The Effect of Psychobiotics on Gut Microbiota and Neurological Functions

Year 2025, Volume: 7 Issue: 2, 621 - 635, 07.08.2025

Esma Avci , Zeynep Begüm Kalyoncu Atasoy

https://doi.org/10.46413/boneyusbad.1514178

Abstract

In the past decade, studies have highlihted the potential effects of probiotics on neurological function processes such as neuroinflammation and neurogenesis. As a result, there is increasing interest in psychobiotics, a class of probiotics thought to influence the treatment of neurological disorders and psychiatric diseases. Psychobiotics are defined as microorganisms that interact with the gut microbiota and have a positive effect on mental health and neurological functions with adequate consumption of probiotics. Additionally, psychobiotics influence physical and mental states though the microbiota-gut-brain axis, offering different approaches for the treatment of psychiatric diseases. Research indicates that psychobiotics may regulate the hypothalamic-pituitary-adrenal axis and neurotransmitters, impacting central nervous system functionality in conditions such as anxiety, depression, stress, and cognitive disorders. This review evaluates the mechanisms of action of psychobiotics, their relationship with gut microbiota and neurological functions, and current information on their therapeutic effects in neurological diseases such as Alzheimer’s disease, anxiety, depression, and autism spectrum disorders.

Keywords

Psychobiotic , Probiotic , Microbiota , Gut - brain axis

Psikobiyotiklerin Bağırsak Mikrobiyotası ve Nörolojik Fonksiyonlara Etkisi

Abstract

Son on yılda yapılan çalışmalar probiyotiklerin nöroinflamasyon, nörojenez gibi nörolojik fonksiyon süreçlerinde etkisinin olabileceğini vurgulamaktadır. Bu nedenle nörolojik bozukluklar-psikiyatrik hastalıkların tedavisine etkisinin olacağı düşünülen ve probiyotik sınıfından olan psikobiyotiklere olan ilgi giderek artmaktadır. Psikobiyotikler; probiyotiklerin yeterli düzeyde tüketilmesiyle birlikte bağırsak mikrobiyotası ile etkileşime girerek ruh sağlığı ve nörolojik fonksiyonlar üzerinde pozitif etki yaratan mikroorganizmalar olarak tanımlanmaktadır. Aynı zamanda psikobiyotikler, mikrobiyota-bağırsak-beyin aksı aracılığı ile fiziksel ve zihinsel durumu etkilemekte psikiyatrik hastalıkların tedavisinde farklı yaklaşımlara olanak sağlamaktadır. Psikobiyotiklerin hipofiz-adrenal aksı ve nörotransmitterleri düzenleyerek anksiyete, depresyon, stres ve bilişsel bozukluklarda merkezi sinir sisteminin işlevselliği üzerine etkisinin olduğuna yönelik çalışmalar mevcuttur. Bu derlemede psikobiyotiklerin etki mekanizmaları, bağırsak mikrobiyotası ve nörolojik fonksiyonlarla ilişkisi, nörolojik hastalıklarda (Alzheimer hastalığı, anksiyete, depresyon ve otizm spektrum bozuklukları gibi) kullanımının tedaviye etkisine ilişkin güncel bilgiler değerlendirilmiştir.

Keywords

Psikobiyotik , Probiyotik , Mikrobiyota , Bağırsak-beyin aksı

References

• Abhari, K., Hosseini, H. (2018). Psychobiotics: next generation treatment for mental disorders. Journal of Clinical Nutrition and Dietetics, 4(1), 1. doi: 10.4172/2472-1921.100063
• Adıgüzel, E., Çiçek, B., Ünal, G., Aydın, M. F., Barlak-Keti, D. (2022). Probiotics and prebiotics alleviate behavioral deficits, inflammatory response, and gut dysbiosis in prenatal VPA-induced rodent model of autism. Physiology & behavior, 256, 113961.
• Akbari, E., Asemi, Z., Daneshvar Kakhaki, R., Bahmani, F., Kouchaki, E., Tamtaji, O. R., ... Salami, M. (2016). Effect of probiotic supplementation on cognitive function and metabolic status in Alzheimer's disease: a randomized, double-blind and controlled trial. Frontiers in Aging Neuroscience, 8, 256. doi: 10.3389/fnagi.2016.00256
• Alonazi, M., Ben Bacha, A., Al Suhaibani, A., Almnaizel, A. T., Aloudah, H. S., El-Ansary, A. (2022). Psychobiotics improve propionic acid-induced neuroinflammation in juvenile rats, rodent model of autism. Translational Neuroscience, 13(1), 292-300.
• Sağlık Bakanlığı, T. S. (2019). Türkiye Beslenme ve Sağlık Araştırması (TBSA) 2019. Türkiye Cumhuriyeti Sağlık Bakanlığı.
• Berding, K., Bastiaanssen, T. F., Moloney, G. M., Boscaini, S., Strain, C. R., Anesi, A., ... Cryan, J. F. (2023). Feed your microbes to deal with stress: A psychobiotic diet impacts microbial stability and perceived stress in a healthy adult population. Molecular Psychiatry, 28(2), 601-610. doi: 10.1038/s41380-022-01817-y
• Berding, K., Bastiaanssen, T. F., Moloney, G. M., Clarke, G., Dinan, T. G., Cryan, J. F. (2024). Adherence to a psychobiotic diet stabilizes the microbiome and reduces perceived stress: plenty of food for thought. Molecular Psychiatry, 1-2. doi: 10.1038/s41380-024-02674-7
• Bermudez-Brito, M., Plaza-Díaz, J., Muñoz-Quezada, S., Gómez-Llorente, C., Gil, A. (2012). Probiotic mechanisms of action. Annals of Nutrition and Metabolism, 61(2), 160-174. doi: 10.1159/000342079
• Bleibel, L., Dziomba, S., Waleron, K. F., Kowalczyk, E., Karbownik, M. S. (2023). Deciphering psychobiotics’ mechanism of action: bacterial extracellular vesicles in the spotlight. Frontiers in Microbiology, 14, 1211447. doi: 10.3389/fmicb.2023.1211447
• Borgo, F., Riva, A., Benetti, A., Casiraghi, M. C., Bertelli, S., Garbossa, S., ... Borghi, E. (2017). Microbiota in anorexia nervosa: the triangle between bacterial species, metabolites and psychological tests. PloS One, 12(6), e0179739. doi: 10.1371/journal.pone.0179739
• Burnet, P. W., Cowen, P. J. (2013). Psychobiotics highlight the pathways to happiness. Biological Psychiatry, 74(10), 708-709. doi: 10.1016/j.biopsych.2013.08.002
• Casertano, M., Fogliano, V., Ercolini, D. (2022). Psychobiotics, gut microbiota and fermented foods can help preserving mental health. Food Research International, 152, 110892. doi: 10.1016/j.foodres.2021.110892
• Cheng, L. H., Liu, Y. W., Wu, C. C., Wang, S., Tsai, Y. C. (2019). Psychobiotics in mental health, neurodegenerative and neurodevelopmental disorders. Journal of Food and Drug Analysis, 27(3), 632-648.
• Cheng, Y., Liu, J., Ling, Z. (2022). Short-chain fatty acids-producing probiotics: A novel source of psychobiotics. Critical Reviews in Food Science and Nutrition, 62(28), 7929-7959. doi: 10.1080/10408398.2021.1920884
• Choudhary, S., Shanu, K., Devi, S. (2023). Psychobiotics as an Emerging Category of Probiotic Products. In Probiotics, Prebiotics, Synbiotics, and Postbiotics: Human Microbiome and Human Health (pp. 361-391). Singapore: Springer Nature Singapore. doi: 10.1007/978-981-99-1463-0_19
• Cremon, C., Barbaro, M. R., Ventura, M., Barbara, G. (2018). Pre-and probiotic overview. Current Opinion in Pharmacology, 43, 87-92. doi: 10.1016/j.coph.2018.08.010
• Cryan, J. F., O'Riordan, K. J., Cowan, C. S., Sandhu, K. V., Bastiaanssen, T. F., Boehme, M., ... Dinan, T. G. (2019). The microbiota-gut-brain axis. Physiological Reviews, 99, 1877–2013. doi: 10.1152/physrev.00018.2018
• Dai, L., Gu, Y., Xu, J., Guo, J., Jiang, K., Zhou, X., Xu, Y. (2022). Toward green production of xylooligosaccharides and glucose from sorghum straw biowaste by sequential acidic and enzymatic hydrolysis. Industrial Crops and Products, 179, 114662. doi: 10.1016/j.indcrop.2022.114662
• Dao, V. H., Hoang, L. B., Trinh, T. O., Tran, T. T. T., Dao, V. L. (2021). Psychobiotics for patients with chronic gastrointestinal disorders having anxiety or depression symptoms. Journal of Multidisciplinary Healthcare, 1395-1402. doi: 10.2147/JMDH.S312316
• Das, T. K., Pradhan, S., Chakrabarti, S., Mondal, K. C., Ghosh, K. (2022). Current status of probiotic and related health benefits. Applied Food Research, 2(2), 100185. doi: 10.1016/j.afres.2022.100185
• De Oliveira, F. L., Salgaço, M. K., de Oliveira, M. T., Mesa, V., Sartoratto, A., Peregrino, A. M., ... Sivieri, K. (2023). Exploring the potential of lactobacillus helveticus R0052 and Bifidobacterium longum R0175 as promising Psychobiotics using SHIME. Nutrients, 15(6), 1521. doi: 10.3390/nu15061521
• Del Toro-Barbosa, M., Hurtado-Romero, A., Garcia-Amezquita, L. E., García-Cayuela, T. (2020). Psychobiotics: mechanisms of action, evaluation methods and effectiveness in applications with food products. Nutrients, 12(12), 3896. doi: 10.3390/nu12123896
• Dhyani, P., Goyal, C., Dhull, S. B., Chauhan, A. K., Singh Saharan, B., Harshita, ... Goksen, G. (2023). Psychobiotics for Mitigation of Neuro‐Degenerative Diseases: Recent Advancements. Molecular Nutrition Food Research, 68(13), 2300461. doi: 10.1002/mnfr.202300461
• Dinan, T. G., Stanton, C., Cryan, J. F. (2013). Psychobiotics: a novel class of psychotropic. Biological Psychiatry, 74(10), 720-726. doi: 10.1016/j.biopsych.2013.05.001
• Ducrotté, P., Sawant, P., Jayanthi, V. (2012). Clinical trial: Lactobacillus plantarum 299v (DSM 9843) improves symptoms of irritable bowel syndrome. World Journal of Gastroenterology: WJG, 18(30), 4012. doi: 10.3748/wjg.v18.i30.4012
• EFSA, N. D. A. (2014). Panel (EFSA Panel on Dietetic Products, Nutrition and Allergies), 2014. Scientific Opinion on the evaluation of allergenic foods and food ingredients for labelling purposes. EFSA Journal, 12(11), 3894. FAO/WHO (2002). Guidelines for the Evaluation Of Probiotics in Food. Paris: FAO, 1–11. doi: 10.2903/j.efsa.2014.3894
• Fang, H., Yao, T., Li, W., Pan, N., Xu, H., Zhao, Q., ... Wang, J. (2023). Efficacy and safety of fecal microbiota transplantation for chronic insomnia in adults: a real world study. Frontiers in Microbiology, 14, 1299816. doi: 10.3389/fmicb.2023.1299816
• Gasbarrini, G., Bonvicini, F., Gramenzi, A. (2016). Probiotics history. Journal of Clinical Gastroenterology, 50, S116-S119. doi: 10.1097/MCG.0000000000000697
• Gazete, R. (2017). Türk Gıda Kodeksi Beslenme ve Sağlık Beyanları Yönetmeliği. Resmi Gazete, (29960).
• Grimaldi, R., Gibson, G. R., Vulevic, J., Giallourou, N., Castro-Mejía, J. L., Hansen, L. H., ... and Costabile, A. (2018). A prebiotic intervention study in children with autism spectrum disorders (ASDs). Microbiome, 6, 1-13. doi: 10.1186/s40168-018-0523-3
• Guidetti, C., Salvini, E., Viri, M., Deidda, F., Amoruso, A., Visciglia, A., ... Caucino, A. C. (2022). Randomized double-blind crossover study for evaluating a probiotic mixture on gastrointestinal and behavioral symptoms of autistic children. Journal of Clinical Medicine, 11(18), 5263. doi: 10.3390/jcm11185263
• Gwioździk, W., Helisz, P., Grajek, M., Krupa-Kotara, K. (2023). Psychobiotics as an intervention in the treatment of irritable bowel syndrome: a systematic review. Applied Microbiology, 3(2), 465-475. doi: 10.3390/applmicrobiol3020032
• Heidarzadeh-Rad, N., Gökmen-Özel, H., Kazemi, A., Almasi, N., Djafarian, K. (2020). Effects of a psychobiotic supplement on serum brain-derived neurotrophic factor levels in depressive patients: a post hoc analysis of a randomized clinical trial. Journal of Neurogastroenterology and Motility, 26(4), 486. doi: 10.5056/jnm20079
• Hsiao, E. Y., McBride, S. W., Hsien, S., Sharon, G., Hyde, E. R., McCue, T., ... Mazmanian, S. K. (2013). Microbiota modulate behavioral and physiological abnormalities associated with neurodevelopmental disorders. Cell, 155(7), 1451-1463. doi: 10.1016/j.cell.2013.11.024
• Hwang, Y. H., Park, S., Paik, J. W., Chae, S. W., Kim, D. H., Jeong, D. G., ... Chung, Y. C. (2019). Efficacy and safety of Lactobacillus plantarum C29-fermented soybean (DW2009) in individuals with mild cognitive impairment: A 12-week, multi-center, randomized, double-blind, placebo-controlled clinical trial. Nutrients, 11(2), 305. doi: 10.3390/nu11020305
• İkiz, K., Kaymaz, K., Adaköy, A. (2023). Bağırsaktan Beyine: Mod Değiştiren Nootropikler. Sempozyum Onursal Başkanları, 77.
• Jarosz, Ł. S., Socała, K., Michalak, K., Wiater, A., Ciszewski, A., Majewska, M., ... Wlaź, P. (2024). The effect of psychoactive bacteria, Bifidobacterium longum Rosell®-175 and Lactobacillus rhamnosus JB-1, on brain proteome profiles in mice. Psychopharmacology, 241(5), 925-945. doi: 10.1007/s00213-023-06519-z
• Kahraman, M., Karahan, A. G. (2018). Probiyotiklerin tümör baskılayıcı etkileri. Türk Hijyen ve Deneysel Biyoloji Dergisi, 75(4), 421-442. doi: 10.5505/TurkHijyen.2018.15428
• Khalili, L., Alipour, B., Asghari Jafarabadi, M., Hassanalilou, T., Mesgari Abbasi, M., Faraji, I. (2019). Probiotic assisted weight management as a main factor for glycemic control in patients with type 2 diabetes: a randomized controlled trial. Diabetology & metabolic syndrome, 11, 1-9. doi: 10.1186/s13098-019-0400-7
• Kocsis, T., Molnár, B., Németh, D., Hegyi, P., Szakács, Z., Bálint, A., ... Solymar, M. (2020). Probiotics have beneficial metabolic effects in patients with type 2 diabetes mellitus: a meta-analysis of randomized clinical trials. Scientific Reports, 10(1), 11787. doi: 10.1038/s41598-020-68440-1
• Kong, X. J., Liu, J., Liu, K., Koh, M., Sherman, H., Liu, S., ... Song, Y. (2021). Probiotic and oxytocin combination therapy in patients with autism spectrum disorder: a randomized, double-blinded, placebo-controlled pilot trial. Nutrients, 13(5), 1552. doi: 10.3390/nu13051552
• Kuyumcu, A., Yıldız, M. (2020). Sağlık bilimleri fakültesi öğrencilerinin psikobiyotik özellik gösteren besinlerin tüketim durumları ile mutluluk düzeyleri arasındaki ilişki. Namık Kemal Tıp Dergisi, 8(2), 212-218. doi: 10.37696/nkmj.688156
• Lambert, K., Rinninella, E., Biruete, A., Sumida, K., Stanford, J., Raoul, P., ... Mafra, D. (2023). Targeting the gut microbiota in kidney disease: The future in renal nutrition and metabolism. Journal of Renal Nutrition, doi: 10.1053/j.jrn.2022.12.004
• Liu, T. (2024). Prebiotics vs. Probiotics: Understanding the Key Differences, Nutritional Supplements Directory. Magalhães-Guedes, K. T. (2022). Psychobiotic therapy: method to reinforce the immune system. Clinical Psychopharmacology and Neuroscience, 20(1), 17. doi: 10.9758/cpn.2022.20.1.17
• Majeed, M., Nagabhushanam, K., Arumugam, S., Majeed, S., Ali, F. (2018). Bacillus coagulans MTCC 5856 for the management of major depression with irritable bowel syndrome: a randomised, double-blind, placebo controlled, multi-centre, pilot clinical study. Food Nutrition Research, 62. doi: 10.29219/fnr.v62.1218
• Mazziotta, C., Tognon, M., Martini, F., Torreggiani, E., Rotondo, J. C. (2023). Probiotics mechanism of action on immune cells and beneficial effects on human health. Cells, 12(1), 184. doi: 10.3390/cells12010184
• Mensi, M. M., Rogantini, C., Marchesi, M., Borgatti, R., Chiappedi, M. (2021). Lactobacillus plantarum PS128 and other probiotics in children and adolescents with autism spectrum disorder: a real-world experience. Nutrients, 13(6), 2036. doi: 10.3390/nu13062036
• Messaoudi, M., Lalonde, R., Violle, N., Javelot, H., Desor, D., Nejdi, A., ... Cazaubiel, J. M. (2011). Assessment of psychotropic-like properties of a probiotic formulation (Lactobacillus helveticus R0052 and Bifidobacterium longum R0175) in rats and human subjects. British Journal of Nutrition, 105(5), 755-764. doi: 10.1017/S0007114510004319
• Misra, S., Mohanty, D. (2019). Psychobiotics: a new approach for treating mental illness?. Critical Reviews in Food Science and Nutrition, 59(8), 1230-1236. doi: 10.1080/10408398.2017.1399860
• Morales-Torres, R., Carrasco-Gubernatis, C., Grasso-Cladera, A., Cosmelli, D., Parada, F. J., Palacios-García, I. (2023). Psychobiotic effects on anxiety are modulated by lifestyle behaviors: A randomized placebo-controlled trial on healthy adults. Nutrients, 15(7), 1706. doi: 10.3390/nu15071706
• Morita, C., Tsuji, H., Hata, T., Gondo, M., Takakura, S., Kawai, K., ... Sudo, N. (2015). Gut dysbiosis in patients with anorexia nervosa. PloS one, 10(12), e0145274. doi: 10.1371/journal.pone.0145274
• Nguyen, M., Ferge, K. K., Vaughn, A. R., Burney, W., Teng, L. H., Pan, A., ... Sivamani, R. K. (2020). Probiotic supplementation and food intake and knowledge among patients and consumers. Probiotics and Antimicrobial Proteins, 12, 824-833. doi: 10.1007/s12602-019-09602-0
• Nimgampalle, M., Kuna, Y. (2017). Anti-Alzheimer properties of probiotic, Lactobacillus plantarum MTCC 1325 in Alzheimer’s disease induced albino rats. Journal of clinical and diagnostic research: Journal of Clinical and Diagnostic Research, 11(8), KC01. doi: 10.7860/JCDR/2017/26106.10428
• Nishihira, J., Kagami-Katsuyama, H., Tanaka, A., Nishimura, M., Kobayashi, T., Kawasaki, Y. (2014). Elevation of natural killer cell activity and alleviation of mental stress by the consumption of yogurt containing Lactobacillus gasseri SBT2055 and Bifidobacterium longum SBT2928 in a double-blind, placebo-controlled clinical trial. Journal of Functional Foods, 11, 261-268. doi: 10.1016/j.jff.2014.09.002
• Oleskin, A. V., Shenderov, S. A. (2020). Probiotics, psychobiotics, and metabiotics: problems and prospects. Physical and Rehabilitation Medicine, Medical Rehabilitation, 2(3), 233-243. doi: 10.36425/rehab25811
• Oroojzadeh, P., Bostanabad, S. Y., Lotfi, H. (2022). Psychobiotics: the influence of gut microbiota on the gut-brain axis in neurological disorders. Journal of Molecular Neuroscience, 72(9), 1952-1964. doi: 10.1007/s12031-022-02053-3
• Reid, G. (2016). Probiotics: definition, scope and mechanisms of action. Best Practice Research Clinical Gastroenterology, 30(1), 17-25. doi: 10.1016/j.bpg.2015.12.001
• Ritchie, G., Strodl, E., Parham, S., Bambling, M., Cramb, S., & Vitetta, L. (2023). An exploratory study of the gut microbiota in major depression with anxious distress. Journal of Affective Disorders, 320, 595-604.
• Sanders, M. E., Merenstein, D., Merrifield, C. A., Hutkins, R. (2018). Probiotics for human use. Nutrition Bulletin, 43(3), 212-225. doi: 10.1111/nbu.12334
• Selhub, E. M., Logan, A. C., Bested, A. C. (2014). Fermented foods, microbiota, and mental health: ancient practice meets nutritional psychiatry. Journal of Physiological Anthropology, 33, 1-12. doi: 10.1186/1880-6805-33-2
• Sharma, R., Gupta, D., Mehrotra, R., Mago, P. (2021). Psychobiotics: The next-generation probiotics for the brain. Current Microbiology, 78, 449-463. doi: 10.1007/s00284-020-02289-5
• Skowron, K., Budzyńska, A., Wiktorczyk-Kapischke, N., Chomacka, K., Grudlewska-Buda, K., Wilk, M., ... Gospodarek-Komkowska, E. (2022). The Role of Psychobiotics in Supporting the Treatment of Disturbances in the Functioning of the Nervous System—A Systematic Review. International Journal of Molecular Sciences, 23(14), 7820. doi: 10.3390/ijms23147820
• Snigdha Misra, S. M., Debapriya Mohanty, D. M. (2019). Psychobiotics: a new approach for treating mental illness?, Critical Reviews in Food Science and Nutrition, 59, 1230-1236. doi: 10.1080/10408398.2017.1399860
• Şahin, A. N. (2017, Aralık). Yetişkin bireylerde psikobiyotik özellik gösteren probiyotik besinlerin tüketimi ve mental sağlık arasındaki ilişkinin incelenmesi, (Yayınlanmış Yüksek Lisans Tezi), Başkent Üniversitesi Sağlık Bilimleri Enstitüsü, Ankara.
• Taşdemir, A. (2017). Probiyotikler, prebiyotikler, sinbiyotikler. Sağlık Akademisi Kastamonu, 2(1), 71-88. doi: 10.25279/sak.300045
• Venkataraman, R., Madempudi, R. S., Neelamraju, J., Ahire, J. J., Vinay, H. R., Lal, A., ... Stephen, S. (2021). Effect of multi-strain probiotic formulation on students facing examination stress: a double-blind, placebo-controlled study. Probiotics and Antimicrobial Proteins, 13(1), 12-18. doi: 10.1007/s12602-020-09681-4
• Vinot, N., 2023. Probiotics regulation in Europe: when lack of harmonization undermines both consumers and the industry. Microbiome post. https://microbiomepost.com/probiotics-regulation-in-europe-when-lack-of-harmonization-undermines-both-consumers-and-the-industry/
• Wang, H. C., Lau, C. I., Lin, C. C., Chang, A., & Kao, C. H. (2016). Group A streptococcal infections are associated with increased risk of pediatric neuropsychiatric disorders: a Taiwanese population-based cohort study. The Journal of clinical psychiatry, 77(7), 20070.
• Wang, L. J., Yang, C. Y., Kuo, H. C., Chou, W. J., Tsai, C. S., Lee, S. Y. (2022). Effect of Bifidobacterium bifidum on clinical characteristics and gut microbiota in Attention-Deficit/Hyperactivity Disorder. Journal of Personalized Medicine, 12(2), 227. doi: 10.3390/jpm12020227
• World Health Organization. (2022). Mental disorder: https://www. who. int/news-room/fact-sheets/detail/mental-disorders. 2022. Accessed Nov, 25.
• Yang, R., Zhao, X., Wu, W., Shi, J. (2021). Potential of probiotics for use as functional foods in patients with non-infectious gastric ulcer. Trends in Food Science Technology, 111, 463-474. doi: 10.1016/j.tifs.2021.02.070
• Yang, Y., Tian, J., Yang, B. (2018). Targeting gut microbiome: A novel and potential therapy for autism. Life Sciences, 194, 111-119. doi: 10.1016/j.lfs.2017.12.027
• You, S., Ma, Y., Yan, B., Pei, W., Wu, Q., Ding, C., Huang, C. (2022). The promotion mechanism of prebiotics for probiotics: A review. Frontiers in Nutrition, 9, 1000517 doi: 10.3389/fnut.2022.1000517
• Zhu, R., Fang, Y., Li, H., Liu, Y., Wei, J., Zhang, S., ... Chen, T. (2023). Psychobiotic Lactobacillus plantarum JYLP-326 relieves anxiety, depression, and insomnia symptoms in test anxious college via modulating the gut microbiota and its metabolism. Frontiers in Immunology, 14, 1158137. doi: 10.3389/fimmu.2023.1158137
• Zhu, X., Han, Y., Du, J., Liu, R., Jin, K., Yi, W. (2017). Microbiota-gut-brain axis and the central nervous system. Oncotarget, 8(32), 53829. doi: 10.18632/oncotarget.17754