Global research trends in stroke and gut microbiota: a multi-database bibliometric analysis and cross-validation study.

Background: The fields of stroke and the gut microbiota are closely linked via the "gut-brain axis," and their complex bidirectional interactions have emerged as a significant research focus. This study represents the first systematic bibliometric analysis of this field, aiming to delineate its knowledge structure, evolutionary trajectory, current research hotspots, and emerging frontiers. Methods: Data for this study were retrieved from the Web of Science Core Collection, covering the period from January 1, 2000, to August 31, 2025. Following a screening process, a total of 1,236 relevant articles were included in the analysis. Bibliometric and visualization tools, including CiteSpace, VOSviewer, R software, and Microsoft Excel, were employed to systematically analyze the distribution of research disciplines, publication output, contributions by country/region, institutional collaborations, influential authors, core journals, co-cited references, and keyword co-occurrence. Furthermore, to assess the robustness of our findings and explore characteristic differences across databases, we performed a multi-database validation and comparative analysis using data from Scopus and PubMed. Results: The number of annual publications has shown a continuous increase, with a rapid surge in the number of articles published over the past 5 years, achieving an average annual growth rate of 20.6%. China leads the world in terms of the number of publications, while the United States plays a central role in early-stage research and international collaboration. This study demonstrates significant interdisciplinary integration, encompassing multiple disciplines including neuroscience, pharmacology, immunology, and microbiology. Current research hotspots focus on the interaction between gut microbiota dysbiosis and post-stroke neuroinflammation, the therapeutic potential of microbial metabolites (e.g., short-chain fatty acids), the exploration of gut-brain axis mechanisms, and probiotic intervention strategies. Mechanistic research and clinical translation have been identified as the primary drivers for the development of this field. Multi-database validation showed that the annual publication trends, keyword distribution, and rankings of major contributing countries were consistent. Conclusion: Current research hotspots have expanded from basic mechanisms toward clinical translation, underscoring the importance of elucidating common pathophysiological mechanisms and identifying potential therapeutic targets. Future research priorities include refining screening and diagnostic protocols for gut microbial biomarkers, developing effective prevention strategies based on probiotics and other microbiota-targeted interventions, and advancing individualized and targeted therapeutic approaches. By integrating multi-omics data with precision medicine approaches, the field is poised to further accelerate the translation of mechanistic discoveries into clinical practice, ultimately offering novel strategies for the prevention and treatment of stroke.