Neurobehavioral dysfunction in non-alcoholic steatohepatitis is associated with hyperammonemia, gut dysbiosis, and metabolic and functional brain regional deficits

PLoS One. 2019 Sep 20;14(9):e0223019. doi: 10.1371/journal.pone.0223019. eCollection 2019.

Abstract

Non-alcoholic steatohepatitis (NASH) is one of the most prevalent diseases worldwide. While it has been suggested to cause nervous impairment, its neurophysiological basis remains unknown. Therefore, the aim of this study is to unravel the effects of NASH, through the interrelationship of liver, gut microbiota, and nervous system, on the brain and human behavior. To this end, 40 Sprague-Dawley rats were divided into a control group that received normal chow and a NASH group that received a high-fat, high-cholesterol diet. Our results show that 14 weeks of the high-fat, high-cholesterol diet induced clinical conditions such as NASH, including steatosis and increased levels of ammonia. Rats in the NASH group also demonstrated evidence of gut dysbiosis and decreased levels of short-chain fatty acids in the gut. This may explain the deficits in cognitive ability observed in the NASH group, including their depressive-like behavior and short-term memory impairment characterized in part by deficits in social recognition and prefrontal cortex-dependent spatial working memory. We also reported the impact of this NASH-like condition on metabolic and functional processes. Brain tissue demonstrated lower levels of metabolic brain activity in the prefrontal cortex, thalamus, hippocampus, amygdala, and mammillary bodies, accompanied by a decrease in dopamine levels in the prefrontal cortex and cerebellum and a decrease in noradrenalin in the striatum. In this article, we emphasize the important role of ammonia and gut-derived bacterial toxins in liver-gut-brain neurodegeneration and discuss the metabolic and functional brain regional deficits and behavioral impairments in NASH.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Brain / metabolism*
  • Cholesterol, Dietary / adverse effects
  • Cognition Disorders / etiology
  • Cognition Disorders / metabolism*
  • Cognition Disorders / microbiology
  • Diet, High-Fat / adverse effects
  • Disease Models, Animal
  • Dysbiosis / metabolism*
  • Dysbiosis / microbiology
  • Gastrointestinal Microbiome*
  • Humans
  • Hyperammonemia / metabolism*
  • Liver / metabolism*
  • Male
  • Non-alcoholic Fatty Liver Disease / etiology
  • Non-alcoholic Fatty Liver Disease / metabolism*
  • Non-alcoholic Fatty Liver Disease / microbiology
  • Rats, Sprague-Dawley

Substances

  • Cholesterol, Dietary

Grants and funding

This work was supported by the Ministry of Science, Innovation and Universities (PSI2017-83893-R to JLA) and the Ministry of Economy and Business (PSI2015-63658-R, PSI2015-73111-EXP to JLA, and PSI2017-90806-REDT to JLA) (Spain). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.