Effects of a synbiotic on symptoms, and daily functioning in attention deficit hyperactivity disorder – A double-blind randomized controlled trial

Skott, Elin; Liu, Yang; Stiernborg, Miranda; Söderström, Åsa; Rüegg, Joëlle; Schalling, Martin; Forsell, Yvonne; Giacobini, MaiBritt; Lavebratt, Catharina

doi:10.1016/j.bbi.2020.05.056

Cited by 45 publications

(41 citation statements)

References 57 publications

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“…However, the results obtained in the serum cytokine profile and in ADHD-RS-IV scores, a psychometric scale specifically designed to detect ADHD core symptoms, were mixed. Similar mixed results were also offered by the clinical trial carried out by Skott et al [197] on a pediatric population with ADHD. Only a tendency to significance was found for the reduction in autistic symptoms in the group randomized to the synbiotic, whereas the ADHD symptom score (SNAP-IV) decreased to a similar degree in the supplemented and placebo groups.…”

Section: Therapeutic Role Of the Gut Microbiome In Adhd: Probioticssupporting

confidence: 66%

“…In a double-blind randomized placebo-controlled trial, Skott et al [197] aimed at investigating the effects of a synbiotic on ADHD core symptoms, autistic comorbid symptoms and daily functioning in a population of children and adults with ADHD. A synbiotic is a product that combines prebiotics and probiotics and in which the prebiotic component favors the probiotic strains [198].…”

Section: Therapeutic Role Of the Gut Microbiome In Adhd: Probioticsmentioning

confidence: 99%

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

et al. 2021

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Studies suggest that the bidirectional relationship existent between the gut microbiome (GM) and the central nervous system (CNS), or so-called the microbiome–gut–brain axis (MGBA), is involved in diverse neuropsychiatric diseases in children and adults. In pediatric age, most studies have focused on patients with autism. However, evidence of the role played by the MGBA in attention deficit/hyperactivity disorder (ADHD), the most common neurodevelopmental disorder in childhood, is still scanty and heterogeneous. This review aims to provide the current evidence on the functioning of the MGBA in pediatric patients with ADHD and the specific role of omega-3 polyunsaturated fatty acids (ω-3 PUFAs) in this interaction, as well as the potential of the GM as a therapeutic target for ADHD. We will explore: (1) the diverse communication pathways between the GM and the CNS; (2) changes in the GM composition in children and adolescents with ADHD and association with ADHD pathophysiology; (3) influence of the GM on the ω-3 PUFA imbalance characteristically found in ADHD; (4) interaction between the GM and circadian rhythm regulation, as sleep disorders are frequently comorbid with ADHD; (5) finally, we will evaluate the most recent studies on the use of probiotics in pediatric patients with ADHD.

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Section: Therapeutic Role Of the Gut Microbiome In Adhd: Probioticssupporting

confidence: 66%

Section: Therapeutic Role Of the Gut Microbiome In Adhd: Probioticsmentioning

confidence: 99%

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

et al. 2021

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“…Currently, the vast potential of the microbiome as a diagnostic and therapeutic tool is undercut by a dearth in the mechanistic understanding of how the microbiome exerts its influence on the host's brain; however, some promising evidence is emerging. Probiotics (live, beneficial microorganisms introduced to the host), prebiotics (non‐digestible dietary fibre that serves as an energy source for the host's resident microbiome) and synbiotics (a combination of the two) have been increasingly used in a clinical setting by a variety of medical fields, exhibiting salubrious health effects, including normalization of neuropsychiatric symptoms (Moosmang, 2005 ; Kali, 2016 ; Cepeda, Katz & Blacketer, 2017 ; Mörkl et al ., 2020 ; Morshedi, Saghafi‐Asl & Hosseinifard, 2020 ; Skott et al ., 2020 ).…”

Section: Synthesismentioning

confidence: 99%

Microbes, metabolites and (synaptic) malleability, oh my! The effect of the microbiome on synaptic plasticity

et al. 2021

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The microbiome influences the emotional and cognitive phenotype of its host, as well as the neurodevelopment and pathophysiology of various brain processes and disorders, via the well‐established microbiome–gut–brain axis. Rapidly accumulating data link the microbiome to severe neuropsychiatric disorders in humans, including schizophrenia, Alzheimer's and Parkinson's. Moreover, preclinical work has shown that perturbation of the microbiome is closely associated with social, cognitive and behavioural deficits. The potential of the microbiome as a diagnostic and therapeutic tool is currently undercut by a lack of clear mechanistic understanding of the microbiome–gut–brain axis. This review establishes the hypothesis that the mechanism by which this influence is carried out is synaptic plasticity – long‐term changes to the physical and functional neuronal structures that enable the brain to undertake learning, memory formation, emotional regulation and more. By examining the different constituents of the microbiome–gut–brain axis through the lens of synaptic plasticity, this review explores the diverse aspects by which the microbiome shapes the behaviour and mental wellbeing of the host. Key elements of this complex bi‐directional relationship include neurotransmitters, neuronal electrophysiology, immune mediators that engage with both the central and enteric nervous systems and signalling cascades that trigger long‐term potentiation of synapses. The importance of establishing mechanistic correlations along the microbiome–gut–brain axis cannot be overstated as they hold the potential for furthering current understanding regarding the vast fields of neuroscience and neuropsychiatry. This review strives to elucidate the promising theory of microbiome‐driven synaptic plasticity in the hope of enlightening current researchers and inspiring future ones.

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“…In contrast, a study in Sweden reported that both Synbiotic 2000 and placebos improved ADHD symptoms equally well. In adults with ADHD, those with elevated plasma vascular cell adhesion molecule-1 (sVCAM-1) levels proposed a reduction in autism symptoms in children and an improvement of emotional regulation [18]. In a 10-week randomized control trial for micronutrient supplementation in 17 children with ADHD, micronutrient administration modulated Bifidobacterium abundance and had potential implications for modulating and regulating ADHD behavior [19].…”

Section: Introductionmentioning

confidence: 99%

Effect of Bifidobacterium bifidum on Clinical Characteristics and Gut Microbiota in Attention-Deficit/Hyperactivity Disorder

Wang

Yang

Kuo

et al. 2022

JPM

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This study aimed to examine whether probiotics supplements using Bifidobacterium bifidum (Bf-688) can improve clinical characteristics and gut microbiomes among patients with attention-deficit/hyperactivity disorder (ADHD). This open-label, single-arm trial consisted of 30 children aged 4–16 years who met the criteria for ADHD diagnosis. Each subject took Bf-688, with one sachet in the morning and one in the evening (daily bacteria count 5 × 109 CFUs), for 8 weeks. Patients’ clinical symptoms were assessed using the Swanson, Nolan, and Pelham Rating Scale (SNAP-IV). We collected stool samples at the baseline, the 8th week, and the 12th week for gut microbiota examination. During the 8-week Bf-688 supplement period, patients’ inattention symptoms and hyperactivity/impulsive symptoms improved, and their weights and BMIs increased. For gut microbiota, the Firmicutes to Bacteroidetes ratio (F/B ratio) decreased significantly. LEfSe analysis revealed that Firmicutes significantly decreased while Proteobacteria significantly increased during the 8-week treatment period. After Bf-688 was discontinued for 4 weeks (12 weeks from baseline), Bacteroidota significantly decreased and Shigella significantly increased. The probiotic Bf-688 supplement was associated with an improvement of clinical symptoms and with weight gain among ADHD children. Furthermore, gut microbiota composition was significantly altered by the Bf-688 supplement. A future randomized control trial is warranted to verify these findings.

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Effects of a synbiotic on symptoms, and daily functioning in attention deficit hyperactivity disorder – A double-blind randomized controlled trial

Cited by 45 publications

References 57 publications

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

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

Microbes, metabolites and (synaptic) malleability, oh my! The effect of the microbiome on synaptic plasticity

Effect of Bifidobacterium bifidum on Clinical Characteristics and Gut Microbiota in Attention-Deficit/Hyperactivity Disorder

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