The effect of sulforaphane on autism spectrum disorder: systematic review and meta-analysis.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized controlled trials
PubMed 40458076 · doi:10.17179/excli2025-8239
What was done
Systematic review and meta-analysis of randomized controlled trials (RCTs) assessing sulforaphane for autism spectrum disorder (ASD) across eight databases searched through September 2024. Six RCTs met inclusion criteria. Symptom efficacy outcomes were pooled using mean differences (MD) or standardized mean differences (SMD), safety was assessed via relative risk of adverse events, study quality was appraised using the Cochrane risk-of-bias tool, and evidence certainty was evaluated with GRADE.
What was found
Sulforaphane significantly improved total ASD symptoms (SMD = -0.27, 95% CI: -0.42 to -0.12), aberrant behavior (SMD = -0.43, 95% CI: -0.66 to -0.19), hyperactivity (SMD = -0.58, 95% CI: -1.03 to -0.13), social interaction (SMD = -0.43, 95% CI: -0.59 to -0.27), social communication (SMD = -0.24, 95% CI: -0.35 to -0.12), and restricted and repetitive behaviors (SMD = -0.16, 95% CI: -0.31 to -0.00). Effects on irritability, anxiety, sensory sensitivity, total social skills, social awareness, social cognition, and social motivation were not statistically significant. Rates of adverse events did not differ significantly between sulforaphane and control groups.
Why it matters
This review suggests sulforaphane may provide modest benefits for certain behavioral and social domains in ASD with a favorable safety profile, addressing a condition with few pharmacological options.
Limits
The meta-analysis is based on only six RCTs, and the total participant count is not reported in the abstract. Several domains (irritability, anxiety, sensory sensitivity, overall social skills) showed no significant benefit. The authors note potential confounding from variability in assessment tools, outcome assessors, and intervention durations, and long-term efficacy and safety remain unconfirmed.