If you’ve ever had a gut feeling that you are what you eat,
new research suggests that you may be much closer to the mark than you
think.
The role of the gut – dubbed our body’s most under-rated organ –
briefly hit the popular consciousness with the international
best-selling book, Gut, by micro-biologist Guilia Enders.
What is becoming clear in this rapidly evolving field of academic
research is that our largest sensory organ – about eight metres long if
laid end to end – has an intimate connection with our brain, and thus
both with our mental health, our emotions and disorders such as
schizophrenia.
Often called ‘the second brain’, the trillions of microbes that we
carry in the gut produce the vast bulk of the same neuro-transmitters
that are used for regulation of the brain. If the vagus nerve, which
connects the brain and the digestive system, is cut, the digestive
system functions fine on its own.
Enders writes that 10 years ago there was hardly any research linking
the gut with the brain, where now there are several hundred academic
articles.
World-first study
Adding to that field of research is a project about to start at the
Illawarra Health and Medical Research Institute at the University of
Wollongong, headed by Dr Katrina Green and Professor Xu-Feng Huang, as
well psychiatric Professor Nagesh Pai and psychologist Dr Jason Cusack.
The pilot project will study about 30 patients with schizophrenia to
investigate the link between bacteria in our gut and brain functioning
to identify new ways to improve cognitive function.
“I find it fascinating that we get these gut feelings,” Dr Green says.
“When a person has a psychotic episode it’s in your face, so that’s
what gets treated. The cognitive deficit that comes along with
schizophrenia is in the background.
Memory and learning loss
“Research is showing that cognitive deficit – problems with memory
and learning – occurs in a lot of people before the first signs of the
illness appear.
“I often hear that people’s sons or daughters are performing well at
school, and then they go into a decline. By the time they are 19 or 20,
they end up with psychosis.”
The project will not only look at ways of improving the brain
functioning of those with schizophrenia, but also has the potential of
providing early diagnosis for the disease.
The hypothesis of the study is that gut microbes are a key factor in the psychological changes in the brain.
The method will be to examine the gut microbes in the stool samples
of patients, both when they are exhibiting symptoms of psychosis, and
when they are not.
“Cognition is often not tested by clinicians and is not addressed by current anti-psychotic medications,” Dr Green says.
Neuro-transmitters in the gut
These gut bacteria produce the same neuro-transmitters that regulate
emotion and mental health in the brain – dopamine, serotonin, glutamate,
norephinephrine.
“If we can find out what’s dysfunctional, then we can figure out how
to fix it. The aim is to try and improve the functioning of people with
schizophrenia and restore normality to their lives.”
Clinical psychologist Dr Jason Cusack is the researcher in charge with testing the cognition of the patients in the study.
As part of the Illawarra Brain Injury Service, he is experienced at
administering tests to measure impairment of brain function, whether
that’s from trauma or psychosis.
“The very interesting thing with schizophrenia and cognition is that it’s becoming more recognised as a core effect,” he says.
“Traditionally, the disease has been seen in terms of psychosis and
hallucination, as well as the social factor of withdrawal. We have these
negative symptoms of apathy, as well as the positive symptoms of
psychosis.”
Cognition is key
More recently, research and the most recent Diagnostic and
Statistical Manual of Mental Disorders, published by the American
Psychiatric Association, incorporates cognition as one of the key
factors in schizophrenia.
Symptoms can include changes in memory and learning, perception and
speech, distraction, inability to focus, depression, anxiety and a
reduction in self-care.
For Professor Nagesh Pai, the research into the gut and its
connection with mental health started in 2009; when he began researching
why anti-psychotic drugs often caused weight-gain in patients.
Currently research is investigating a medication derived from lizard
salvia; this medication is used to counter the symptoms of diabetes.
This medication has shown promise in mice with both weight loss and
improvements in cognition; planning is under way for human trials.
Huge effect on mental health
“We also know that patients with schizophrenia have two to three
times the risk of developing diabetes, compared to the general
population,” Dr Pai says.
“We are trying to find out the part that genetic factors play in
this, as well as social or environmental factors. The aetiology of
schizophrenia is multifactorial and while the role of genetic factors
are well established further work is needed investigating the role of
environmental and social factors in controlling diabetes in this
population.
The UOW research team believe that altered gut microbes effect the neuronal functioning of the brain.
There is a lot of evidence that there is a bi-directional
communication between the brain and the gut and that both influence the
functioning of each other.
“If we are able to establish this, a new direction may be provided for the management of schizophrenia.”
Story By: William Verity