Effect of probiotic supplementation on cognitive function in children and adolescents: a systematic review of randomised trials

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.

Current Evidence on the Role of the Gut Microbiome in ADHD Pathophysiology and Therapeutic Implications

“…A recent systematic review included randomized controlled trials, published between 1990 and 2018, that had evaluated the effects of probiotic supplementation on the cognitive function in children and adolescents. Seven studies were found to meet the inclusion criteria, but only one of them reported a significant reduction in the risk to develop ADHD or ASD [195]. This was a double-blind randomized placebo-controlled trial conducted by Pärtty et al [152] on a Finnish population of 159 infants who had at least one family member with allergic disease.…”

Physicochemical Properties and Sensory Acceptability of a Next-Generation Functional Chocolate Added with Omega-3 Polyunsaturated Fatty Acids and Probiotics

“…For that reason, the addition of probiotic strains such as L. plantarum 299v has been found to improve cognitive functioning in patients with major depression [8]. Additionally, other lactic bacteria such as L. rhamnosus GG have shown improvements in children's and adolescents' cognitive function, generating the reduction of behavior and communication disorders such as autism [9]. Therefore, the development of next-generation functional foods is crucial to make available to consumers products with beneficial health effects [10].…”

Antimicrobial Prophylaxis and Modifications of the Gut Microbiota in Children with Cancer

“…Probiotics are live microorganisms, which, when administered in adequate amounts, confer a health benefit on the host [ 96 , 97 ]. Probiotic supplementation has been widely studied in children presenting various health conditions [ 98 , 99 , 100 , 101 , 102 , 103 , 104 ], whereas there have been very few studies regarding gut microbiota dysbiosis in pediatric patients with cancer. The first one was published in 1980 [ 105 ] and was also one of the first works that examined the concept of intestinal decontamination, that is, a prophylactic strategy that consists of the administration of antimicrobials with limited anaerobicidal activity in order to reduce the burden of aerobic gram-negative bacteria and/or yeast in the intestinal tract and so prevent infections caused by these organisms.…”