Sumra Bushra, Kocherry Cyril, Shamim Hina, Jhakri Kiran, Al-Shudifat Moath, Mohammed Lubna
Clinical Research, University of London, London, GBR.
School of Medicine, Ninewells Hospital, Dundee, GBR.
Cureus. 2025 Mar 9;17(3):e80291. doi: 10.7759/cureus.80291. eCollection 2025 Mar.
Autism spectrum disorder (ASD) is defined as a complex neurodevelopmental disorder that is characterized by a set of deficits not limited to social communication, which is restricted and repetitive behaviors. The prevalence of autism has been seen to be consistently increasing globally. Autism is multifactorial in its etiology, and it involves several physiological systems, including the central nervous system and the gut-brain axis. Omega-3 fatty acids are essential for neural development and functionality, particularly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). They both play a crucial role in not only reducing the neuroinflammation associated with autism but also supporting cognitive processing as well. Given the low levels of omega-3 noted in ASD individuals, this systematic review aims to assess the influence of omega-3 supplementation on cognitive outcomes in children with ASD. The systematic review was done following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, where different databases were assessed across PubMed, Science Direct, Cochrane Library, Google Scholar, and Scopus. MeSH terms used included keywords "Omega-3", "EPA", "DHA" AND "Autism Spectrum Disorder" OR "ASD". Articles published between 2007 and 2023 that focused on ages 2 to 18 years were screened, and cognitive outcomes relevant to omega-3 supplementation were included. Studies with inadequate access to full text excluded non-human trials and older individuals. After generating 25,312 articles, 211 were selected for further review, with 11 meeting the inclusion criteria. The articles reviewed panned over five different countries that involved omega-3 supplementation lasting up to one year. Results suggested that DHA and EPA supplementation may improve cognitive functions such as memory, attention, and executive functioning in children with ASD. The prefrontal cortex development was associated with DHA supplementation, whereas EPA showed improved emotional regulation and reduced neuroinflammation. However, conclusive results were not reached as there was variability in study designs, different dosages, and assessment methods. The power of the studies conducted was also noted to be limited. While promising, extensive research and trials are required to standardize the dosage of omega-3 and the length of intervention. Future studies should aim to identify the long-term effects of omega-3 supplementation, understand the gut-brain axis, and investigate the combination of omega-3 with other therapies to improve cognitive functioning.
自闭症谱系障碍（ASD）被定义为一种复杂的神经发育障碍，其特征是一系列不限于社交沟通的缺陷，还包括受限的重复行为。自闭症在全球的患病率一直在持续上升。自闭症的病因是多因素的，涉及多个生理系统，包括中枢神经系统和肠脑轴。ω-3脂肪酸对神经发育和功能至关重要，尤其是二十碳五烯酸（EPA）和二十二碳六烯酸（DHA）。它们不仅在减轻与自闭症相关的神经炎症方面发挥关键作用，而且在支持认知加工方面也发挥着重要作用。鉴于自闭症患者体内ω-3水平较低，本系统评价旨在评估补充ω-3对自闭症儿童认知结果的影响。该系统评价是按照系统评价和Meta分析的首选报告项目（PRISMA）指南进行的，在PubMed、科学Direct、Cochrane图书馆、谷歌学术和Scopus等不同数据库中进行了评估。使用的医学主题词包括关键词“ω-3”、“EPA”、“DHA”以及“自闭症谱系障碍”或“ASD”。筛选了2007年至2023年发表的关注2至18岁年龄段的文章，并纳入了与补充ω-3相关的认知结果。无法充分获取全文的研究排除了非人体试验和年龄较大的个体。在生成25312篇文章后，选择了211篇进行进一步审查，其中11篇符合纳入标准。所审查的文章涵盖了五个不同的国家，这些国家涉及长达一年的ω-3补充。结果表明，补充DHA和EPA可能改善自闭症儿童的认知功能，如记忆、注意力和执行功能。前额叶皮质发育与补充DHA有关，而EPA显示出情绪调节改善和神经炎症减轻。然而，由于研究设计、不同剂量和评估方法存在差异，尚未得出确凿的结果。所进行研究的效力也被认为是有限的。虽然前景乐观，但需要进行广泛的研究和试验，以规范ω-3的剂量和干预时间。未来的研究应旨在确定补充ω-3的长期影响，了解肠脑轴，并研究ω-3与其他疗法的联合使用以改善认知功能。
