Effect of N-3 Polyunsaturated Fatty Acid on Behavioral Response in Autism: A Systematic Review and Meta-Analysis

Saturday, May 13, 2017: 12:00 PM-1:40 PM
Golden Gate Ballroom (Marriott Marquis Hotel)
L. Lin, M. Dai, J. Liang, M. Cao, J. Jing and L. Cai, Department of Maternal and Child Health, Sun Yat-Sen University, Guangzhou, China
Background:  The deficits of n-3 polyunsaturated fatty acid (PUFA) is thought to be associated with behavioral abnormalities in autism spectrum disorder (ASD). However, the effectiveness of n-3 PUFA intervention aimed at improving the behavioral symptoms in ASD children has not been well established.

Objectives:  To examine the effects of n-3 PUFA supplement on behavioral response in ASD children.

Methods:  We searched PubMed, EMBASE, PsychINFO, Scopus, the Cochrane Library, SinoMed, CNKI, VIP and Wanfang database through February 12, 2016 for relevant full-text articles in English or Chinese. Randomized controlled trials (RCTs) were selected if they implemented n-3 PUFA supplement for at least four weeks in ASD and reported behavioral outcomes. The quality of the studies was examined by the Cochrane Collaboration’s tool for assessing risk of bias. Fixed-effects models were used in the meta-analysis.

Results: Among the 1502 identified articles, seven RCTs (n =216 subjects) were included. A few sporadic significant improvements were found in the n-3 PUFA group regarding social functioning, emotional and externalizing problems. Meta-analysis of four included RCTs applying the Aberrant Behavior Checklist (ABC) revealed significant improvements in the n-3 PUFA group compared to the control group with pooled effects of -1.98 (95% CI: -3.57, -0.39; P=0.015) in social withdrawal and -1.11 (95% CI: -2.18, -0.04; P=0.042) in stereotypic behavior of the ABC. Non-significant improvement on inappropriate speech, hyperactivity and irritability in the n-3 PUFA group was found. Variability in other behavioral outcomes across studies precluded meta-analysis.

Conclusions:  N-3 PUFA exerted significant improvements in social withdrawal and stereotypic behavior of ASD children. There was still insufficient evidence regarding the effect of n-3 PUFA on other behavioral response. More robust studies are required to establish full efficacy of n-3 PUFA supplement.