This interventional trial will involve a double-blind placebo-controlled crossover trial
structured in 4 appointments: week 0 (W0), week 4 (W4), week 8 (W8) and week 12 (W12). The
study will therefore last 12 weeks, and will include a screening visit and 4 study visits.
The interventional study has a cross-over design, and participants will therefore be invited
to consume both the active probiotic supplement and the placebo at different times. The
probiotic supplement (Lactobacillus brevis) was chosen based on the ability to produce GABA
in vitro (Monteagudo et al., 2022). The placebo will be maltodextrin The products will be
provided as capsules and are identical in texture and appearance.
For participants to be considered compliant and therefore included in the study they will be
require:
to take the probiotic supplement or placebo at least 6 out of every 7 days of the trial
for the week period;
to provide faecal, blood and urine samples and to be tested with a battery involving
behaviour and brain measures relating to GABA levels/activity and
to complete a food diary using an online app once every 4 weeks.
As age and BMI are factors associated with significant variation in gut microbiota
composition/brain and behaviour functioning, both study arms will be matched on these
criteria.
All interested Individuals will be invited to complete an initial screening questionnaire,
which includes questions related to a) the study inclusion criteria. Individuals who meet the
study inclusion criteria will then be asked to complete b) an MRI contraindications
questionnaire and, in absence of any MRI-related contraindications, they will be asked to c)
complete a medical/lifestyle questionnaire to confirm the absence of any exclusion criteria.
Individuals who meet the inclusion criteria will be invited to attend a screening visit at
the University of Reading for familiarisation with the procedures and for any clarification
they might need. Participants will be provided with a sample collection kit (for faecal and
urine sample collection), will be instructed on how to use it, and will be asked to track
their diet using an online app (eNutri).
All study appointments will take place at the University of Reading. On the day of the study
appointment, participants will be asked to provide a fresh faecal sample and spot urine
sample (first morning urine), collected using the sample kit they were provided with at the
screening visit. A venous blood sample (equal to 10ml/ 2tsp) will be collected by experienced
and trained phlebotomists at the University of Reading. Participants will then undergo a
neuroimaging battery, which will include structural magnetic resonance images, magnetic
resonance spectroscopy (MRS) to quantify concentrations of GABA in determined regions of the
brain, and functional magnetic resonance imaging to evaluate functional connectivity between
brain areas. Participants will then complete a battery of GABA-dependent behavioural assays
including a facial emotion recognition task, a motor learning task, and a tactile frequency
discrimination task. Participants will then complete the Autism Spectrum Quotient (AQ), the
State and Trait Anxiety Inventory (STAI), and the Centre for Epidemiological Studies
Depression Scale (CES-D). Participants will complete this battery of tasks at each of the
four study visits at W0, W4, W8 and W12.
At the end of visit 1 (W0), participants will be provided with either the probiotic OR
placebo supplement to consume daily for the next 4 weeks, i.e. between study visits 1 and 2.
At the end of visit 2 (W4), participants will not be provided with any supplements as they
will enter their 4-week period of washout. At the end of visit 3 (W8), participants will be
provided with either the probiotic OR placebo supplement to consume daily for the next 4
weeks. If the participant received the probiotic following visit 1, they will receive the
placebo at this point, and vice versa. Participants will be asked to take this daily until
their fourth and final study visit (W12). Study visit 4 finalises the study.