Skip to main content

Gut microbiota and attention deficit hyperactivity disorder: new perspectives for a challenging condition


A bidirectional communication between the gut and the brain (gut–brain axis) is well recognized with the gut microbiota viewed as a key regulator of this cross-talk. Currently, a body of preclinical and to a lesser extent epidemiological evidence supports the notion that host–microbe interactions play a key role in brain development and function and in the etiology of neurodevelopmental disorders. Early life events and shifts away from traditional lifestyles are known to impact gut microbiota composition and function and, thereby, may increase the risk of developing neurodevelopmental disorders. Attention deficit hyperactivity disorder (ADHD) is nowadays the most prevalent neurodevelopmental disorder. Despite many years of research its etiology is unclear and its diagnosis and treatment are still challenging. Different factors reported to be associated with the risk of developing ADHD and/or linked to different ADHD manifestations have also been linked to shifts in gut microbiota composition, suggesting a link between the microbiota and the disorder. Evidence from preliminary human studies also suggests that dietary components that modulate gut microbiota may also influence ADHD development or symptoms, although further studies are warranted to confirm this hypothesis. Here, we firstly review the potential mechanisms by which the gut microbiota may regulate the brain–gut axis and influence behavior and neurodevelopmental disorders. Secondly, we discuss the current knowledge about the different factors and dietary components reported to be associated with the risk of developing ADHD or its manifestations and with shifts in gut microbiota composition. Finally, we briefly highlight the need to progress our understanding regarding the role of the gut microbiota in ADHD, since this could open new avenues for early intervention and improved management of the disease.

This is a preview of subscription content, access via your institution.

Fig. 1


  1. 1.

    Martens G, van Loo K (2007) Genetic and environmental factors in complex neurodevelopmental disorders. Curr Genom 8:429–444

    Article  Google Scholar 

  2. 2.

    Polanczyk G, de Lima MS, Horta BL, Biederman J, Rohde LA (2007) The worldwide prevalence of ADHD: a systematic review and metaregression analysis. Am J Psychiatry 164:942–948

    PubMed  Article  Google Scholar 

  3. 3.

    Kooij SJJ et al (2010) European consensus statement on diagnosis and treatment of adult ADHD: the European network adult ADHD. BMC Psychiatry 10:67

    PubMed  PubMed Central  Article  Google Scholar 

  4. 4.

    Trull TJ, Tragesser SL, Solhan M, Schwartz-Mette R (2007) Dimensional models of personality disorder: diagnostic and statistical manual of mental disorders fifth edition and beyond. Curr Opin Psychiatry 20:52–56

    PubMed  Article  Google Scholar 

  5. 5.

    Larson K, Russ SA, Kahn RS, Halfon N (2011) Patterns of comorbidity, functioning, and service use for US children with ADHD, 2007. Pediatrics 127:462–470

    PubMed  PubMed Central  Article  Google Scholar 

  6. 6.

    Dias TGC et al (2013) Developments and challenges in the diagnosis and treatment of ADHD. Rev Bras Psiquiatr 35:S40–S50

    PubMed  Article  Google Scholar 

  7. 7.

    Childress AC, Sallee FR (2014) Attention-deficit/hyperactivity disorder with inadequate response to stimulants: approaches to management. CNS Drugs 28:121–129

    CAS  PubMed  Article  Google Scholar 

  8. 8.

    Shyu Y-C et al (2015) Attention-deficit/hyperactivity disorder, methylphenidate use and the risk of developing schizophrenia spectrum disorders: a nationwide population-based study in Taiwan. Schizophr Res 168:161–167

    PubMed  Article  Google Scholar 

  9. 9.

    Martinez-Raga J, Knecht C, Szerman N, Martinez MI (2013) Risk of serious cardiovascular problems with medications for attention-deficit hyperactivity disorder. CNS Drugs 27:15–30

    CAS  PubMed  Article  Google Scholar 

  10. 10.

    Sprich S, Biederman J, Crawford MH, Mundy E, Faraone SV (2000) Adoptive and biological families of children and adolescents with ADHD. J Am Acad Child Adolesc Psychiatry 39:1432–1437

    CAS  PubMed  Article  Google Scholar 

  11. 11.

    Thapar A, Cooper M, Eyre O, Langley K (2013) Practitioner review: what have we learnt about the causes of ADHD? J Child Psychol Psychiatry 54:3–16

    PubMed  PubMed Central  Article  Google Scholar 

  12. 12.

    Sharma A, Couture J (2014) A review of the pathophysiology, etiology, and treatment of attention-deficit hyperactivity disorder (ADHD). Ann Pharmacother 48:209–225

    PubMed  Article  Google Scholar 

  13. 13.

    Banaschewski T, Becker K, Scherag S, Franke B, Coghill D (2010) Molecular genetics of attention-deficit/hyperactivity disorder: an overview. Eur Child Adolesc Psychiatry 19:237–257

    PubMed  PubMed Central  Article  Google Scholar 

  14. 14.

    Dinan TG, Cryan JF (2015) The impact of gut microbiota on brain and behaviour: implications for psychiatry. Curr Opin Clin Nutr Metab Care 18:552–558

    PubMed  Article  Google Scholar 

  15. 15.

    Borre YE et al (2014) Microbiota and neurodevelopmental windows: implications for brain disorders. Trends Mol Med. doi:10.1016/j.molmed.2014.05.002

    PubMed  Google Scholar 

  16. 16.

    Cryan JF, Dinan TG (2012) Mind-altering microorganisms: the impact of the gut microbiota on brain and behaviour. Nat Rev Neurosci 13:701–712

    CAS  PubMed  Article  Google Scholar 

  17. 17.

    McVey Neufeld K-A, Luczynski P, Seira Oriach C, Dinan TG, Cryan JF (2016) What’s bugging your teen?-The microbiota and adolescent mental health. Neurosci Biobehav Rev. doi:10.1016/j.neubiorev.2016.06.005

    PubMed  Google Scholar 

  18. 18.

    Luczynski P et al (2016) Growing up in a bubble: using germ-free animals to assess the influence of the gut microbiota on brain and behavior. Int J Neuropsychopharmacol. 19(8). doi:10.1093/ijnp/pyw020

  19. 19.

    Cryan JF, Dinan TG (2015) More than a gut feeling: the microbiota regulates neurodevelopment and behavior. Neuropsychopharmacology 40:241–242

    PubMed  Article  Google Scholar 

  20. 20.

    De Palma G et al (2015) Microbiota and host determinants of behavioural phenotype in maternally separated mice. Nat Commun 6:7735

    PubMed  Article  CAS  Google Scholar 

  21. 21.

    Collins SM, Kassam Z, Bercik P (2013) The adoptive transfer of behavioral phenotype via the intestinal microbiota: experimental evidence and clinical implications. Curr Opin Microbiol 16:240–245

    PubMed  Article  Google Scholar 

  22. 22.

    Rogers GB et al (2016) From gut dysbiosis to altered brain function and mental illness: mechanisms and pathways. Mol Psychiatry 21:738–748

    CAS  PubMed  PubMed Central  Article  Google Scholar 

  23. 23.

    Lyte M (2011) Probiotics function mechanistically as delivery vehicles for neuroactive compounds: microbial endocrinology in the design and use of probiotics. Bioessays 33:574–581

    CAS  PubMed  Article  Google Scholar 

  24. 24.

    Bercik P et al (2011) The intestinal microbiota affect central levels of brain-derived neurotropic factor and behavior in mice. Gastroenterology 141:599–609 (609.e1–3)

    CAS  PubMed  Article  Google Scholar 

  25. 25.

    Collins SM, Bercik P (2009) The relationship between intestinal microbiota and the central nervous system in normal gastrointestinal function and disease. Gastroenterology 136:2003–2014

    PubMed  Article  Google Scholar 

  26. 26.

    Barrett E, Ross RP, O’Toole PW, Fitzgerald GF, Stanton C (2012) γ-Aminobutyric acid production by culturable bacteria from the human intestine. J Appl Microbiol 113:411–417

    CAS  PubMed  Article  Google Scholar 

  27. 27.

    Dinan TG, Stanton C, Cryan JF (2013) Psychobiotics: a novel class of psychotropic. Biol Psychiatry 74:720–726

    CAS  PubMed  Article  Google Scholar 

  28. 28.

    Clarke G et al (2012) A distinct profile of tryptophan metabolism along the kynurenine pathway downstream of toll-like receptor activation in irritable bowel syndrome. Front Pharmacol 3:90

    CAS  PubMed  PubMed Central  Article  Google Scholar 

  29. 29.

    O’Mahony SM, Clarke G, Borre YE, Dinan TG, Cryan JF (2014) Serotonin, tryptophan metabolism and the brain–gut- microbiome axis. Behav Brain Res 277:32–48

    PubMed  Article  CAS  Google Scholar 

  30. 30.

    Maes M, Mihaylova I, Ruyter M De, Kubera M, Bosmans E (2007) The immune effects of TRYCATs (tryptophan catabolites along the IDO pathway): relevance for depression—and other conditions characterized by tryptophan depletion induced by inflammation. Neuro Endocrinol Lett 28:826–831

    CAS  PubMed  Google Scholar 

  31. 31.

    Guillemin GJ (2012) Quinolinic acid, the inescapable neurotoxin. FEBS J 279:1356–1365

    CAS  PubMed  Article  Google Scholar 

  32. 32.

    O’ Mahony SM, Clarke G, Dinan TG, Cryan JF (2015) Early life adversity and brain development: is the microbiome a missing piece of the puzzle? Neuroscience. doi:10.1016/j.neuroscience.2015.09.068

  33. 33.

    Clarke G et al (2013) The microbiome-gut–brain axis during early life regulates the hippocampal serotonergic system in a sex-dependent manner. Mol Psychiatry 18:666–673

    CAS  PubMed  Article  Google Scholar 

  34. 34.

    Desbonnet L, Garrett L, Clarke G, Bienenstock J, Dinan TG (2008) The probiotic Bifidobacteria infantis: an assessment of potential antidepressant properties in the rat. J Psychiatr Res 43:164–174

    PubMed  Article  Google Scholar 

  35. 35.

    Foley KA, MacFabe DF, Vaz A, Ossenkopp K-P, Kavaliers M (2014) Sexually dimorphic effects of prenatal exposure to propionic acid and lipopolysaccharide on social behavior in neonatal, adolescent, and adult rats: implications for autism spectrum disorders. Int J Dev Neurosci 39:68–78

    CAS  PubMed  Article  Google Scholar 

  36. 36.

    MacFabe DF et al (2007) Neurobiological effects of intraventricular propionic acid in rats: possible role of short chain fatty acids on the pathogenesis and characteristics of autism spectrum disorders. Behav Brain Res 176:149–169

    CAS  PubMed  Article  Google Scholar 

  37. 37.

    Stilling RM, Dinan TG, Cryan JF (2014) Microbial genes, brain and behaviour-epigenetic regulation of the gut–brain axis. Genes Brain Behav 13:69–86

    CAS  PubMed  Article  Google Scholar 

  38. 38.

    Erny D et al (2015) Host microbiota constantly control maturation and function of microglia in the CNS. Nat Neurosci 18:965–977

    CAS  PubMed  PubMed Central  Article  Google Scholar 

  39. 39.

    Corominas-Roso M et al (2013) Decreased serum levels of brain-derived neurotrophic factor in adults with attention-deficit hyperactivity disorder. Int J Neuropsychopharmacol 1–9. doi:10.1017/S1461145712001629

  40. 40.

    Sucksdorff M et al (2015) Preterm birth and poor fetal growth as risk factors of attention-deficit/hyperactivity disorder. Pediatrics. doi:10.1542/peds.2015-1043

    PubMed  Google Scholar 

  41. 41.

    Rodriguez A, Bohlin G (2005) Are maternal smoking and stress during pregnancy related to ADHD symptoms in children? J Child Psychol Psychiatry 46:246–254

    PubMed  Article  Google Scholar 

  42. 42.

    Zijlmans MAC, Korpela K, Riksen-Walraven JM, de Vos WM, de Weerth C (2015) Maternal prenatal stress is associated with the infant intestinal microbiota. Psychoneuroendocrinology 53:233–245

    PubMed  Article  Google Scholar 

  43. 43.

    Barrett E et al (2013) The individual-specific and diverse nature of the preterm infant microbiota. Arch Dis Child Fetal Neonatal Ed 98:F334–F340

    PubMed  Article  Google Scholar 

  44. 44.

    Jakobsson HE et al (2014) Decreased gut microbiota diversity, delayed bacteroidetes colonisation and reduced Th1 responses in infants delivered by caesarean section. Gut 63:559–566

    CAS  PubMed  Article  Google Scholar 

  45. 45.

    Grönlund MM, Lehtonen OP, Eerola E, Kero P (1999) Fecal microflora in healthy infants born by different methods of delivery: permanent changes in intestinal flora after cesarean delivery. J Pediatr Gastroenterol Nutr 28:19–25

    PubMed  Article  Google Scholar 

  46. 46.

    Dominguez-Bello MG et al (2010) Delivery mode shapes the acquisition and structure of the initial microbiota across multiple body habitats in newborns. Proc Natl Acad Sci USA 107:11971–11975

    PubMed  PubMed Central  Article  Google Scholar 

  47. 47.

    Boksa P, El-Khodor BF (2003) Birth insult interacts with stress at adulthood to alter dopaminergic function in animal models: possible implications for schizophrenia and other disorders. Neurosci Biobehav Rev 27:91–101

    CAS  PubMed  Article  Google Scholar 

  48. 48.

    Curran EA et al (2015) Association between obstetric mode of delivery and autism spectrum disorder: a population-based sibling design study. JAMA psychiatry 72:935–942

    PubMed  Article  Google Scholar 

  49. 49.

    Curran EA et al (2015) Research review: birth by caesarean section and development of autism spectrum disorder and attention-deficit/hyperactivity disorder: a systematic review and meta-analysis. J Child Psychol Psychiatry 56:500–508

    PubMed  Article  Google Scholar 

  50. 50.

    Talge NM, Allswede DM, Holzman C (2016) Gestational age at term, delivery circumstance, and their association with childhood attention deficit hyperactivity disorder symptoms. Paediatr Perinat Epidemiol 30:171–180

    PubMed  Article  Google Scholar 

  51. 51.

    Amiri S, Malek A, Sadegfard M, Abdi S (2012) Pregnancy-related maternal risk factors of attention-deficit hyperactivity disorder: a case-control study. ISRN Pediatr 2012:458064

    PubMed  PubMed Central  Article  Google Scholar 

  52. 52.

    Chu S-M et al (2012) The relationship between attention deficit hyperactivity disorder and premature infants in Taiwanese: a case control study. BMC Psychiatry 12:85

    PubMed  PubMed Central  Article  Google Scholar 

  53. 53.

    Johnson S et al (2016) Antecedents of attention-deficit/hyperactivity disorder symptoms in children born extremely preterm. J Dev Behav Pediatr 37:285–297

    PubMed  PubMed Central  Article  Google Scholar 

  54. 54.

    Becattini S, Taur Y, Pamer EG (2016) Antibiotic-induced changes in the intestinal microbiota and disease. Trends Mol Med 22:458–478

    CAS  PubMed  PubMed Central  Article  Google Scholar 

  55. 55.

    Sternbach H, State R (1997) Antibiotics: neuropsychiatric effects and psychotropic interactions. Harv Rev Psychiatry 5:214–226

    CAS  PubMed  Article  Google Scholar 

  56. 56.

    Van den Bergh BRH, Marcoen A (2004) High antenatal maternal anxiety is related to ADHD symptoms, externalizing problems, and anxiety in 8- and 9-year-olds. Child Dev 75:1085–1097

    PubMed  Article  Google Scholar 

  57. 57.

    Li J, Olsen J, Vestergaard M, Obel C (2010) Attention-deficit/hyperactivity disorder in the offspring following prenatal maternal bereavement: a nationwide follow-up study in Denmark. Eur Child Adolesc Psychiatry 19:747–753

    PubMed  Article  Google Scholar 

  58. 58.

    Grizenko N, Shayan YR, Polotskaia A, Ter-Stepanian M, Joober R (2008) Relation of maternal stress during pregnancy to symptom severity and response to treatment in children with ADHD. J Psychiatry Neurosci 33:10–16

    PubMed  PubMed Central  Google Scholar 

  59. 59.

    Culhane JF et al (2001) Maternal stress is associated with bacterial vaginosis in human pregnancy. Matern Child Health J 5:127–134

    CAS  PubMed  Article  Google Scholar 

  60. 60.

    Sudo N et al (2004) Postnatal microbial colonization programs the hypothalamic-pituitary-adrenal system for stress response in mice. J Physiol 558:263–275

    CAS  PubMed  PubMed Central  Article  Google Scholar 

  61. 61.

    Sterley T-L, Howells FM, Russell VA (2013) Maternal separation increases GABA(A) receptor-mediated modulation of norepinephrine release in the hippocampus of a rat model of ADHD, the spontaneously hypertensive rat. Brain Res 1497:23–31

    CAS  PubMed  Article  Google Scholar 

  62. 62.

    Womersley JS, Hsieh JH, Kellaway LA, Gerhardt GA, Russell VA (2011) Maternal separation affects dopamine transporter function in the spontaneously hypertensive rat: an in vivo electrochemical study. Behav Brain Funct 7:49

    CAS  PubMed  PubMed Central  Article  Google Scholar 

  63. 63.

    Sanz Y (2016) Bifidobacteria in Foods: health Effects. Encycl Food Heal 1:388–394

    Article  Google Scholar 

  64. 64.

    Mann JR, McDermott S (2011) Are maternal genitourinary infection and pre-eclampsia associated with ADHD in school-aged children? J Atten Disord 15:667–673

    PubMed  Article  Google Scholar 

  65. 65.

    Silva D, Colvin L, Hagemann E, Bower C (2014) Environmental risk factors by gender associated with attention-deficit/hyperactivity disorder. Pediatrics 133:e14–e22

    PubMed  Article  Google Scholar 

  66. 66.

    Hsiao EY et al (2013) Microbiota modulate behavioral and physiological abnormalities associated with neurodevelopmental disorders. Cell 155:1451–1463

    CAS  PubMed  PubMed Central  Article  Google Scholar 

  67. 67.

    Derecki NC et al (2010) Regulation of learning and memory by meningeal immunity: a key role for IL-4. J Exp Med 207:1067–1080

    CAS  PubMed  PubMed Central  Article  Google Scholar 

  68. 68.

    Ceylan MF et al (2014) Increased levels of serum neopterin in attention deficit/hyperactivity disorder (ADHD). J Neuroimmunol. doi:10.1016/j.jneuroim.2014.06.002

    PubMed  Google Scholar 

  69. 69.

    Rivera HM, Christiansen KJ, Sullivan EL (2015) The role of maternal obesity in the risk of neuropsychiatric disorders. Front Neurosci 9:194

    PubMed  PubMed Central  Article  Google Scholar 

  70. 70.

    Jo H et al (2015) Maternal prepregnancy body mass index and child psychosocial development at 6 years of age. Pediatrics 135:e1198–e1209

    PubMed  PubMed Central  Article  Google Scholar 

  71. 71.

    Rodriguez A et al (2008) Maternal adiposity prior to pregnancy is associated with ADHD symptoms in offspring: evidence from three prospective pregnancy cohorts. Int J Obes (Lond) 32:550–557

    CAS  Article  Google Scholar 

  72. 72.

    Kang SS, Kurti A, Fair DA, Fryer JD (2014) Dietary intervention rescues maternal obesity induced behavior deficits and neuroinflammation in offspring. J Neuroinflammation 11:156

    PubMed  PubMed Central  Article  CAS  Google Scholar 

  73. 73.

    Cabrera-Rubio R et al (2012) The human milk microbiome changes over lactation and is shaped by maternal weight and mode of delivery. Am J Clin Nutr 96:544–551

    CAS  PubMed  Article  Google Scholar 

  74. 74.

    Cortese S et al (2015) Association between ADHD and obesity: a systematic review and meta-analysis. Am J Psychiatry appiajp201515020266. doi:10.1176/appi.ajp.2015.15020266

  75. 75.

    Cani PD (2013) Gut microbiota and obesity: lessons from the microbiome. Brief Funct Genom 12:381–387

    CAS  Article  Google Scholar 

  76. 76.

    Foster JA, McVey Neufeld K-A (2013) Gut–brain axis: how the microbiome influences anxiety and depression. Trends Neurosci 36:305–312

    CAS  PubMed  Article  Google Scholar 

  77. 77.

    Mimouni-Bloch A et al (2013) Breastfeeding may protect from developing attention-deficit/hyperactivity disorder. Breastfeed Med 8:363–367

    PubMed  Article  Google Scholar 

  78. 78.

    Park S et al (2014) Protective effect of breastfeeding with regard to children’s behavioral and cognitive problems. Nutr J 13:111

    PubMed  PubMed Central  Article  Google Scholar 

  79. 79.

    David LA et al (2013) Diet rapidly and reproducibly alters the human gut microbiome. Nature. doi:10.1038/nature12820

  80. 80.

    Dash S, Clarke G, Berk M, Jacka FN (2015) The gut microbiome and diet in psychiatry: focus on depression. Curr Opin Psychiatry 28:1–6

    PubMed  Article  Google Scholar 

  81. 81.

    Psaltopoulou T et al (2013) Mediterranean diet, stroke, cognitive impairment, and depression: a meta-analysis. Ann Neurol 74:580–591

    PubMed  Article  Google Scholar 

  82. 82.

    Jacka FN et al (2013) Maternal and early postnatal nutrition and mental health of offspring by age 5 years: a prospective cohort study. J Am Acad Child Adolesc Psychiatry 52:1038–1047

    PubMed  Article  Google Scholar 

  83. 83.

    Konikowska K, Regulska-Ilow B, Rózańska D (2012) The influence of components of diet on the symptoms of ADHD in children. Rocz Państwowego Zakładu Hig 63:127–134

    CAS  Google Scholar 

  84. 84.

    Pelsser LM et al (2011) Effects of a restricted elimination diet on the behaviour of children with attention-deficit hyperactivity disorder (INCA study): a randomised controlled trial. Lancet 377:494–503

    CAS  PubMed  Article  Google Scholar 

  85. 85.

    Sonuga-Barke EJS et al (2013) Nonpharmacological interventions for ADHD: systematic review and meta-analyses of randomized controlled trials of dietary and psychological treatments. Am J Psychiatry 170:275–289

    PubMed  Article  Google Scholar 

  86. 86.

    Stulnig TM, Zeyda M (2004) Immunomodulation by polyunsaturated fatty acids: impact on T-cell signaling. Lipids 39:1171–1175

    CAS  PubMed  Article  Google Scholar 

  87. 87.

    Kaliannan K, Wang B, Li X-Y, Kim K-J, Kang JX (2015) A host–microbiome interaction mediates the opposing effects of omega-6 and omega-3 fatty acids on metabolic endotoxemia. Sci Rep 5:11276

    CAS  PubMed  PubMed Central  Article  Google Scholar 

  88. 88.

    Yu H-N et al (2014) Effects of fish oil with a high content of n-3 polyunsaturated fatty acids on mouse gut microbiota. Arch Med Res 45:195–202

    CAS  PubMed  Article  Google Scholar 

  89. 89.

    Chassaing B et al (2015) Dietary emulsifiers impact the mouse gut microbiota promoting colitis and metabolic syndrome. Nature 519:92–96

    CAS  PubMed  PubMed Central  Article  Google Scholar 

  90. 90.

    Hawkey E, Nigg JT (2014) Omega-3 fatty acid and ADHD: blood level analysis and meta-analytic extension of supplementation trials. Clin Psychol Rev 34:496–505

    PubMed  PubMed Central  Article  Google Scholar 

  91. 91.

    Ferreira CF et al (2014) Correlation between n-3 polyunsaturated fatty acids consumption and BDNF peripheral levels in adolescents. Lipids Health Dis 13:44

    PubMed  PubMed Central  Article  CAS  Google Scholar 

  92. 92.

    Howard AL et al (2011) ADHD is associated with a ‘Western’ dietary pattern in adolescents. J Atten Disord 15:403–411

    PubMed  Article  Google Scholar 

  93. 93.

    Freeman MP et al (2006) Omega-3 fatty acids: evidence basis for treatment and future research in psychiatry. J Clin Psychiatry 67:1954–1967

    CAS  PubMed  Article  Google Scholar 

  94. 94.

    Zhang X-W, Hou W-S, Li M, Tang Z-Y (2015) Omega-3 fatty acids and risk of cognitive decline in the elderly: a meta-analysis of randomized controlled trials. Aging Clin Exp Res. doi:10.1007/s40520-015-0381-9

    Google Scholar 

  95. 95.

    Letenneur L, Proust-Lima C, Le Gouge A, Dartigues JF, Barberger-Gateau P (2007) Flavonoid intake and cognitive decline over a 10-year period. Am J Epidemiol 165:1364–1371

    CAS  PubMed  Article  Google Scholar 

  96. 96.

    Desideri G et al (2012) Benefits in cognitive function, blood pressure, and insulin resistance through cocoa flavanol consumption in elderly subjects with mild cognitive impairment: the cocoa, cognition, and aging (CoCoA) study. Hypertension 60:794–801

    CAS  PubMed  Article  Google Scholar 

  97. 97.

    Dvoráková M et al (2007) Urinary catecholamines in children with attention deficit hyperactivity disorder (ADHD): modulation by a polyphenolic extract from pine bark (pycnogenol). Nutr Neurosci 10:151–157

    PubMed  Article  CAS  Google Scholar 

  98. 98.

    Selma MV, Espín JC, Tomás-Barberán FA (2009) Interaction between phenolics and gut microbiota: role in human health. J Agric Food Chem 57:6485–6501

    CAS  PubMed  Article  Google Scholar 

  99. 99.

    Duda-Chodak A, Tarko T, Satora P, Sroka P (2015) Interaction of dietary compounds, especially polyphenols, with the intestinal microbiota: a review. Eur J Nutr 54:325–341

    CAS  PubMed  PubMed Central  Article  Google Scholar 

  100. 100.

    Laparra JM, Sanz Y (2010) Interactions of gut microbiota with functional food components and nutraceuticals. Pharmacol Res 61:219–225

    CAS  PubMed  Article  Google Scholar 

  101. 101.

    McKeown C, Hisle-Gorman E, Eide M, Gorman GH, Nylund CM (2013) Association of constipation and fecal incontinence with attention-deficit/hyperactivity disorder. Pediatrics 132:e1210–e1215

    PubMed  PubMed Central  Article  Google Scholar 

  102. 102.

    Stevens LJ, Kuczek T, Burgess JR, Hurt E, Arnold LE (2011) Dietary sensitivities and ADHD symptoms: thirty-five years of research. Clin Pediatr (Phila) 50:279–293

    Article  Google Scholar 

  103. 103.

    Pärtty A, Kalliomäki M, Wacklin P, Salminen S, Isolauri E (2015) A possible link between early probiotic intervention and the risk of neuropsychiatric disorders later in childhood: a randomized trial. Pediatr Res 77:823–828

    PubMed  Article  Google Scholar 

  104. 104.

    Sekirov I, Russell SL, Antunes LCM, Finlay BB (2010) Gut microbiota in health and disease. Physiol Rev 90:859–904

    CAS  PubMed  Article  Google Scholar 

  105. 105.

    Chung H, Kasper DL (2010) Microbiota-stimulated immune mechanisms to maintain gut homeostasis. Curr Opin Immunol 22:455–460

    CAS  PubMed  Article  Google Scholar 

  106. 106.

    Atarashi K, Honda K (2011) Microbiota in autoimmunity and tolerance. Curr Opin Immunol 23:761–768

    CAS  PubMed  Article  Google Scholar 

  107. 107.

    Verlaet AAJ, Noriega DB, Hermans N, Savelkoul HFJ (2014) Nutrition, immunological mechanisms and dietary immunomodulation in ADHD. Eur Child Adolesc Psychiatry 23:519–529

    PubMed  Article  Google Scholar 

  108. 108.

    Toral M et al (2014) The probiotic Lactobacillus coryniformis CECT5711 reduces the vascular pro-oxidant and pro-inflammatory status in obese mice. Clin Sci 127:33–45

    PubMed  Article  Google Scholar 

  109. 109.

    Chen L et al (2013) Lactobacillus acidophilus ATCC 4356 attenuates the atherosclerotic progression through modulation of oxidative stress and inflammatory process. Int Immunopharmacol 17:108–115

    PubMed  Article  CAS  Google Scholar 

  110. 110.

    Joseph N, Zhang-James Y, Perl A, Faraone SV (2015) Oxidative stress and ADHD: a meta-analysis. J Atten Disord 19:915–924

    PubMed  Article  Google Scholar 

  111. 111.

    Kul M et al (2015) Evaluation of oxidative metabolism in child and adolescent patients with attention deficit hyperactivity disorder. Psychiatry Investig 12:361–366

    CAS  PubMed  PubMed Central  Article  Google Scholar 

  112. 112.

    Sezen H et al (2016) Increased oxidative stress in children with attention deficit hyperactivity disorder. Redox Rep 21:248–253

    CAS  PubMed  Article  Google Scholar 

Download references


This work was supported by Grant AGL2014-52101-P from the Spanish Ministry of Economy and Competitiveness (MINECO). The Sara Borrell postdoctoral contract of MCC from ISCIII and the PTA contract of IC from MINECO are fully acknowledged.

Author information



Corresponding authors

Correspondence to María Carmen Cenit or Yolanda Sanz.

Ethics declarations

Conflict of interest

The authors declare no conflict of interest.

Additional information

This article is part of the Focused Issue “The role of nutrition in child and adolescent onset mental disorders” of European Child and Adolescent Psychiatry.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Cenit, M.C., Nuevo, I.C., Codoñer-Franch, P. et al. Gut microbiota and attention deficit hyperactivity disorder: new perspectives for a challenging condition. Eur Child Adolesc Psychiatry 26, 1081–1092 (2017).

Download citation


  • Microbiota
  • ADHD
  • Microbiota
  • Gut–brain axis
  • Dysbiosis