Lewis Naomi, Villani Anthony, Lagopoulos Jim
School of Health, University of the Sunshine Coast, 90 Sippy Downs Dr, Sippy Downs, QLD 4556, Australia; Thompson Institute, University of the Sunshine Coast, 12 Innovation Pkwy, Birtinya, QLD 4575, Australia.
School of Health, University of the Sunshine Coast, 90 Sippy Downs Dr, Sippy Downs, QLD 4556, Australia.
Neuroscience. 2025 Mar 17;569:298-321. doi: 10.1016/j.neuroscience.2025.01.031. Epub 2025 Jan 21.
There is mounting evidence for the involvement of the immune system, neuroinflammation and disturbed gut microbiota, or dysbiosis, in attention-deficit/hyperactivity disorder (ADHD). Gut dysbiosis is strongly implicated in many physical, autoimmune, neurological, and neuropsychiatric conditions, however knowledge of its particular pathogenic role in ADHD is sparse. As such, this narrative review examines and synthesizes the available evidence related to inflammation, dysbiosis, and neural processes in ADHD. Minimal differences in microbiota diversity measures between cases and controls were found, however many relative abundance differences were observed at all classification levels (phylum to strain). Compositional differences of taxa important to key gut-brain axis pathways, in particular Bacteroides species and Faecalibacterium, may contribute to inflammation, brain functioning differences, and symptoms, in ADHD. We have identified one possible model of ADHD etiopathogenesis involving systemic inflammation, an impaired blood-brain barrier, and neural disturbances as downstream consequences of gut dysbiosis. Nevertheless, studies conducted to date have varied degrees of methodological rigour and involve diverse participant characteristics and analytical techniques, highlighting a need for additional research.
越来越多的证据表明，免疫系统、神经炎症以及肠道微生物群紊乱（即生态失调）与注意力缺陷多动障碍（ADHD）有关。肠道生态失调与许多身体、自身免疫、神经和神经精神疾病密切相关，然而，关于其在ADHD中具体致病作用的了解却很少。因此，本叙述性综述审视并综合了与ADHD中炎症、生态失调和神经过程相关的现有证据。虽然在病例组和对照组之间发现微生物群多样性测量的差异很小，但在所有分类水平（从门到菌株）都观察到了许多相对丰度差异。对关键肠-脑轴途径重要的分类群的组成差异，特别是拟杆菌属和粪杆菌属，可能导致ADHD中的炎症、脑功能差异和症状。我们已经确定了一种ADHD病因发病机制的可能模型，该模型涉及全身炎症、血脑屏障受损以及作为肠道生态失调下游后果的神经紊乱。然而，迄今为止进行的研究在方法严谨程度上各不相同，涉及不同的参与者特征和分析技术，这突出表明需要更多的研究。
