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Accumulating evidence highlights the importance of microbiota-directed intervention in neuropsychiatric disorders. This study aims to investigate the effects of probiotic supplements as an adjunct therapy in combination with Ritalin in children with attention-deficit hyperactivity disorder (ADHD).

Children with ADHD, aged 6–12 years, who had an intelligent quotient of ≥70 were enrolled in the study. Participants were randomly assigned to either the group that received probiotics or the group that received the placebo in addition to the weight-adjusted dose of Ritalin. Parents were asked to complete the revised Conners Parent Rating Scale–short version (CPRS–RS), and the psychiatrist completed the seven-point Clinical Global Impression–Severity (CGI–S) scale. Two study groups were compared in three time points, including T1 (before intervention), T2 (at the end of fourth week) and T3 (at the end of the eighth week).

A total of 38 participants completed the study. After eight weeks of intervention, the probiotic group had a significant improvement regarding CPRS–RS scores in T2 (9.4 unit, p = 0.014) and T3 (18.6 unit, p < 0.001), compared to placebo. In addition, children in the probiotic group had 0.7 unit lower CGI in T3 (p = 0.018) than the placebo group. A significant reduction of CGI scores was observed in each interval (T2 vs T1, T3 vs T2 and T3 vs T1; p < 0.05). This significant change in CGI score between intervals was also detected in the placebo group in T2 vs T1 (p = 0.002) and T3 vs T1 (p < 0.001). Mean CPRS scores of the groups were different in T2 and T3 (p = 0.011 and p < 0.001, respectively) and mean CGI scores of the two study groups were different in T3 (p = 0.018).

Eight weeks of supplementation with probiotics had a favorable effect on symptoms and severity of ADHD. Therefore, probiotics as an adjuvant treatment might have a promising efficacy regarding the management of ADHD.

Diet is recognized as a possible potential factor in migraine pathogenesis. Limited evidence exists on the effect of diet on pediatric migraine, so this paper aims to investigate the association between fruit and vegetable consumption and odds of migraine in children.

The authors conducted a case-control study in tertiary Sina hospital, Tehran, Iran. A hundred children with migraine as case group and 190 sex-matched healthy controls were included in this study. Definite diagnosis of migraine was based on 2018 international classification of headache disorder 3 (ICHD3) criteria. Demographic and anthropometric characteristics were collected. Common dietary intake of participants was obtained using a validated semi-quantitative food frequency questionnaire.

Children in the migraine group had significantly higher BMI and age compared with the control group (p-value = <0.01). After adjustment for age, gender, BMI and total energy intake, a significant association between higher intake of vegetables in second tertile (OR: 0.47; CI: 0.24-0.92), fruits in third tertile (OR: 0.31; CI:0.14-0.69) and fiber in fourth quartile (OR:0.28; CI:0.095-0.85) was obtained. Controlling for all confounders in Model 3, the odds of migraine, decreased by 50 per cent and 70 per cent as the consumption of vegetables and fruits increased, in the second tertile of vegetables (p-value = 0.04) and the third tertile of fruits (p-value = <0.01).

The findings confirm a plausible protective role of dietary fruits and vegetables against the risk of migraine in children, which can be attributed to the probable effect of dietary fiber.