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. 2022 Oct 2;12(10):1634.
doi: 10.3390/jpm12101634.

Association between Gut Microbiota and Emotional-Behavioral Symptoms in Children with Attention-Deficit/Hyperactivity Disorder

Min-Jing Lee  1   2 , Hsin-Chih Lai  3   4   5   6   7 , Yu-Lun Kuo  8 , Vincent Chin-Hung Chen  1   2
Affiliations

Association between Gut Microbiota and Emotional-Behavioral Symptoms in Children with Attention-Deficit/Hyperactivity Disorder

Min-Jing Lee et al. J Pers Med. .

Abstract

Previous studies have explored the role of the microbiome in attention-deficit/hyperactivity disorder (ADHD). However, whether the microbiome is correlated with emotional-behavioral disturbances, the most common comorbid symptom of ADHD, remains unclear. We established a cross-sectional study in which 6- to 18-year-old children with ADHD who were receiving no medication and a healthy control group of children without ADHD were recruited to analyze their microbiome composition. Microbiota of fecal samples were collected and analyzed using a 16s rRNA gene sequencing approach. In comparison with the healthy control group, the gut microbiota in children with ADHD exhibited significantly lower beta diversity. The abundance of the phylum Proteobacteria and the genera Agathobacter, Phascolarctobacterium, Prevotella_2, Acidaminococcus, Roseburia, and Ruminococcus gnavus group was increased in the ADHD group compared with the healthy group. Linear discriminant effect size (LEfSe) analysis was used to highlight specific bacteria phylotypes that were differentially altered between the ADHD and control groups. A regression analysis was performed to investigate the association between microbiota and emotional-behavioral symptoms in children with ADHD. A significant association was noted between withdrawal and depression symptoms and Agathobacter (p = 0.044), and between rule-breaking behavior and the Ruminococcus gnavus group (p = 0.046) after adjusting for sex, age, and the ADHD core symptoms score. This study advances the knowledge of how gut microbiota composition may contribute to emotional-behavioral symptoms in children with ADHD. The detailed mechanisms underlying the role of the gut microbiota in ADHD pathophysiology still require further investigation.

Keywords: attention-deficit/hyperactivity disorder; behavior; emotion; gut microbiota.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of enrollment of the study participants.
Figure 2
Figure 2
Beta diversity using unweighted and weighted uniFrac. Comparison of beta diversity measurements in ADHD children with treatment-naïve and healthy controls. Beta diversity, measured by unweighted (A) and weighted (B) unique fraction (UniFrac) is plotted for ADHD children with treatment-naïve (orange) and healthy controls (blue). The line inside the box represents the median, while the whiskers represent the lowest and highest values within the 1.5 interquartile range. Outliers as well as individual samples are shown as dots. The results indicated that there was significant difference in the gut microbiota communities between ADHD children with treatment-naïve and healthy controls.
Figure 3
Figure 3
PLS−DA. Partial Least Squares Discriminant Analysis (PLS−DA) of ADHD children with treatment-naïve and healthy controls. Each point represents a sample. The orange points represent ADHD children with treatment-naïve and the blue points represent healthy controls.
Figure 4
Figure 4
Linear discriminant effect size (LEfSe) analysis. Comparison of microbiota relative abundance at the genus level between ADHD children with treatment-naïve and healthy controls using LEfSe cladograms (A) and histogram of linear discriminant analysis (LDA, B). The bacterial difference was identified by Kruskal-Wallis test. Nominal significant threshold: p < 0.05.
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