Rehabilitation improves sleep and development in autistic children, linked to altered gut microbiome and specific metabolites like ornithine
Background
Children with autism spectrum disorder (ASD) frequently experience gut microbiota dysbiosis and metabolic imbalances, yet the precise mechanisms connecting these alterations to clinical symptoms remain poorly understood. Current interventions often overlook the gut-brain axis. This study aimed to clarify how rehabilitation impacts clinical outcomes and gut microbiota, identifying specific microbial-metabolic signatures and their mechanistic links to sleep disorders and developmental abilities in ASD.
Study Design
A nested case-control study enrolled 26 autistic children (mean age 61.79 ± 11.15 months) and 19 age- and sex-matched healthy controls. The ASD group received standardized rehabilitation therapy for 6 months (2 hours/day, 5 days/week), encompassing occupational and cognitive-linguistic training. Primary outcomes included comprehensive clinical assessments using Griffiths Development Scales-Chinese (GDS-C), Children's Sleep Habits Questionnaire (CSHQ), Autism Behavior Checklist (ABC), and Childhood Autism Rating Scale (CARS). Longitudinal multi-omics analysis, specifically metagenomic sequencing and LC-MS-based metabolomics, was performed to profile gut microbiota and metabolites.
Results
Following 6 months of rehabilitation, autistic children showed significant clinical improvements in sleep quality (across CSHQ total and subscores) and developmental performance (GDS-C). Multi-omics profiling revealed distinct biological signatures in ASD children compared to healthy controls.
These signatures were characterized by elevated
Intestinibacter_bartlettiiand reduced levels of ornithine and siderophore nonribosomal peptide biosynthesis. Crucially, correlation analysis, afterFDRcorrection (q < 0.05), demonstrated that ornithine levels were significantly positively correlated with multipleGDS-Cdevelopmental domains. Additionally, tyrosine levels were associated with parasomnias, highlighting specific metabolic links to clinical symptoms.
Key Findings
- Rehabilitation improved sleep quality and developmental performance in autistic children.
- Autistic children showed elevated
Intestinibacter_bartlettiiand reduced ornithine/siderophore biosynthesis. - Ornithine levels positively correlated with multiple
GDS-Cdevelopmental domains (q < 0.05). - Tyrosine levels were associated with parasomnias.
Why It Matters
This study provides compelling evidence that rehabilitation interventions can positively impact both clinical symptoms and gut microbiome profiles in autistic children. The identified microbial-metabolic signatures, particularly the roles of ornithine and tyrosine, offer potential biomarkers for monitoring treatment efficacy and new targets for adjunctive therapies. While this study focused on rehabilitation, future research could explore how specific dietary or probiotic interventions, informed by these findings, might enhance the benefits of therapy. Integrating gut microbiome analysis could personalize treatment strategies for ASD, moving towards more targeted and effective interventions beyond traditional behavioral approaches.
autism
gut-microbiome
rehabilitation
metabolomics
metagenomics
child-health