The study aims to explore possible biomarkers from gut microbiota and plasma metabolites at 3 days after acute ischemic stroke for 2-week post stroke depression(PSD), which will help doctors make decisions on intervention to avoid delayed diagnosis and treatment of PSD. 

Post stroke depression (PSD) is the most common neuropsychiatric disorders in stroke, and can negatively affect the prognosis of stroke patients. Gut microbiota and plasma metabolites play important roles in the pathogenesis of PSD, and the prediction of possible biomarkers from gut microbiota and plasma metabolites at 3 days after acute ischemic stroke for 2-week PSD may help to improve the prognosis of PSD.

86 patients were diagnosed with acute ischemic stroke and were followed up in the outpatient or ward at 2 weeks. Fecal 16s RNA sequencing and liquid chromatography-mass spectrometry (LC-MS) of plasma were detected at 3 days after acute ischemic stroke. Multi-omics analysis of clinical data, gut bacteria and plasma metabolites at 3 days after acute ischemic stroke were used to screen out potential biomarkers to predict 2-week PSD.

At the level of genus, PSD patients has higher abundance of Blautia, Eubacterium_hallii_group, Tyzzerella, lower abundance of Ellin6067, Massilia, Luedemannella and Gemmataceae_others compared with non-PSD patients. There were 32 altered plasma metabolites at 3 days after acute ischemic stroke when predicting 2-week PSD, of which 29 metabolites increased and 3 metabolites decreased in PSD patients, mainly belonging to steroid and steroid derivatives, glycerophospholipids, fatty acyls, prenol lipids. The predicted AUCs of clinical data, cytokines and metabolomic and combined dataset were 0.664, 0.739, 0.870 and 0.955, respectively. 

Gut bacteria disorders and alteration of plasma metabolites may promote the pathogenesis of PSD. A panel of combined biomarkers screened from metabolites, gut bacteria, and clinical data showed excellent prediction ability for predicting 2-week PSD.