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Effects of Probiotic Supplementation on Gastrointestinal, Sensory and Core Symptoms in Autism Spectrum Disorders: A
Elisa Santocchi1, Letizia Guiducci2, Margherita Prosperi1,3
1Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy.
Insights
Probiotics may improve core autism symptoms in some children with Autism Spectrum Disorder (ASD) who do not have gastrointestinal issues. Further research is needed to confirm these findings.
Area of Science:
- Neuroscience
- Microbiology
- Pediatrics
Background:
- The microbiota-gut-brain axis influences neuropsychiatric health.
- Probiotics, or psychobiotics, may modulate brain function.
- Autism Spectrum Disorder (ASD) is a neurodevelopmental condition affecting behavior.
Purpose of the Study:
- To evaluate the effects of probiotics on behavioral profiles in children with ASD.
- To investigate if probiotics impact core autism symptoms.
- To explore potential benefits in subgroups with or without gastrointestinal symptoms.
Main Methods:
- A double-blind, randomized, placebo-controlled trial involving 85 preschoolers with ASD.
- Participants received either probiotics (De Simone Formulation) or placebo for six months.
- Outcomes measured included the Autism Diagnostic Observation Schedule - Calibrated Severity Score (ADOS-CSS), gastrointestinal symptoms, adaptive functioning, and sensory profiles.
Main Results:
- No significant difference in the primary outcome (ADOS-CSS) between probiotic and placebo groups overall.
- In children without gastrointestinal symptoms (NGI group), probiotics significantly reduced Total ADOS-CSS and Social-Affect ADOS-CSS.
- In children with gastrointestinal symptoms (GI group), probiotics showed improvements in GI symptoms, adaptive functioning, and sensory profiles.
Conclusions:
- Probiotics may offer benefits for core autism symptoms in a subset of ASD children, independent of gastrointestinal symptom improvement.
- These findings suggest a potential role for probiotics in modulating the microbiota-gut-brain axis for specific ASD populations.
- Further research is warranted to validate these results in larger, diverse ASD populations.
Abstract:
The microbiota-gut-brain axis has been recently recognized as a key modulator of neuropsychiatric health. In this framework, probiotics (recently named "psychobiotics") may modulate brain activity and function, possibly improving the behavioral profiles of children with Autism Spectrum Disorder (ASD). We evaluated the effects of probiotics on autism in a double-blind randomized, placebo-controlled trial of 85 preschoolers with ASD (mean age, 4.2 years; 84% boys). Participants were randomly assigned to probiotics (De Simone Formulation) (n=42) or placebo (n=43) for six months. Sixty-three (74%) children completed the trial. No differences between groups were detected on the primary outcome measure, the Total Autism Diagnostic Observation Schedule - Calibrated Severity Score (ADOS-CSS). An exploratory secondary analysis on subgroups of children with or without Gastrointestinal Symptoms (GI group, n= 30; NGI group, n=55) revealed in the NGI group treated with probiotics a significant decline in ADOS scores as compared to that in the placebo group, with a mean reduction of 0.81 in Total ADOS CSS and of 1.14 in Social-Affect ADOS CSS over six months. In the GI group treated with probiotics we found greater improvements in some GI symptoms, adaptive functioning, and sensory profiles than in the GI group treated with placebo. These results suggest potentially positive effects of probiotics on core autism symptoms in a subset of ASD children independent of the specific intermediation of the probiotic effect on GI symptoms. Further studies are warranted to replicate and extend these promising findings on a wider population with subsets of ASD patients which share targets of intervention on the microbiota-gut-brain axis.
Clinical Trial Registration:
ClinicalTrials.gov, identifier NCT02708901.
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