A single-arm pilot study to assess salivary metabolites in facilitators tested with Pre-Texts arts-literacy intervention

The Pre-Texts arts-literacy intervention has demonstrated effectiveness for reducing depression and anxiety symptoms in adolescents. However, the biological mechanisms underlying these psychological changes remain largely unexplored. This single-arm pilot study investigated the impact of Pre-Texts training on salivary metabolite profiles in adults (N=10) undergoing facilitator training. Participants completed a 20-hour Pre-Texts program over four days, with saliva samples collected at baseline, during training (day 3), immediately post-intervention (day 4), and at 8-week follow-up. Flow injection analysis-tandem mass spectrometry quantified seven key metabolites linked to glutamate signaling (glutamic acid, glycine, valine, proline) and cellular metabolism/energy production (alanine, citrulline, C3 propionylcarnitine). Results demonstrated significant and sustained increases in glutamic acid, glycine, valine, proline, alanine, and citrulline, with concurrent decreases in C3 propionylcarnitine, versus baseline. These neurobiochemical changes were still present at follow-up, indicating the possibility of sustained effects on neurotransmission and cellular energetics. The observed metabolic shifts may reflect mechanisms involving NMDA receptor activation, neuroplasticity, cognitive flexibility, and stress response regulation. This preliminary investigation establishes methodological foundations for an expanded research examining the biological mechanisms underlying arts-based interventions, suggesting that Pre-Texts may foster neurometabolic changes that may be supportive of cognitive and emotional wellbeing. • Pre-Texts reduces depression and anxiety, although its biological basis is unclear. • Pre-Texts influences key metabolites linked to glutamate signaling and metabolism. • This pilot study identifies biomarkers that may guide future research on Pre-Texts