{
  "abstract": "Background Social cognitive difficulties are common in multiple sclerosis (MS) and impact interpersonal functioning and quality of life. Emerging evidence suggests disruptions in the gut-brain axis, particularly through gut microbiome dysbiosis and kynurenine pathway dysregulation, may play a role in MS pathophysiology. Given that probiotics may influence these pathways, this study investigates their effects on social cognition in MS and explores associations with the gut microbiome and nicotinamide adenine dinucleotide (NAD+) metabolism.Methods In this 12-week, double-blind, randomised controlled trial, 29 participants with relapsing-remitting or secondary-progressive MS were randomly assigned to receive either a probiotic or placebo. Social cognition was assessed using neuropsychological tests, with secondary outcomes including NAD+, NADH, and gut microbiome diversity.Results The probiotic group demonstrated significantly higher Emotion Recognition Task (ERT) scores for sad expressions compared to the placebo group, with an adjusted mean difference of 1.46 (95% CI: 0.04–2.88) and a large effect size (partial η² = 0.16). No significant differences were observed in other social cognition domains. Across all participants, higher NAD+ levels were positively correlated with social cognition, whereas greater microbiome diversity was negatively correlated with social cognition.Conclusions Probiotic administration had limited impact on most domains of social cognition, with a selective benefit observed in the recognition of sad expressions. The positive association between social cognition and NAD+ aligns with evidence supporting its role in neuronal function. Conversely, the unexpected inverse relationship between social cognition and microbiome diversity challenges conventional views on gut-brain interactions, warranting further exploration in larger, longer-term studies.",
  "authors": [
    {
      "affiliations": [
        "School of Medicine, College of Health and Medicine, University of Tasmania, Launceston, TAS, Australia"
      ],
      "name": "Peta Antypas"
    },
    {
      "affiliations": [
        "School of Medicine, College of Health and Medicine, University of Tasmania, Launceston, TAS, Australia",
        "Department of Neurology, Launceston General Hospital, Launceston, TAS, Australia"
      ],
      "name": "Lauren Giles"
    },
    {
      "affiliations": [
        "School of Medicine, College of Health and Medicine, University of Tasmania, Launceston, TAS, Australia"
      ],
      "name": "Kathryn Ogden"
    },
    {
      "affiliations": [
        "School of Psychological Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS, Australia"
      ],
      "name": "Terry Purton"
    },
    {
      "affiliations": [
        "Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia"
      ],
      "name": "Chai K Lim"
    },
    {
      "affiliations": [
        "School of Psychological Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS, Australia"
      ],
      "name": "Cynthia Honan"
    }
  ],
  "title": "3415 The impact of probiotics on social cognition, the gut microbiome, and NAD+ metabolism in multiple sclerosis: a pilot study",
  "uid": "91b14548-be31-53c7-907d-f2b4bdca8880"
}