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产前、围产期和产后因素与 ADHD 的关系:营养、饮食和压力的作用。

The Relationship Between Prenatal, Perinatal, and Postnatal Factors and ADHD: The Role of Nutrition, Diet, and Stress.

机构信息

Faculty of Medicine, Cyprus International University, Nicosia, Cyprus.

出版信息

Dev Psychobiol. 2024 Dec;66(8):e70004. doi: 10.1002/dev.70004.

Abstract

Attention-Deficit Hyperactive Disorder (ADHD) is a neurobehavioral syndrome affecting children aged 6-17 with symptoms manifesting before age 12. ADHD presents heterogeneously and is associated with various psychiatric disorders. The cause remains elusive, but genetic and environmental factors, brain region maturation delays, and neurotransmitter dysregulation are implicated. Effective treatment requires a multi-disciplinary approach, primarily involving pharmacological and behavioral intervention. Stimulants like methylphenidate and amphetamines are first-line medications, but non-stimulants may be considered for some patients. However, stimulants face challenges related to misuse, dependence, and long-term tolerability issues. The etiology of ADHD involved genetic predisposition, environmental influences, and prenatal, perinatal, and postnatal factors. Prenatal causes encompass maternal diet, alcohol consumption, viral infections, and stress. Postnatal factors include head trauma, meningitis, toxin, nutritional deficiencies, as well as iodine deficiency and hypothyroidism. The gut microbiome's role in ADHD is emerging, influencing neurodevelopment through microbiota-gut-brain axis. Understanding these diverse etiological factors is essential for comprehensive ADHD management.

摘要

注意缺陷多动障碍(ADHD)是一种影响 6-17 岁儿童的神经行为综合征,其症状在 12 岁前表现出来。ADHD 表现出异质性,与各种精神障碍有关。其病因仍不清楚,但遗传和环境因素、脑区成熟延迟以及神经递质调节紊乱都与之相关。有效的治疗需要多学科的方法,主要包括药物治疗和行为干预。哌甲酯和安非他命等兴奋剂是一线药物,但对于一些患者,也可以考虑使用非兴奋剂。然而,兴奋剂在滥用、依赖和长期耐受性方面存在挑战。ADHD 的病因涉及遗传易感性、环境影响以及产前、围产期和产后因素。产前因素包括母体饮食、饮酒、病毒感染和压力。产后因素包括头部创伤、脑膜炎、毒素、营养缺乏以及碘缺乏和甲状腺功能减退。肠道微生物组在 ADHD 中的作用正在显现,通过微生物群-肠道-大脑轴影响神经发育。了解这些不同的病因因素对于全面管理 ADHD 至关重要。

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