were randomized to intervention (Lactobacillus reuteri DSM 17938) or placebo supplementation (daily for 8 weeks +/- 2 weeks) at a 1:1 ratio, stratified by irritable bowel syndrome status. Thirty-one Veterans were enrolled and randomized (15 to the placebo condition and 16 to the probiotic condition).Results: Thresholds for feasibility, acceptability, and safety were met. Probiotic supplementation resulted in a decrease in plasma C-reactive protein (CRP) concentrations relative to the placebo group that approached statistical significance (p = 0.056). Although during the Trier Social Stress Test (TSST; administered post-supplementation) no between-group differences were found on a subjective measure of stress responsivity (Visual Analog Scale), there was a significantly larger increase in mean heart beats per minute between baseline and the math task for the placebo group as compared with the probiotic group (estimated mean change, probiotic 5.3 [95% Confidence Interval: −0.55, 11.0], placebo 16.9 [11.0, 22.7], p = 0.006).Conclusions: Findings from this trial support the feasibility, acceptability, and safety of supplementation with an anti-inflammatory/immunoregulatory probiotic, L. reuteri DSM 17938, among Veterans with PPC and PTSD symptoms. Moreover, results suggest that CRP may be a viable inflammatory marker of interest. A larger randomized controlled trial aimed at measuring both biological and clinical outcomes is indicated.Clinical Trial Registration:ClinicalTrials.gov, Identifier NCT02723344. |
topic |
traumatic brain injury posttraumatic stress disorder (PTSD) probiotic Veteran gut-brain axis Lactobacillus reuteri DSM 17938 |
url |
https://www.frontiersin.org/articles/10.3389/fneur.2020.01015/full |
work_keys_str_mv |
AT lisaabrenner evaluationofanimmunomodulatoryprobioticinterventionforveteranswithcooccurringmildtraumaticbraininjuryandposttraumaticstressdisorderapilotstudy AT lisaabrenner evaluationofanimmunomodulatoryprobioticinterventionforveteranswithcooccurringmildtraumaticbraininjuryandposttraumaticstressdisorderapilotstudy AT lisaabrenner evaluationofanimmunomodulatoryprobioticinterventionforveteranswithcooccurringmildtraumaticbraininjuryandposttraumaticstressdisorderapilotstudy AT lisaabrenner evaluationofanimmunomodulatoryprobioticinterventionforveteranswithcooccurringmildtraumaticbraininjuryandposttraumaticstressdisorderapilotstudy AT jerieforster evaluationofanimmunomodulatoryprobioticinterventionforveteranswithcooccurringmildtraumaticbraininjuryandposttraumaticstressdisorderapilotstudy AT jerieforster evaluationofanimmunomodulatoryprobioticinterventionforveteranswithcooccurringmildtraumaticbraininjuryandposttraumaticstressdisorderapilotstudy AT jerieforster evaluationofanimmunomodulatoryprobioticinterventionforveteranswithcooccurringmildtraumaticbraininjuryandposttraumaticstressdisorderapilotstudy AT kellyastearnsyoder evaluationofanimmunomodulatoryprobioticinterventionforveteranswithcooccurringmildtraumaticbraininjuryandposttraumaticstressdisorderapilotstudy AT kellyastearnsyoder evaluationofanimmunomodulatoryprobioticinterventionforveteranswithcooccurringmildtraumaticbraininjuryandposttraumaticstressdisorderapilotstudy AT kellyastearnsyoder evaluationofanimmunomodulatoryprobioticinterventionforveteranswithcooccurringmildtraumaticbraininjuryandposttraumaticstressdisorderapilotstudy AT christopherestamper evaluationofanimmunomodulatoryprobioticinterventionforveteranswithcooccurringmildtraumaticbraininjuryandposttraumaticstressdisorderapilotstudy AT christopherestamper evaluationofanimmunomodulatoryprobioticinterventionforveteranswithcooccurringmildtraumaticbraininjuryandposttraumaticstressdisorderapilotstudy AT christopherestamper evaluationofanimmunomodulatoryprobioticinterventionforveteranswithcooccurringmildtraumaticbraininjuryandposttraumaticstressdisorderapilotstudy AT andrewjhoisington evaluationofanimmunomodulatoryprobioticinterventionforveteranswithcooccurringmildtraumaticbraininjuryandposttraumaticstressdisorderapilotstudy AT andrewjhoisington evaluationofanimmunomodulatoryprobioticinterventionforveteranswithcooccurringmildtraumaticbraininjuryandposttraumaticstressdisorderapilotstudy AT andrewjhoisington evaluationofanimmunomodulatoryprobioticinterventionforveteranswithcooccurringmildtraumaticbraininjuryandposttraumaticstressdisorderapilotstudy AT andrewjhoisington evaluationofanimmunomodulatoryprobioticinterventionforveteranswithcooccurringmildtraumaticbraininjuryandposttraumaticstressdisorderapilotstudy AT dianapbrostow evaluationofanimmunomodulatoryprobioticinterventionforveteranswithcooccurringmildtraumaticbraininjuryandposttraumaticstressdisorderapilotstudy AT dianapbrostow evaluationofanimmunomodulatoryprobioticinterventionforveteranswithcooccurringmildtraumaticbraininjuryandposttraumaticstressdisorderapilotstudy AT dianapbrostow evaluationofanimmunomodulatoryprobioticinterventionforveteranswithcooccurringmildtraumaticbraininjuryandposttraumaticstressdisorderapilotstudy AT meredithmealer evaluationofanimmunomodulatoryprobioticinterventionforveteranswithcooccurringmildtraumaticbraininjuryandposttraumaticstressdisorderapilotstudy AT meredithmealer evaluationofanimmunomodulatoryprobioticinterventionforveteranswithcooccurringmildtraumaticbraininjuryandposttraumaticstressdisorderapilotstudy AT halswortzel evaluationofanimmunomodulatoryprobioticinterventionforveteranswithcooccurringmildtraumaticbraininjuryandposttraumaticstressdisorderapilotstudy AT halswortzel evaluationofanimmunomodulatoryprobioticinterventionforveteranswithcooccurringmildtraumaticbraininjuryandposttraumaticstressdisorderapilotstudy AT teodortpostolache evaluationofanimmunomodulatoryprobioticinterventionforveteranswithcooccurringmildtraumaticbraininjuryandposttraumaticstressdisorderapilotstudy AT teodortpostolache evaluationofanimmunomodulatoryprobioticinterventionforveteranswithcooccurringmildtraumaticbraininjuryandposttraumaticstressdisorderapilotstudy AT teodortpostolache evaluationofanimmunomodulatoryprobioticinterventionforveteranswithcooccurringmildtraumaticbraininjuryandposttraumaticstressdisorderapilotstudy AT teodortpostolache evaluationofanimmunomodulatoryprobioticinterventionforveteranswithcooccurringmildtraumaticbraininjuryandposttraumaticstressdisorderapilotstudy AT christopheralowry evaluationofanimmunomodulatoryprobioticinterventionforveteranswithcooccurringmildtraumaticbraininjuryandposttraumaticstressdisorderapilotstudy AT christopheralowry evaluationofanimmunomodulatoryprobioticinterventionforveteranswithcooccurringmildtraumaticbraininjuryandposttraumaticstressdisorderapilotstudy AT christopheralowry evaluationofanimmunomodulatoryprobioticinterventionforveteranswithcooccurringmildtraumaticbraininjuryandposttraumaticstressdisorderapilotstudy AT christopheralowry evaluationofanimmunomodulatoryprobioticinterventionforveteranswithcooccurringmildtraumaticbraininjuryandposttraumaticstressdisorderapilotstudy AT christopheralowry evaluationofanimmunomodulatoryprobioticinterventionforveteranswithcooccurringmildtraumaticbraininjuryandposttraumaticstressdisorderapilotstudy AT christopheralowry evaluationofanimmunomodulatoryprobioticinterventionforveteranswithcooccurringmildtraumaticbraininjuryandposttraumaticstressdisorderapilotstudy |
_version_ |
1724458771882704896 |
spelling |
doaj-c6095579cf494755988d2fbdfabeac602020-11-25T03:57:46ZengFrontiers Media S.A.Frontiers in Neurology1664-22952020-10-011110.3389/fneur.2020.01015546517Evaluation of an Immunomodulatory Probiotic Intervention for Veterans With Co-occurring Mild Traumatic Brain Injury and Posttraumatic Stress Disorder: A Pilot StudyLisa A. Brenner0Lisa A. Brenner1Lisa A. Brenner2Lisa A. Brenner3Jeri E. Forster4Jeri E. Forster5Jeri E. Forster6Kelly A. Stearns-Yoder7Kelly A. Stearns-Yoder8Kelly A. Stearns-Yoder9Christopher E. Stamper10Christopher E. Stamper11Christopher E. Stamper12Andrew J. Hoisington13Andrew J. Hoisington14Andrew J. Hoisington15Andrew J. Hoisington16Diana P. Brostow17Diana P. Brostow18Diana P. Brostow19Meredith Mealer20Meredith Mealer21Hal S. Wortzel22Hal S. Wortzel23Teodor T. Postolache24Teodor T. Postolache25Teodor T. Postolache26Teodor T. Postolache27Christopher A. Lowry28Christopher A. Lowry29Christopher A. Lowry30Christopher A. Lowry31Christopher A. Lowry32Christopher A. Lowry33VA Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional Veterans Affairs (VA) Medical Center (RMRVAMC), Aurora, CO, United StatesDepartment of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, United StatesDepartment of Psychiatry and Neurology, University of Colorado Anschutz Medical Campus, Aurora, CO, United StatesMilitary and Veteran Microbiome: Consortium for Research and Education, Aurora, CO, United StatesVA Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional Veterans Affairs (VA) Medical Center (RMRVAMC), Aurora, CO, United StatesDepartment of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, United StatesMilitary and Veteran Microbiome: Consortium for Research and Education, Aurora, CO, United StatesVA Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional Veterans Affairs (VA) Medical Center (RMRVAMC), Aurora, CO, United StatesDepartment of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, United StatesMilitary and Veteran Microbiome: Consortium for Research and Education, Aurora, CO, United StatesVA Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional Veterans Affairs (VA) Medical Center (RMRVAMC), Aurora, CO, United StatesDepartment of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, United StatesMilitary and Veteran Microbiome: Consortium for Research and Education, Aurora, CO, United StatesVA Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional Veterans Affairs (VA) Medical Center (RMRVAMC), Aurora, CO, United StatesDepartment of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, United StatesMilitary and Veteran Microbiome: Consortium for Research and Education, Aurora, CO, United StatesDepartment of Systems Engineering & Management, Air Force Institute of Technology, Wright-Patterson Air Force Base, OH, United StatesVA Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional Veterans Affairs (VA) Medical Center (RMRVAMC), Aurora, CO, United StatesDepartment of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, United StatesMilitary and Veteran Microbiome: Consortium for Research and Education, Aurora, CO, United StatesVA Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional Veterans Affairs (VA) Medical Center (RMRVAMC), Aurora, CO, United StatesDepartment of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, United StatesVA Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional Veterans Affairs (VA) Medical Center (RMRVAMC), Aurora, CO, United StatesDepartment of Psychiatry and Neurology, University of Colorado Anschutz Medical Campus, Aurora, CO, United StatesVA Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional Veterans Affairs (VA) Medical Center (RMRVAMC), Aurora, CO, United StatesMilitary and Veteran Microbiome: Consortium for Research and Education, Aurora, CO, United StatesMood and Anxiety Program, University of Maryland School of Medicine, Baltimore, MD, United StatesVeterans Integrated Service Network (VISN) 5 MIRECC, Department of Veterans Affairs, Baltimore, MD, United StatesVA Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional Veterans Affairs (VA) Medical Center (RMRVAMC), Aurora, CO, United StatesDepartment of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, United StatesMilitary and Veteran Microbiome: Consortium for Research and Education, Aurora, CO, United StatesDepartment of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United StatesCenter for Neuroscience, University of Colorado Boulder, Boulder, CO, United States0Center for Neuroscience, University of Colorado Anschutz Medical Campus, Aurora, CO, United StatesBackground: US military Veterans returned from Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn (OEF/OIF/OND) with symptoms associated with mild traumatic brain injury [mTBI; i.e., persistent post-concussive (PPC) symptoms] and posttraumatic stress disorder (PTSD). Interventions aimed at addressing symptoms associated with both physical and psychological stressors (e.g., PPC and PTSD symptoms) are needed. This study was conducted to assess the feasibility, acceptability, and safety of a probiotic intervention, as well as to begin the process of evaluating potential biological outcomes.Methods: A pilot randomized controlled trial was implemented among US military Veterans from recent conflicts in Iraq and Afghanistan. Those enrolled had clinically significant PPC and PTSD symptoms. Participants were randomized to intervention (Lactobacillus reuteri DSM 17938) or placebo supplementation (daily for 8 weeks +/- 2 weeks) at a 1:1 ratio, stratified by irritable bowel syndrome status. Thirty-one Veterans were enrolled and randomized (15 to the placebo condition and 16 to the probiotic condition).Results: Thresholds for feasibility, acceptability, and safety were met. Probiotic supplementation resulted in a decrease in plasma C-reactive protein (CRP) concentrations relative to the placebo group that approached statistical significance (p = 0.056). Although during the Trier Social Stress Test (TSST; administered post-supplementation) no between-group differences were found on a subjective measure of stress responsivity (Visual Analog Scale), there was a significantly larger increase in mean heart beats per minute between baseline and the math task for the placebo group as compared with the probiotic group (estimated mean change, probiotic 5.3 [95% Confidence Interval: −0.55, 11.0], placebo 16.9 [11.0, 22.7], p = 0.006).Conclusions: Findings from this trial support the feasibility, acceptability, and safety of supplementation with an anti-inflammatory/immunoregulatory probiotic, L. reuteri DSM 17938, among Veterans with PPC and PTSD symptoms. Moreover, results suggest that CRP may be a viable inflammatory marker of interest. A larger randomized controlled trial aimed at measuring both biological and clinical outcomes is indicated.Clinical Trial Registration:ClinicalTrials.gov, Identifier NCT02723344.https://www.frontiersin.org/articles/10.3389/fneur.2020.01015/fulltraumatic brain injuryposttraumatic stress disorder (PTSD)probioticVeterangut-brain axisLactobacillus reuteri DSM 17938 |