Abstract

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.

Highlights

  • Attention-deficit/hyperactivity disorder (ADHD) is one of the most common mental disorders that occur in childhood

  • A high male-to-female ratio was found (4:1), which corresponds to an attentiondeficit/hyperactivity disorder (ADHD) prevalence ratio ranging from 2:1 to 10:1 [43,44]

  • This study is the first one to use B. bifidum (Bf-688 strain) as a supplement for ADHD, and ADHD symptoms improved during the 8-week test period

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Summary

Introduction

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common mental disorders that occur in childhood. It affects approximately 3 to 10% school-age children around the world [1]. The “gut–brain axis,” which refers to the link between gut microbiota and the central nervous system, has been suggested to affect neurodevelopmental disorders such as ADHD [5,6,7,8,9]. Modification of microbiota profiles by using probiotics supplements in patients with ADHD may shed light on the search for novel therapeutic applications [10,11,12,13]

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