Anxiety Clinical Trial
Official title:
Effects of a Probiotic Supplement on Symptoms of ADHD and Anxiety in Children
The study will examine the effect of a probiotic supplement (Lactobacillus helveticus R0052 and Bifidobacterium Longum R0175) dissolved in a dairy product such as milk or ice-cream on symptoms of ADHD and anxiety in children. The main goal is to determine if probiotics might be useful as a treatment for anxiety and ADHD symptoms in children. A second goal is to examine the effects of probiotics on saliva cortisol levels. Finally, the investigators are also interested in the effects of the probiotics on children's digestive health.
Participants will be recruited using information distributed through schools in the
Annapolis Valley area and with the use of advertising campaigns visible across Nova Scotia
as previously described. Interested participants will be directed to the study's website
(www.probioticstudy.com), where they will be able to view a complete summary of the study's
timeline and details. After reviewing the website, guardians of potential participants will
be able to complete an initial consent form and preliminary questionnaire in order to
determine their child's eligibility for participation. The process of completing the consent
form and initial questionnaires is expected to take approximately 15 minutes. Participants'
responses to the preliminary questionnaire will be reviewed by the researchers, and initial
appointments will be scheduled, either at the Acadia University location or the Halifax
location.
Each participant will be enrolled in the study for a thirteen-week period with a six-month
follow-up session. The first week will be an information-gathering week during which
participants will complete a daily food diary online with their parents' assistance. Each
evening during this initial week, and at the end of each week throughout the study period,
the child will answer a few questions about his or her symptoms of anxiety and/or ADHD, and
gastrointestinal health. Parents/guardians will answer parallel questions about the child's
symptoms of anxiety and/or ADHD.
Confidentiality will be maintained by assigning each participant a code number based on the
last four digits of their phone number and the first letter of their last name when they
begin the study (for siblings the first letter of their first name will be used). The food
diary and all other subsequent questionnaires will be matched with the participant's data
via their code number. Participants or their guardians will be required to remember their
individual code, although, in the event they forget their code number, a master list will be
kept on an external hard-drive in an encrypted, password-protected file, locked in the
researchers' office.
During or shortly after the food-diary week, the researcher will schedule a meeting with
each participant and guardian in order to provide detailed instructions on the first phase
of the study and to obtain informed consent for continuation in the study from the
parent/guardian and assent from the child. During the first meeting parents/guardians will
complete study outcome measures. Child participants will also complete outcome measures and
cognitive tests. These measures will be administered once again following the completion of
the first phase (week five), following the four-week wash-out period (week nine), and the
second phase (week thirteen). These measures are the clinical trial's primary end-points.
Following the information-gathering week, participants will begin the first phase of the
study. They will consume either the probiotic or placebo powder taken with milk or ice cream
for four weeks. For the second phase, the conditions will be reversed, and the participant
will consume the alternate substance for four weeks; thus, all participants will receive the
probiotic in one phase and the placebo in another phase. The order in which participants
receive the probiotics and placebo will be randomized within groups of ten participants to
ensure counterbalancing - i.e., roughly equal numbers of participants receiving probiotics
and placebo in the first phase. The four-week intervention phases will be separated by a
four-week washout period to ensure that any potential residual effects from the first phase
have passed by the time the second phase commences. Following the wash-out period,
participants will complete the relevant outcome measures once again to establish baseline
scores prior to beginning the second intervention phase. Because this a double-blind design,
the participants, their parents/guardians and the researchers administering the probiotics
and placebos will not be aware which powder (probiotic or placebo) the participant is
receiving in each of the two phases; only the Clinical Director at Lallemand Health
Solutions will be privy to the experimental condition of the participants. Morning saliva
samples for cortisol analysis will be collected from participants during weeks two (baseline
visit), five (second visit), nine (third visit), and thirteen (fourth visit) of the study.
During the first week of each phase, the researcher will contact the participants by email
or phone on the third and sixth day to check in and make sure participants/their guardians
do not have any concerns and/or questions regarding their participation. Following the
initial week of each phase, participants will be contacted weekly in order to monitor
progress and address any concerns.
During first and second meetings, parents will be supplied with either probiotic or placebo
powder as well as detailed instructions for the first and second intervention phases. At the
fourth and final appointment, participants will complete the aforementioned questionnaires
(if not done online) and be given the opportunity to ask any questions they may have about
the study. If participants wish to know during which phase they received the probiotic
formula, they be supplied with this information following the completion of the study.
;
Allocation: Randomized, Intervention Model: Crossover Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Basic Science
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