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dc.contributor.authorBrenner, Lisa A.
dc.contributor.authorForster, Jeri E.
dc.contributor.authorStearns-Yoder, Kelly A.
dc.contributor.authorStamper, Christopher E.
dc.contributor.authorHoisington, Andrew J.
dc.contributor.authorBrostow, Diana P.
dc.contributor.authorMealer, Meredith
dc.contributor.authorWortzel, Hal S.
dc.contributor.authorPostolache, Teodor T.
dc.contributor.authorLowry, Christopher A.
dc.date.accessioned2020-11-09T19:16:08Z
dc.date.available2020-11-09T19:16:08Z
dc.date.issued2020-10-20
dc.identifier.urihttp://hdl.handle.net/10713/14055
dc.description.abstractBackground: 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.en_US
dc.description.sponsorshipU.S. Department of Veterans Affairsen_US
dc.description.urihttps://doi.org/10.3389/fneur.2020.01015en_US
dc.language.isoen_USen_US
dc.publisherFrontiers Media S.A.en_US
dc.relation.ispartofFrontiers in Neurologyen_US
dc.subjectgut-brain axisen_US
dc.subjectLactobacillus reuteri DSM 17938en_US
dc.subjectmicrobiomeen_US
dc.subjectposttraumatic stress disorder (PTSD)en_US
dc.subjectprobioticen_US
dc.subjecttraumatic brain injuryen_US
dc.subjectVeteranen_US
dc.titleEvaluation of an Immunomodulatory Probiotic Intervention for Veterans With Co-occurring Mild Traumatic Brain Injury and Posttraumatic Stress Disorder: A Pilot Studyen_US
dc.typeArticleen_US
dc.identifier.doi10.3389/fneur.2020.01015
dc.source.volume11


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