Sustained Dysbiosis and Decreased Fecal Short Chain Fatty Acids after Traumatic Brain Injury and Impact on Neurologic Outcome.

Traumatic brain injury (TBI) alters microbial populations present in the gut, which may impact healing and tissue recovery. However, the duration and impact of these changes on outcome from TBI are unknown. Short chain fatty acids (SCFAs), produced by bacterial fermentation of dietary fiber, are important signaling molecules in the microbiota-gut-brain axis. We hypothesized that TBI would lead to a sustained reduction in SCFA producing bacteria, fecal SCFAs concentration, and administration of soluble SCFAs would improve functional outcome after TBI. Adult mice (n=10) had the controlled cortical impact (CCI) model of TBI performed (6m/s, 2-mm depth, 50msec dwell). Stool samples were collected serially until 28 days after CCI and analyzed for SCFA concentration by HPLC-MS/MS and microbiome analyzed by 16S gene sequencing. In a separate experiment, mice (n=10/group) were randomized two weeks before CCI to standard drinking water or water supplemented with the SCFAs acetate (67.5mM), propionate (25.9mM), and butyrate (40mM). Morris water maze performance was assessed on post-injury days 14-19. Alpha diversity remained stable until 72h at which point a decline in diversity was observed without recovery out to 28 days. The taxonomic composition of post-TBI fecal samples demonstrated depletion of bacteria from Lachnospiraceae, Ruminococcaceae, and Bacteroidaceea families and enrichment of bacteria from the Verrucomicrobiaceae family. Analysis from paired fecal samples revealed a reduction in total SCFAs at 24h and 28 days after TBI. Acetate, the most abundant SCFA detected in the fecal samples, was reduced at 7 days and 28 days after TBI. SCFA administration improved spatial learning after TBI vs. standard drinking water. In conclusion, TBI is associated with reduced richness and diversity of commensal microbiota in the gut and a reduction in SCFAs detected in stool. Supplementation of soluble SCFAs improves spatial learning after TBI.