Cognitive behavioral therapy for irritable bowel syndrome induces bidirectional alterations in the brain-gut-microbiome axis associated with gastrointestinal symptom improvement.

The increased accuracy of the microbiome classifier was highly significant by bootstrap analysis ( p =6×10 −5 and p =.0001 compared to the clinical/demographic and combined brain classifiers, respectively; there was no significant difference between the clinical/demographic and brain classifiers) (Fig. 2 A).

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Differential abundance testing did not reveal any metabolites with a statistically significant association with CBT response after correcting for multiple hypothesis testing, though 55 metabolites were nominally significant (Table S3).

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