Abstract

Novel strategies aim at augmenting the armamentarium of the existing treatment for stroke remains one of the thorniest issues within the realm of stroke research. A new promising therapeutic opportunity as complementary medicine for stroke that needs to be harnessed is embedded within the microbiota-gut-brain axis. Hence, the current study analyzed evidence about microbiome-based interventions that successfully target gut microbiota and affect stroke outcome. Five electronic databases namely PubMed, Web of Science, Cochrane Library, Ebsco, and Scopus were searched for eligible studies from 1st January 1990 to 31st December 2022. A total of 24108 studies were identified out of which 42 met the eligibility criteria. Among the 42 studies included, 39 (92.85 %) were experimental animal studies and 3 (7.14 %) were human clinical studies. The analysis showed significant benefit with traditional Chinese medicine treatment (ES -1.96, 95% CI -2.86 - -1.07). bacteriotherapy based interventions treatment (ES -1.38, 95% CI -2.06 - -0.70), synthetic chemicals/drugs treatment (ES -2.03, 95% CI -2.99 - -1.06), but not with natural product treatment (ES -0.52, 95% CI -0.94 - -0.11) against stroke deficit compared with control. The analysis of interventions from overall animal (ES -1.35, 95% CI -1.78 - -0.93) studies showed significant benefit against stroke deficit than the control, but overall human clinical (ES 0.39, 95% CI -0.53 - 1.32) studies showed no significant benefit against stroke deficit than the control. The diversity of the identified microbiome-based interventions points to their prospective inclusion into stroke management to complement the existing treatment. PROSPERO registration number: CRD42021281950 (animal study section) and CRD42021284426 (human study section).

Keywords: Stroke; Complementary medicine; Microbiome-based interventions; Gut-brain axis