WHAT IS ADHD?
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by persistent inattention, hyperactivity, and impulsivity that interfere with daily functioning and development. It is most often diagnosed in childhood but can persist into adulthood.
WHEN DOES ADHD START?
Symptoms of ADHD usually appear in early childhood, often before age 12. However, the first signs may be noticeable as early as preschool age (ages 3–5). It is a chronic condition that can persist throughout life.
CLINICAL MANIFESTATIONS OF ADHD
The main symptoms of ADHD fall into two categories:
Inattention: difficulty concentrating, distractibility, forgetfulness, poor organization, difficulty following instructions.
Hyperactivity-impulsivity: restlessness, excessive talkativeness, difficulty sitting still, interrupting conversations, impulsive behavior.
Symptoms may manifest as predominant inattention, predominant hyperactivity-impulsivity, or a mixed type.
WHAT CHANGES IN THE BRAIN PRECURSE ADHD?
ADHD is associated with structural and functional abnormalities of the brain, including:
Disruption of dopamine and norepinephrine transmission.
Delayed maturation of the cerebral cortex, especially in the frontal lobe.
Decreased volume of gray matter in certain areas of the brain.
An imbalance in the brain's default mode network (DMN), making it difficult to maintain concentration.
WHAT SPECIFIC AREAS OF THE BRAIN ARE AFFECTED?
Key areas covered:
Prefrontal cortex – responsible for executive functions, impulse control, and attention.
Basal ganglia (striatum, caudate nucleus, putamen) – involved in movement control and learning.
Anterior cingulate cortex (ACC) – regulates cognitive control and error processing.
Cerebellum – affects coordination of movements and cognitive processes.
Corpus callosum - its changes can lead to disruption of interaction between the hemispheres of the brain.
OFFICIAL VIEWS ON THE CAUSES OF ADHD
The main factors that determine the development of ADHD:
Genetics – heritability is up to 50%.
Neurochemical disturbances – dopamine and norepinephrine dysfunction.
Environmental factors – exposure to toxins (lead), stress, prematurity, chronic infections, etc.
Delayed brain development – slower maturation of the areas responsible for attention and impulse control.
THE ROLE OF INFLAMMATION AND NEUROINFLAMMATORY IN ADHD
Growing evidence links ADHD to inflammation in the brain:
Increased levels of proinflammatory cytokines (IL-6, TNF-α).
Increased activation of microglia leading to neuronal damage.
Association between maternal immune activation during pregnancy and increased risk of ADHD in the child.
THE ROLE OF CHRONIC AND LATENT INFECTIONS IN ADHD
Chronic infections such as cytomegalovirus (CMV), Epstein-Barr virus (EBV), Mycoplasma pneumoniae may contribute to the development of ADHD.
Latent infections can cause long-term inflammation, alter the immune system, and affect brain function.
Association between streptococcal infections (PANDAS/PANS) and ADHD symptoms.
ADHD AND IMMUNE SYSTEM DYSREGULATION
People with ADHD have been shown to have immune abnormalities, including altered cytokine levels and T-cell dysfunction.
Increased risk of autoimmune diseases (celiac disease, asthma, rheumatoid arthritis).
Dysregulation of immune responses may impact brain development.
ADHD AND THE MICROBIOME
Disturbances in the gut-brain axis may contribute to the development of ADHD.
ADHD patients often exhibit:
Deficiency of Bifidobacteria, Lactobacilli.
Increased number of opportunistic bacteria (Proteobacteria).
Impaired synthesis of short-chain fatty acids (SCFAs), which are important for brain function.
Research shows that probiotics may improve ADHD symptoms.
ADHD AND ENDOCRINE DYSREGULATION
ADHD is associated with dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis, resulting in abnormal cortisol levels.
Hypothyroidism and thyroid hormone imbalances can worsen cognitive and behavioral symptoms.
Association of ADHD with insulin resistance and metabolic syndrome.
ADHD AND METABOLIC DYSREGULATION
Impaired glucose metabolism and insulin sensitivity, which affects dopamine regulation.
Possible role of mitochondrial dysfunction in the pathogenesis of ADHD.
Elevated levels of oxidative stress in patients with ADHD.
OFFICIAL ADHD TREATMENT METHODS
Pharmacological therapy:
Psychostimulants: methylphenidate (Ritalin), amphetamines (Adderall) – increase the levels of dopamine and norepinephrine.
Non-stimulant drugs: atomoxetine (Strattera), guanfacine, clonidine – affect the norepinephrine system.
Behavioural therapy: cognitive behavioural therapy (CBT), parent training, social training.
Lifestyle changes:
Diet correction (elimination of artificial additives, enrichment of the diet with omega-3).
Physical activity, improving sleep quality.
ANTI-INFLAMMATORY AND ANTI-INFECTIOUS METHODS OF ADHD TREATMENT
Anti-inflammatory therapy:
Anti-infective therapy: (antiviral, antibacterial, antifungal, antiparasitic, etc.)
Restoration and regulation of the microbiome: Probiotics, prebiotics, postbiotics, metabiotics.
DIET
Exclusion of gluten, casein, artificial additives.
Ketogenic or low-carb diet.