Altered gut microbiota composition in adults with chronic subdural hematoma: a case-control study
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background and purpose Chronic subdural hematoma (CSDH) is increasingly recognized as a dynamic inflammatory and angiogenic disorder, but whether it is associated with alterations in the gut microbiota remains unclear. We therefore characterized the gut microbial profiles of adults with CSDH and healthy controls (HCs). Methods We conducted an observational case-control study of 40 adults with CSDH and 96 HCs. Fecal bacterial communities were profiled by 16S rRNA gene sequencing. We assessed alpha and beta diversity, identified differentially abundant genera using covariate-adjusted centered log-ratio models with false-discovery-rate correction, evaluated genus-level discrimination using a random forest classifier with repeated nested cross-validation, and examined associations with clinical characteristics using partial Spearman correlations. Results There was no clear evidence of an alpha-diversity difference after covariate adjustment. Community structure differed across Bray-Curtis, weighted UniFrac, and unweighted UniFrac distances (all P = 0.001), with the largest explained variance for weighted UniFrac (R² = 0.106). Thirteen genera remained significant after adjustment and multiple-testing correction, including sensitivity analyses that additionally accounted for diabetes and recorded medication exposure. Collinsella and Dorea were more abundant in CSDH, whereas Bacteroides was more abundant in HCs. Across 10 repeated outer cross-validation partitions, the mean out-of-fold area under the receiver-operating-characteristic curve was 0.938 ± 0.010; averaging participant-level out-of-fold probabilities yielded an area under the curve of 0.951. Dorea was positively associated with diabetes, and Bacteroides was inversely associated with cerebral infarction after false-discovery-rate correction. Conclusions Adults with CSDH showed differences in gut microbial community structure and genus-level composition, without clear evidence of an alpha-diversity difference. These are exploratory associations in a selected case-control sample. The cross-sectional, single-center design precludes causal inference, and the classifier has not established calibration, external validity or clinical utility.
Language: English
Topic: Gut microbiota and health
Subfield: Molecular Biology
Domain: Life Sciences
Open Access status: gold
Estimated APC paid: $3,801
OpenAlex ID: W7223315956