Cell reports. MedicineMar 10, 2026

Changes in the gut microbiome linked to physical and behavioral traits in autism

Gut-Brain Axis Weekly Brief ↗PubMed ↗DOI ↗

Updated Jun 27, 2026

Abstract

Essence

In children with ASD, gut microbiome differences, especially Clostridioides difficile abundance, were linked to symptom severity and brain structure.

Evidence

This observational multi-omics analysis compared neuroimaging, gut microbiome, and plasma metabolome data from 326 children with ASD and 169 typically developing controls aged 0-10 years.

Caveat

The microbe-metabolite-brain pathway came from predictive and mediation models, so it cannot prove causality, and the ASD-control differences diminished with age.

Simplified

This study employs a multi-omics approach to investigate the gut-brain axis in 326 children with autism spectrum disorder (ASD) and 169 typically developing (TD) controls, aged 0-10 years. By analyzing neuroimaging, gut microbiome, and plasma metabolome data, we find that microbial features could accurately distinguish ASD from TD children. A key finding is that gut microbial abundance, particularly an increase in Clostridioides difficile, serves as the strongest predictor of both ASD symptom severity and brain structural variations. Crucially, these gut and brain differences are age dependent, diminishing as children with ASD aged and converging toward TD patterns. A mediation model suggests a potential pathway where specific microbes influence brain structure and behavior via metabolites. The findings establish the gut microbiota as a robust predictor of brain and behavioral phenotypes in pediatric ASD, underscoring the necessity for early, age-stratified therapeutic strategies via modulating the composition of the gut microbiome.