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Effect of probiotic supplementation on cognitive function in children and adolescents: a systematic review of
D Rianda1, R Agustina1,2, E A Setiawan1
1Department of Nutrition, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia.
Insights
Probiotic supplements may reduce the risk of attention deficit hyperactivity disorder (ADHD) or Asperger syndrome (AS) in children, but more research is needed. One study showed benefits with Lactobacillus rhamnosus GG, while others found no cognitive effects.
Area of Science:
- Neuroscience
- Microbiology
- Pediatrics
Background:
- Existing reviews suggest probiotics influence neurobehavioral outcomes in adults via the gut-brain axis.
- A gap exists in systematic reviews examining probiotic effects on cognitive function in pediatric populations.
- This study addresses the need for evidence on probiotic supplementation for cognitive development in children and adolescents.
Purpose of the Study:
- To systematically review randomized controlled trials (RCTs) assessing probiotic supplementation's impact on cognitive function in children and adolescents.
- To synthesize findings on the efficacy of various probiotic strains and intervention protocols.
- To identify potential benefits or lack thereof in cognitive development.
Main Methods:
- Systematic review of RCTs identified through searches of four major databases (Cochrane, PsycARTICLES, Scopus, PubMed).
- Inclusion criteria focused on studies published between January 1990 and December 2018, involving probiotic supplementation and cognitive outcomes in children/adolescents.
- Analysis of cognitive outcomes from seven eligible studies.
Main Results:
- Only one study reported a positive outcome, linking Lactobacillus rhamnosus GG (LGG) supplementation to a reduced risk of attention deficit hyperactivity disorder (ADHD) or Asperger syndrome (AS).
- This positive finding involved maternal and infant supplementation, with ADHD/AS diagnosed at age 13.
- The remaining six studies showed no significant differences in cognitive function following probiotic supplementation, despite variations in strains, duration, and administration timing.
Conclusions:
- Probiotic supplementation, specifically LGG, may offer a risk reduction for developing ADHD/AS in children, suggesting a potential gut-brain axis effect.
- Current evidence is limited, with only one study demonstrating a significant benefit.
- Further long-term, follow-up trials are necessary to confirm these findings and guide recommendations for routine probiotic use in pediatric cognitive health.
Abstract:
Available reviews have shown potential effects of probiotics on neurobehavioral outcomes through 'gut-brain axis' mechanism in adults. However, reviews on cognitive function in children and adolescents are lacking. Therefore, we conducted a systematic review of randomised controlled trials (RCTs) of the effect of probiotic supplementation on cognitive function in children and adolescents. A search of four databases (Cochrane Central Register of Controlled Trials, PsycARTICLES, Scopus, PubMed) was conducted to identify RCTs published from January 1990 to December 2018. Seven studies met the inclusion criteria and their cognitive outcomes were analysed. Only one study found a positive result with Lactobacillus rhamnosus GG (LGG) 1×1010 cfu supplementation with outcomes on attention deficit hyperactivity disorder (ADHD) or Asperger syndrome (AS) manifestations as diagnosed using the International Classification of Diseases-10 criteria. The supplementations were administered to Finnish mothers for 4 weeks before delivery and continuously given for 6 months after delivery if they breastfed, or to the children. ADHD or AS was diagnosed at the age of 13 years in 17.1% children in the placebo and none in the probiotic group (P=0.008). This study found significant differences in species composition and number of cells belonging to the genus Bifidobacterium between healthy children and children who later developed ADHD or AS at different time points. Six remaining studies with varying strains, durations of intervention, start-time of administration, and outcomes demonstrated no difference in cognition after probiotic supplementation. Metagenomic analyses on gut microbiota composition were not performed in any of these studies. In conclusion, the favourable effect of probiotic supplementation on cognitive function in children and adolescents was observed in one study with LGG supplementation by a risk reduction of developing ADHD or AS (i.e. autism). More long-term and follow-up trials using probiotics identifying the effect on cognition are warranted before routine use.
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