The causal relationship between gut microbiota (GM) and white matter injury and communication remains unclear. We aimed to scrutinize the plausible causal impact of GM on white matter hyperintensities (WMH), white matter microstructure, white matter connectivity and multiple neurological diseases via Mendelian randomization (MR) study. We identified 4 WMH-related bacterial taxa, including class Melainabacteria , order Gastranaerophilales , family Alcaligenaceae and genus Ruminiclostridium 6 . In addition, 3 bacterial taxa were discovered that have consistent effect on multiple aspects of white matter microstructure. Furthermore, we found 12 strong associations between genetic liability in GM and white matter connectivity. Among these bacterial taxa, family Clostridiaceae 1 demonstrated a protective effect against ischemic stroke (IS). Genus Barnesiella showed protective effect on IS and small vessel stroke (SVS) while posed a risk effect on neuromyelitis optica spectrum disorder (NMOSD), as well as on aqua...

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