Decoding the Gut Microbiome in Neuromuscular Diseases: a Review of Fundamental Mechanisms and Condition-Specific Evidence

Background: The gut microbiome is fundamental to gastrointestinal and systemic homeostasis through its interactions with dietary components and host-derived factors. Substantial evidence demonstrates a close functional association between the gut and the central nervous system (CNS), establishing a complex communication network that is essential for both health and disease. Scope of the Review: This review examines the role of the gut microbiota in regulating gastrointestinal physiology and brain function, with particular emphasis on the microbiota-gut-brain axis and its bidirectional signaling mechanisms. Key Findings: The gut microbiota supports normal brain function and gastrointestinal physiology through complex molecular interactions involving the enteric nervous system, neuromuscular junctions, and the CNS. Disruption of microbial balance, known as gut dysbiosis, results in impaired gut integrity, increased intestinal permeability, compromised blood-brain barrier function, and altered neuroimmune signaling. These changes are closely linked to the development and progression of neurological disorders. Conclusion: The microbiota-gut-brain axis constitutes a critical regulatory system that connects gastrointestinal and neurological health. Advancing the understanding of microbiota-mediated mechanisms may yield novel insights into disease pathogenesis and facilitate the development of microbiome-targeted therapeutic strategies.