Thorsheim Corinne, Khan Sana, Lu Ye, Kauffman Robert P
Rocky Vista University College of Osteopathic Medicine, Parker, CO, United States.
Department of Obstetrics and Gynecology, Texas Tech University Health Sciences Center School of Medicine, Amarillo, TX, United States.
Front Psychiatry. 2025 May 29;16:1577707. doi: 10.3389/fpsyt.2025.1577707. eCollection 2025.
Attention deficit hyperactivity disorder (ADHD) is a widely prevalent neurodevelopmental disorder that affects millions of children and adolescents in the U.S. Despite the growing number of diagnoses, the maternal exacerbating and protective factors influencing ADHD symptom severity in offspring remain largely understudied. This narrative review examines the interplay between genetic and epigenetic factors, focusing on specific single nucleotide polymorphisms, polygenic risk scores for ADHD and comorbidities, mitochondrial DNA haplotypes, and X-linked inheritance. Key epigenetic influences include maternal gestational weight gain, young parental age, parental gene-psychopathology interactions, shared genetic loci between maternal educational attainment and ADHD, maternal prenatal stress, maternal hostility and maltreatment, postnatal household chaos, and parenting styles, all which shape ADHD symptom severity in the context of genetic predispositions. Importantly, the positive effects of elevated socioeconomic status and positive parenting on symptom severity may also be influenced by maternal genetic factors, representing an avenue for further research. The maternal environmental factors associated with ADHD in offspring, such as acetaminophen exposure, maternal diet, vitamin D deficiency, and exposure to toxins, particularly from maternal smoking, are highlighted. Ultimately, this review seeks to uncover the combined impact of maternal environmental and existing factors on underlying parental genetics-a critical aspect often overlooked in existing studies. Clinical implications are also addressed, particularly concerning differences in beta and theta wave activity and variations in cerebral blood flow in the dorsolateral prefrontal cortex between children with ADHD and those with comorbid autism spectrum disorder (ASD). By understanding these multifaceted factors, especially maternal contributions, alongside emerging clinical diagnostic strategies, better targeted interventions can be aimed at enhancing treatment efficacy and improving long-term outcomes for children with ADHD.
注意缺陷多动障碍（ADHD）是一种广泛流行的神经发育障碍，影响着美国数百万儿童和青少年。尽管诊断数量不断增加，但影响后代ADHD症状严重程度的母体加重和保护因素在很大程度上仍未得到充分研究。本叙述性综述探讨了遗传和表观遗传因素之间的相互作用，重点关注特定的单核苷酸多态性、ADHD及共病的多基因风险评分、线粒体DNA单倍型和X连锁遗传。关键表观遗传影响包括母体孕期体重增加、父母年龄小、父母基因与精神病理学相互作用、母体教育程度与ADHD之间的共享基因位点、母体产前压力、母体敌意和虐待、产后家庭混乱以及养育方式，所有这些在遗传易感性背景下塑造了ADHD症状严重程度。重要的是，社会经济地位提高和积极养育对症状严重程度的积极影响也可能受到母体遗传因素的影响，这代表了一个有待进一步研究的领域。强调了与后代ADHD相关的母体环境因素，如对乙酰氨基酚暴露、母体饮食、维生素D缺乏以及接触毒素，尤其是来自母体吸烟的毒素。最终，本综述旨在揭示母体环境和现有因素对潜在父母基因的综合影响——这是现有研究中经常被忽视的一个关键方面。还讨论了临床意义，特别是关于ADHD儿童与患有共病自闭症谱系障碍（ASD）儿童之间β波和θ波活动的差异以及背外侧前额叶皮质脑血流的变化。通过了解这些多方面因素，尤其是母体的影响，以及新兴的临床诊断策略，可以制定更有针对性的干预措施，以提高治疗效果并改善ADHD儿童的长期预后。
