Dietary Patterns and Their Impact on the Microbiota–Gut–Brain Axis in Children with Neurodevelopmental Disorders

The microbiota–gut–brain axis (MGBA) has emerged as a central regulatory system in neurodevelopment, integrating immune, metabolic, endocrine, and neuronal signaling pathways. Increasing evidence indicates that alterations in gut microbiota composition (dysbiosis) may contribute to the pathophysiology of neurodevelopmental disorders (NDDs), including autism spectrum disorder, attention-deficit/hyperactivity disorder, and epilepsy. Among the various environmental factors shaping the gut microbiota, diet represents one of the most powerful and modifiable determinants. In early life, dietary exposures play a crucial role in the establishment and maturation of microbial communities, which in turn influence brain development during critical neurodevelopmental windows. Disruptions in this dynamic interplay may promote intestinal inflammation, immune dysregulation, and neuroinflammatory processes, ultimately affecting neurological outcomes. Children with NDDs, particularly those with epilepsy or developmental and epileptic encephalopathies (DEEs), frequently present gastrointestinal disturbances and altered microbial profiles, suggesting a bidirectional relationship between gut dysfunction and brain pathology. However, despite growing interest in microbiota-targeted interventions, a major limitation in the field remains the lack of a detailed baseline characterization of microbial signatures in these populations.