The therapeutic effects of probiotics on core and associated behavioral symptoms of autism spectrum disorders: a systematic review and meta-analysis

Abstract Background We aimed at investigating the efficacies of probiotics in alleviating the core and associated symptoms of autism spectrum disorder (ASD). Methods Randomized placebo-controlled trials were identified from major electronic databases from inception to Nov 2023. The outcomes of inter...

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Main Authors: Jen-Chin Lee, Chia-Min Chen, Cheuk-Kwan Sun, I-Ting Tsai, Yu-Shian Cheng, Hsien-Jane Chiu, Ming Yu Wang, Yen-Hsiang Tang, Kuo-Chuan Hung
Format: Article
Language:English
Published: BMC 2024-12-01
Series:Child and Adolescent Psychiatry and Mental Health
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Online Access:https://doi.org/10.1186/s13034-024-00848-3
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author Jen-Chin Lee
Chia-Min Chen
Cheuk-Kwan Sun
I-Ting Tsai
Yu-Shian Cheng
Hsien-Jane Chiu
Ming Yu Wang
Yen-Hsiang Tang
Kuo-Chuan Hung
author_facet Jen-Chin Lee
Chia-Min Chen
Cheuk-Kwan Sun
I-Ting Tsai
Yu-Shian Cheng
Hsien-Jane Chiu
Ming Yu Wang
Yen-Hsiang Tang
Kuo-Chuan Hung
author_sort Jen-Chin Lee
collection DOAJ
description Abstract Background We aimed at investigating the efficacies of probiotics in alleviating the core and associated symptoms of autism spectrum disorder (ASD). Methods Randomized placebo-controlled trials were identified from major electronic databases from inception to Nov 2023. The outcomes of interests including improvements in the total and associated symptoms of ASD were quantitatively expressed as effect size (ES) based on standardized mean difference (SMD) with 95% confidence interval (CI). Results Ten studies with 522 participants (mean age = 8.11) were included in this meta-analysis. The primary results revealed significant improvement in total symptoms in the probiotics group compared with the controls (SMD = − 0.19, p = 0.03, ten studies, n = 522) but not the core symptoms (i.e., repetitive restricted behaviors, As affiliations 3 and 5 are same, we have deleted the duplicate affiliations and renumbered accordingly. Please check and confirm.problems with social behaviors/communication). Subgroup analyses demonstrated improvement in total symptoms in probiotics users relative to their controls only in studies using multiple-strain probiotics (SMD = − 0.26, p = 0.03, five studies, n = 288) but not studies using single-strain regimens. Secondary results showed improvement in adaptation (SMD = 0.37, p = 0.03, three studies, n = 139) and an improvement trend in anxiety symptoms in the probiotics group compared with controls (SMD = − 0.29, 95% CI − 0.60 to 0.02, p = 0.07, three studies, n = 163) but failed to demonstrate greater improvement in the former regarding symptoms of irritability/aggression, hyperactivity/impulsivity, inattention, and parental stress. Conclusions Our study supported probiotics use against the overall behavioral symptoms of ASD, mainly in individuals receiving multiple-strain probiotics as supplements. However, our results showed that probiotics use was only associated with improvement in adaptation and perhaps anxiety, but not core symptoms, highlighting the impact of adaptation on quality of life rather than just the core symptoms. Nevertheless, the limited number of included trials warrants further large-scale clinical investigations.
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spelling doaj-art-ee8757805104449fa4e2319e8bee749c2025-08-20T02:31:48ZengBMCChild and Adolescent Psychiatry and Mental Health1753-20002024-12-0118111310.1186/s13034-024-00848-3The therapeutic effects of probiotics on core and associated behavioral symptoms of autism spectrum disorders: a systematic review and meta-analysisJen-Chin Lee0Chia-Min Chen1Cheuk-Kwan Sun2I-Ting Tsai3Yu-Shian Cheng4Hsien-Jane Chiu5Ming Yu Wang6Yen-Hsiang Tang7Kuo-Chuan Hung8Department of General Psychiatry, Taoyuan Psychiatric Center, Ministry of Health and WelfareDepartment of Natural Biotechnology, Nanhua UniversityDepartment of Emergency Medicine, E-Da Dachang Hospital, I-Shou UniversityDepartment of Emergency Medicine, E-Da Dachang Hospital, I-Shou UniversityDepartment of Psychiatry, Tsyr-Huey Mental Hospital, Kaohsiung Jen-Ai’s HomeDepartment of General Psychiatry, Taoyuan Psychiatric Center, Ministry of Health and WelfareDepartment of Psychiatry, China Medical University Hsinchu Hospital, China Medical UniversityDepartment of Critical Care Medicine, MacKay Memorial HospitalDepartment of Anesthesiology, Chi Mei Medical CenterAbstract Background We aimed at investigating the efficacies of probiotics in alleviating the core and associated symptoms of autism spectrum disorder (ASD). Methods Randomized placebo-controlled trials were identified from major electronic databases from inception to Nov 2023. The outcomes of interests including improvements in the total and associated symptoms of ASD were quantitatively expressed as effect size (ES) based on standardized mean difference (SMD) with 95% confidence interval (CI). Results Ten studies with 522 participants (mean age = 8.11) were included in this meta-analysis. The primary results revealed significant improvement in total symptoms in the probiotics group compared with the controls (SMD = − 0.19, p = 0.03, ten studies, n = 522) but not the core symptoms (i.e., repetitive restricted behaviors, As affiliations 3 and 5 are same, we have deleted the duplicate affiliations and renumbered accordingly. Please check and confirm.problems with social behaviors/communication). Subgroup analyses demonstrated improvement in total symptoms in probiotics users relative to their controls only in studies using multiple-strain probiotics (SMD = − 0.26, p = 0.03, five studies, n = 288) but not studies using single-strain regimens. Secondary results showed improvement in adaptation (SMD = 0.37, p = 0.03, three studies, n = 139) and an improvement trend in anxiety symptoms in the probiotics group compared with controls (SMD = − 0.29, 95% CI − 0.60 to 0.02, p = 0.07, three studies, n = 163) but failed to demonstrate greater improvement in the former regarding symptoms of irritability/aggression, hyperactivity/impulsivity, inattention, and parental stress. Conclusions Our study supported probiotics use against the overall behavioral symptoms of ASD, mainly in individuals receiving multiple-strain probiotics as supplements. However, our results showed that probiotics use was only associated with improvement in adaptation and perhaps anxiety, but not core symptoms, highlighting the impact of adaptation on quality of life rather than just the core symptoms. Nevertheless, the limited number of included trials warrants further large-scale clinical investigations.https://doi.org/10.1186/s13034-024-00848-3ProbioticsAutism spectrum disorderAnd meta-analysis
spellingShingle Jen-Chin Lee
Chia-Min Chen
Cheuk-Kwan Sun
I-Ting Tsai
Yu-Shian Cheng
Hsien-Jane Chiu
Ming Yu Wang
Yen-Hsiang Tang
Kuo-Chuan Hung
The therapeutic effects of probiotics on core and associated behavioral symptoms of autism spectrum disorders: a systematic review and meta-analysis
Child and Adolescent Psychiatry and Mental Health
Probiotics
Autism spectrum disorder
And meta-analysis
title The therapeutic effects of probiotics on core and associated behavioral symptoms of autism spectrum disorders: a systematic review and meta-analysis
title_full The therapeutic effects of probiotics on core and associated behavioral symptoms of autism spectrum disorders: a systematic review and meta-analysis
title_fullStr The therapeutic effects of probiotics on core and associated behavioral symptoms of autism spectrum disorders: a systematic review and meta-analysis
title_full_unstemmed The therapeutic effects of probiotics on core and associated behavioral symptoms of autism spectrum disorders: a systematic review and meta-analysis
title_short The therapeutic effects of probiotics on core and associated behavioral symptoms of autism spectrum disorders: a systematic review and meta-analysis
title_sort therapeutic effects of probiotics on core and associated behavioral symptoms of autism spectrum disorders a systematic review and meta analysis
topic Probiotics
Autism spectrum disorder
And meta-analysis
url https://doi.org/10.1186/s13034-024-00848-3
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