In this randomized crossover trial, fish oil supplementation improved cognitive function and attention deficit hyperactivity disorder symptoms in adults with autism spectrum disorder.
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Background
Studies have found that children with autism spectrum disorder (ASD) tend to have lower blood levels of n−3 fatty acids, which is associated with impaired cognitive function. Randomized controlled trials on n−3 supplementation in children with ASD have shown some improvements in cognitive function, but overall, the results have been inconsistent.
Because the effects of n−3 supplements in adults with ASD are largely unknown, and because ASD can often co-occur with attention deficit hyperactivity disorder (ADHD), this crossover trial examined the effect of fish oil on various aspects of cognitive function and ADHD in adults with ASD.
The study
In this randomized crossover trial, 21 participants with ASD (10 with ADHD and 11 without ADHD) took fish oil (FO) containing 5.2 grams of n−3 fats or an equivalent amount of fats from safflower oil (SO) for 1 month, after which time the interventions were switched. The interventions were taken in the form of four capsules twice per day, and the sequence in which the interventions were taken was assigned in a randomized order.
The primary outcomes were measures of short-term spatial working memory (assessed by the Corsi block-tapping test) and sustained attention (assessed by the d2 test of attention). The secondary outcomes included measures of inhibition and cognitive flexibility (assessed by the Stroop color and word test) and ADHD symptoms, cognitive function, and social behavior (assessed using neurocognitive questionnaires). The testing was performed at baseline and at the end of each intervention.
The results
Compared to SO, spatial working memory and sustained attention were both improved with FO, as indicated by Corsi scores (which improved by 0.3 standard deviations) and the odds for d2 errors (which were 30% lower with FO).
ADHD symptoms and the behavior regulation index also improved with FO supplementation in participants with ADHD. The participants without ADHD had the most improvements with FO on the d2 test but performed slightly worse compared to SO on the test for executive function. ASD symptoms were not affected by the intervention.
The authors noted that the evidence suggests that fish oil supplementation may improve attention and working memory in adults with ASD and improve ADHD symptoms in individuals with both ASD and ADHD.
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