The gut microbiome in children with mood, anxiety, and neurodevelopmental disorders: An umbrella review
Romano K, Shah AN, Schumacher A, Zasowski C, Zhang T, Bradley-Ridout G, Merriman K, Parkinson J, Szatmari P, Campisi SC, Korczak DJ (2023) Gut Microbiome (Camb) 4 e18. doi: 10.1017/gmb.2023.16.
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Abstract:
Research on the gut microbiome and mental health among children and adolescents is growing. This umbrella review provides a high-level overview of current evidence syntheses to amalgamate current research and inform future directions.Searches were conducted across seven databases for peer-reviewed pediatric (
Among the 39 included review studies, 23 (59%) were observational and 16 (41%) were interventional. Most reviews (92%) focused on ASD. Over half (56%) of the observational and interventional reviews scored low or critically low for methodological quality.
A higher abundance of Clostridium clusters and a lower abundance of Bifidobacterium were consistently observed in ASD studies. Biotic supplementation was associated with ASD symptom improvement.
Gut microbiome-mental health evidence syntheses in child and youth depression, anxiety, bipolar disorder, and OCD are lacking.
Preliminary evidence suggests an association between specific microbiota and ASD symptoms, with some evidence supporting a role for probiotic supplementation ASD therapy.
FAB RESEARCH COMMENT:
Recent years have seen an explosion of research into the so-called 'gut-brain' axis, following the belated recognition that changes to the 'gut microbiome' can influence brain development and function, and therefore mental health and wellbeing.The aim of this systematic umbrella review was to summarise findings from research to date into links between the gut microbiome and mental health disorders in children and adolescents.
Most studies in this area have been focused primarily on Autistic Spectrum Disorders (ASD), followed by ADHD; and studies of children or adolescents with depression, anxiety, OCD, and bipolar disorder were too few to allow any conclusions.
The authors found most studies to be of 'low quality' - highlighting the many serious methodological problems of research in this area. Nonetheless, they found that existing evidence does indicate that
(1) disturbances of gut microbial balance are more common in children with ASD, and
(2) that small treatment trials have reported that supplementation with various probiotic formulations may help to reduce ASD symptoms.
They conclude that further research in this important area is needed, but recommend careful attention to methodology, including better standardisation of how gut microbial composition is assessed.
More detailed characterisation of the populations studied would also help, but with respect to supplementation, dietary interventions or other clinical approaches aimed at improving gut microbial balance and diversity, the complexity and individuality of the gut microbiome is such that a personalised approach is likely to be the most successful.
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