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Unexpected improvement in core autism spectrum disorder symptoms after long-term treatment with probiotics
Enzo Grossi1, Sara Melli1, Delia Dunca1
1Autism Unit, Villa Santa Maria Institute, Neuropsychiatric Rehabilitation Center, Tavernerio, Italy.
Insights
Probiotic treatment unexpectedly improved core symptoms in a boy with Autism Spectrum Disorder (ASD) and celiac disease. This suggests potential new avenues for managing ASD symptoms alongside gastrointestinal issues.
Area of Science:
- Neurodevelopmental disorders
- Gastroenterology
- Microbiome research
Background:
- Autism Spectrum Disorder (ASD) is a neurodevelopmental condition characterized by socio-communicative impairments and restricted behaviors.
- Gastrointestinal disturbances are frequently reported in individuals with ASD.
- Celiac disease is an autoimmune disorder triggered by gluten consumption.
Observation:
- A 12-year-old boy with ASD, severe cognitive disability, and celiac disease received probiotic treatment (VSL#3).
- The study monitored changes in ASD core symptoms using the Autism Diagnostic Observation Schedule (ADOS-2) over a 4-week treatment and 4-month follow-up period.
- Rehabilitation and diet remained stable during the study.
Findings:
- Probiotic treatment reduced abdominal symptoms as anticipated.
- Unexpectedly, core ASD symptoms showed clinical improvement within weeks of probiotic initiation.
- The Social Affect domain score on ADOS-2 improved from 20 to 18 after two months, further decreasing to 17 and remaining stable, a significant change given ADOS score stability.
Implications:
- This case suggests probiotics may offer a novel therapeutic approach for core symptoms in ASD, particularly when co-occurring with gastrointestinal issues.
- Further research into the role of probiotics in managing ASD is warranted.
- Targeting the gut-brain axis could be a promising strategy for future ASD interventions.
Objectives:
Autism spectrum disorder is a neurodevelopmental condition that typically displays socio-communicative impairment as well as restricted stereotyped interests and activities, in which gastrointestinal disturbances are commonly reported. We report the case of a boy with Autism Spectrum Disorder (ASD) diagnosis, severe cognitive disability and celiac disease in which an unexpected improvement of autistic core symptoms was observed after four months of probiotic treatment.
Method:
The case study refers to a 12 years old boy with ASD and severe cognitive disability attending the Villa Santa Maria Institute in resident care since 2009. Diagnosis of ASDs according to DSM-V criteria was confirmed by ADOS-2 assessment (Autism Diagnostic Observation Schedule). The medication used was VSL#3, a multi-strain mixture of ten probiotics. The treatment lasted 4 weeks followed by a four month follow-up. The rehabilitation program and the diet was maintained stable in the treatment period and in the follow up. ADOS-2 was assessed six times: two times before starting treatment; two times during the treatment and two times after interruption of the treatment.
Results:
The probiotic treatment reduced the severity of abdominal symptoms as expected but an improvement in Autistic core symptoms was unexpectedly clinically evident already after few weeks from probiotic treatment start. The score of Social Affect domain of ADOS improved changing from 20 to 18 after two months treatment with a further reduction of 1 point in the following two months. The level 17 of severity remained stable in the follow up period. It is well known that ADOS score does not fluctuate spontaneously along time in ASD and is absolutely stable.
Conclusions:
The appropriate use of probiotics deserves further research, which hopefully will open new avenues in the fight against ASD.
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