The Effects of Probiotic Supplementation on Level of Disability, Depressive Symptoms, and Cognitive Outcomes in Relapsing-Remitting Multiple Sclerosis Patients: A Randomized Double-Blind Placebo-Controlled Trial

Background: Multiple sclerosis (MS) is a chronic autoimmune disease characterized by inflammation and demyelination of the central nervous system. Probiotics, through the gut-brain axis, are suggested to enhance clinical outcomes in patients with MS. This study scrutinizes the effects of probiotic s...

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Main Authors: Amirreza Naseri, Sarvin Sanaie, Sama Rahnemayan, Reza Mosaddeghi-Heris, Malihe Talebi, Mahnaz Talebi
Format: Article
Language:English
Published: Tabriz University of Medical Sciences 2025-07-01
Series:Pharmaceutical Sciences
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Online Access:https://ps.tbzmed.ac.ir/PDF/ps-31-322.pdf
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author Amirreza Naseri
Sarvin Sanaie
Sama Rahnemayan
Reza Mosaddeghi-Heris
Malihe Talebi
Mahnaz Talebi
author_facet Amirreza Naseri
Sarvin Sanaie
Sama Rahnemayan
Reza Mosaddeghi-Heris
Malihe Talebi
Mahnaz Talebi
author_sort Amirreza Naseri
collection DOAJ
description Background: Multiple sclerosis (MS) is a chronic autoimmune disease characterized by inflammation and demyelination of the central nervous system. Probiotics, through the gut-brain axis, are suggested to enhance clinical outcomes in patients with MS. This study scrutinizes the effects of probiotic supplementation in relapsing-remitting MS (RRMS) patients. Methods: In this parallel, randomized, double-blind, placebo-controlled trial, 90 RRMS patients, with Expanded Disability Status Scale (EDSS) < 4, received either the probiotic (Lactocare®) or a placebo twice daily for four months. Assessed outcomes included level of disability (based on EDSS), cognitive function (Symbol Digit Modalities Test [SDMT], three-second version of Paced Auditory Serial Addition Test [PASAT-3]), depressive symptoms (Beck Depression Inventory- II [BDI-II]), and manual dexterity (Nine-Hole Peg Test [9HPT]). Blinding was performed for outcome assessors and the patients. All assessments were conducted at baseline and after four months, and the findings compared between the groups of the study. Results: Out of 90 randomized patients, 60 completed the trial (29 in the probiotics group, 31 in the placebo group). Probiotics supplementation was not associated with significant improvement in EDSS, BDI-II, PASAT, SDMT, and non-dominant hand 9HPT (p-values > 0.05). Intragroup improvements in PASAT-3 (change median: 2 [IQR:9.5]) and dominant hand 9HPT (change median: -0.43 [IQR: 2.15]) were observed in the probiotic supplementation group, which was comparable to placebo. Conclusion: Supplementation with a seven-strain probiotics product for four months does not result in a significant improvement in depressive symptoms, cognitive performance, level of disability, and manual dexterity of RRMS patients with EDSS < 4.
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publisher Tabriz University of Medical Sciences
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spelling doaj-art-1246fbb34dee4af4a69044cb890b8d742025-08-20T03:50:39ZengTabriz University of Medical SciencesPharmaceutical Sciences2383-28862025-07-0131332232910.34172/PS.025.41013ps-41013The Effects of Probiotic Supplementation on Level of Disability, Depressive Symptoms, and Cognitive Outcomes in Relapsing-Remitting Multiple Sclerosis Patients: A Randomized Double-Blind Placebo-Controlled TrialAmirreza Naseri0Sarvin Sanaie1Sama Rahnemayan2Reza Mosaddeghi-Heris3Malihe Talebi4Mahnaz Talebi5Student Research Committee, Tabriz University of Medical Sciences, Tabriz, IranNeurosciences Research Center (NSRC), Imam Reza General Hospital, Tabriz University of Medical Sciences, Tabriz, IranNeurosciences Research Center (NSRC), Imam Reza General Hospital, Tabriz University of Medical Sciences, Tabriz, IranNeurosciences Research Center (NSRC), Imam Reza General Hospital, Tabriz University of Medical Sciences, Tabriz, IranNeurosciences Research Center (NSRC), Imam Reza General Hospital, Tabriz University of Medical Sciences, Tabriz, IranNeurosciences Research Center (NSRC), Imam Reza General Hospital, Tabriz University of Medical Sciences, Tabriz, IranBackground: Multiple sclerosis (MS) is a chronic autoimmune disease characterized by inflammation and demyelination of the central nervous system. Probiotics, through the gut-brain axis, are suggested to enhance clinical outcomes in patients with MS. This study scrutinizes the effects of probiotic supplementation in relapsing-remitting MS (RRMS) patients. Methods: In this parallel, randomized, double-blind, placebo-controlled trial, 90 RRMS patients, with Expanded Disability Status Scale (EDSS) < 4, received either the probiotic (Lactocare®) or a placebo twice daily for four months. Assessed outcomes included level of disability (based on EDSS), cognitive function (Symbol Digit Modalities Test [SDMT], three-second version of Paced Auditory Serial Addition Test [PASAT-3]), depressive symptoms (Beck Depression Inventory- II [BDI-II]), and manual dexterity (Nine-Hole Peg Test [9HPT]). Blinding was performed for outcome assessors and the patients. All assessments were conducted at baseline and after four months, and the findings compared between the groups of the study. Results: Out of 90 randomized patients, 60 completed the trial (29 in the probiotics group, 31 in the placebo group). Probiotics supplementation was not associated with significant improvement in EDSS, BDI-II, PASAT, SDMT, and non-dominant hand 9HPT (p-values > 0.05). Intragroup improvements in PASAT-3 (change median: 2 [IQR:9.5]) and dominant hand 9HPT (change median: -0.43 [IQR: 2.15]) were observed in the probiotic supplementation group, which was comparable to placebo. Conclusion: Supplementation with a seven-strain probiotics product for four months does not result in a significant improvement in depressive symptoms, cognitive performance, level of disability, and manual dexterity of RRMS patients with EDSS < 4.https://ps.tbzmed.ac.ir/PDF/ps-31-322.pdfmultiple sclerosisprobioticscognitive functiondepressive symptomsphysical disabilityrandomized controlled trial
spellingShingle Amirreza Naseri
Sarvin Sanaie
Sama Rahnemayan
Reza Mosaddeghi-Heris
Malihe Talebi
Mahnaz Talebi
The Effects of Probiotic Supplementation on Level of Disability, Depressive Symptoms, and Cognitive Outcomes in Relapsing-Remitting Multiple Sclerosis Patients: A Randomized Double-Blind Placebo-Controlled Trial
Pharmaceutical Sciences
multiple sclerosis
probiotics
cognitive function
depressive symptoms
physical disability
randomized controlled trial
title The Effects of Probiotic Supplementation on Level of Disability, Depressive Symptoms, and Cognitive Outcomes in Relapsing-Remitting Multiple Sclerosis Patients: A Randomized Double-Blind Placebo-Controlled Trial
title_full The Effects of Probiotic Supplementation on Level of Disability, Depressive Symptoms, and Cognitive Outcomes in Relapsing-Remitting Multiple Sclerosis Patients: A Randomized Double-Blind Placebo-Controlled Trial
title_fullStr The Effects of Probiotic Supplementation on Level of Disability, Depressive Symptoms, and Cognitive Outcomes in Relapsing-Remitting Multiple Sclerosis Patients: A Randomized Double-Blind Placebo-Controlled Trial
title_full_unstemmed The Effects of Probiotic Supplementation on Level of Disability, Depressive Symptoms, and Cognitive Outcomes in Relapsing-Remitting Multiple Sclerosis Patients: A Randomized Double-Blind Placebo-Controlled Trial
title_short The Effects of Probiotic Supplementation on Level of Disability, Depressive Symptoms, and Cognitive Outcomes in Relapsing-Remitting Multiple Sclerosis Patients: A Randomized Double-Blind Placebo-Controlled Trial
title_sort effects of probiotic supplementation on level of disability depressive symptoms and cognitive outcomes in relapsing remitting multiple sclerosis patients a randomized double blind placebo controlled trial
topic multiple sclerosis
probiotics
cognitive function
depressive symptoms
physical disability
randomized controlled trial
url https://ps.tbzmed.ac.ir/PDF/ps-31-322.pdf
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