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Research letter
We read with interest the commentary by Bercik1 emphasising the influence that gut intestinal microflora may have on cognitive function—a model with clear therapeutic implications. We would like to propose, however, that a third party—the presence of autonomic nervous system dysfunction—complicates the relationship between cognitive impairment and gut microflora.
In a number of diseases, autonomic dysfunction has been associated with cognitive impairment,2 3 and its presence is associated with impaired gastrointestinal motility, a risk factor for changes in bacterial colonisation. Autonomic dysfunction is a common problem in patients with chronic liver disease (CLD)4—the group of patients highlighted in the commentary as having obvious cognitive problems, as benefiting from treatment aimed at modifying the …
Footnotes
The study was reviewed and approved by the Newcastle and North Tyneside local research ethics committee.
James Frith and Gulnar Fattakhova are joint first authors.
Funding Funding for this study was provided by the Newcastle NIHR Biomedical Research Centre in Ageing.
Competing interests None.
Ethics approval Ethics approval was obtained from the Newcastle and North Tyneside local research ethics committee.
Provenance and peer review Not commissioned; internally peer reviewed.