Endocannabinoid system mediates the association between gut-microbial diversity and anhedonia/amotivation in a general population cohort

<p>Anhedonia and amotivation are debilitating symptoms and represent unmet therapeutic needs in a range of clinical conditions. The gut-microbiome-endocannabinoid axis might represent a potential modifiable target for interventions. Based on results obtained from animal models, we tested the h...

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Main Authors: Minichino, A, Jackson, MA, Francesconi, M, Steves, CJ, Menni, C, Burnet, PWJ, Lennox, BR
Format: Journal article
Language:English
Published: Springer Nature 2021
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author Minichino, A
Jackson, MA
Francesconi, M
Steves, CJ
Menni, C
Burnet, PWJ
Lennox, BR
author_facet Minichino, A
Jackson, MA
Francesconi, M
Steves, CJ
Menni, C
Burnet, PWJ
Lennox, BR
author_sort Minichino, A
collection OXFORD
description <p>Anhedonia and amotivation are debilitating symptoms and represent unmet therapeutic needs in a range of clinical conditions. The gut-microbiome-endocannabinoid axis might represent a potential modifiable target for interventions. Based on results obtained from animal models, we tested the hypothesis that the endocannabinoid system mediates the association between gut-microbiome diversity and anhedonia/amotivation in a general population cohort. We used longitudinal data collected from 786 volunteer twins recruited as part the TwinsUK register. Our hypothesis was tested with a multilevel mediation model using family structure as random intercept. The model was set using alpha diversity (within-individual gut-microbial diversity) as predictor, serum and faecal levels of the endocannabinoid palmitoylethanolamide (PEA) as mediator, and anhedonia/amotivation as outcome. PEA is considered the endogenous equivalent of cannabidiol, with increased serum levels believed to have anti-depressive effects, while increased stool PEA levels, reflecting increased excretion, are believed to have opposite, detrimental, effects on mental health. We therefore expected that either reduced serum PEA or increased stool PEA would mediate the association between microbial diversity and anhedonia amotivation. Analyses were adjusted for obesity, diet, antidepressant use, sociodemographic and technical covariates. Data were imputed using multiple imputation by chained equations. Mean age was 65.2&thinsp;&plusmn;&thinsp;7.6; 93% of the sample were females. We found a direct, significant, association between alpha diversity and anhedonia/amotivation (<em>&beta;</em>&thinsp;=&thinsp;&minus;0.37; 95%CI: &minus;0.71 to &minus;0.03;&nbsp;<em>P</em>&thinsp;=&thinsp;0.03). Faecal, but not serum, levels of the endocannabinoid palmitoylethanolamide (PEA) mediated this association: the indirect effect was significant (<em>&beta;</em>&thinsp;=&thinsp;&minus;0.13; 95%CI: &minus;0.24 to &minus;0.01;&nbsp;<em>P</em>&thinsp;=&thinsp;0.03), as was the total effect (<em>&beta;</em>&thinsp;=&thinsp;&minus;0.38; 95%CI: &minus;0.72 to &minus;0.04;&nbsp;<em>P</em>&thinsp;=&thinsp;0.03), whereas the direct effect of alpha diversity on anhedonia/amotivation was attenuated fully (<em>&beta;</em>&thinsp;=&thinsp;&minus;0.25; 95%CI: &minus;0.60 to 0.09;&nbsp;<em>P</em>&thinsp;=&thinsp;0.16). Our results suggest that gut-microbial diversity might contribute to anhedonia/amotivation via the endocannabinoid system. These findings shed light on the biological underpinnings of anhedonia/amotivation and suggest the gut microbiota-endocannabinoid axis as a promising therapeutic target in an area of unmet clinical need.</p>
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spelling oxford-uuid:46fa7d7d-6171-4713-83d9-0f80d1af18612023-03-07T10:57:14ZEndocannabinoid system mediates the association between gut-microbial diversity and anhedonia/amotivation in a general population cohortJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:46fa7d7d-6171-4713-83d9-0f80d1af1861EnglishSymplectic ElementsSpringer Nature2021Minichino, AJackson, MAFrancesconi, MSteves, CJMenni, CBurnet, PWJLennox, BR<p>Anhedonia and amotivation are debilitating symptoms and represent unmet therapeutic needs in a range of clinical conditions. The gut-microbiome-endocannabinoid axis might represent a potential modifiable target for interventions. Based on results obtained from animal models, we tested the hypothesis that the endocannabinoid system mediates the association between gut-microbiome diversity and anhedonia/amotivation in a general population cohort. We used longitudinal data collected from 786 volunteer twins recruited as part the TwinsUK register. Our hypothesis was tested with a multilevel mediation model using family structure as random intercept. The model was set using alpha diversity (within-individual gut-microbial diversity) as predictor, serum and faecal levels of the endocannabinoid palmitoylethanolamide (PEA) as mediator, and anhedonia/amotivation as outcome. PEA is considered the endogenous equivalent of cannabidiol, with increased serum levels believed to have anti-depressive effects, while increased stool PEA levels, reflecting increased excretion, are believed to have opposite, detrimental, effects on mental health. We therefore expected that either reduced serum PEA or increased stool PEA would mediate the association between microbial diversity and anhedonia amotivation. Analyses were adjusted for obesity, diet, antidepressant use, sociodemographic and technical covariates. Data were imputed using multiple imputation by chained equations. Mean age was 65.2&thinsp;&plusmn;&thinsp;7.6; 93% of the sample were females. We found a direct, significant, association between alpha diversity and anhedonia/amotivation (<em>&beta;</em>&thinsp;=&thinsp;&minus;0.37; 95%CI: &minus;0.71 to &minus;0.03;&nbsp;<em>P</em>&thinsp;=&thinsp;0.03). Faecal, but not serum, levels of the endocannabinoid palmitoylethanolamide (PEA) mediated this association: the indirect effect was significant (<em>&beta;</em>&thinsp;=&thinsp;&minus;0.13; 95%CI: &minus;0.24 to &minus;0.01;&nbsp;<em>P</em>&thinsp;=&thinsp;0.03), as was the total effect (<em>&beta;</em>&thinsp;=&thinsp;&minus;0.38; 95%CI: &minus;0.72 to &minus;0.04;&nbsp;<em>P</em>&thinsp;=&thinsp;0.03), whereas the direct effect of alpha diversity on anhedonia/amotivation was attenuated fully (<em>&beta;</em>&thinsp;=&thinsp;&minus;0.25; 95%CI: &minus;0.60 to 0.09;&nbsp;<em>P</em>&thinsp;=&thinsp;0.16). Our results suggest that gut-microbial diversity might contribute to anhedonia/amotivation via the endocannabinoid system. These findings shed light on the biological underpinnings of anhedonia/amotivation and suggest the gut microbiota-endocannabinoid axis as a promising therapeutic target in an area of unmet clinical need.</p>
spellingShingle Minichino, A
Jackson, MA
Francesconi, M
Steves, CJ
Menni, C
Burnet, PWJ
Lennox, BR
Endocannabinoid system mediates the association between gut-microbial diversity and anhedonia/amotivation in a general population cohort
title Endocannabinoid system mediates the association between gut-microbial diversity and anhedonia/amotivation in a general population cohort
title_full Endocannabinoid system mediates the association between gut-microbial diversity and anhedonia/amotivation in a general population cohort
title_fullStr Endocannabinoid system mediates the association between gut-microbial diversity and anhedonia/amotivation in a general population cohort
title_full_unstemmed Endocannabinoid system mediates the association between gut-microbial diversity and anhedonia/amotivation in a general population cohort
title_short Endocannabinoid system mediates the association between gut-microbial diversity and anhedonia/amotivation in a general population cohort
title_sort endocannabinoid system mediates the association between gut microbial diversity and anhedonia amotivation in a general population cohort
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