Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder of childhood. Although abnormalities in several brain regions and disturbances of the catecholaminergic pathway have been demonstrated, the pathophysiology of ADHD is not completely understood, but as a multifactorial disorder, has been associated with an increase in oxidative stress and neuroinflammation. This review presents an overview of factors that increase oxidative stress and neuroinflammation. The imbalance between oxidants and antioxidants and also the treatment with medications are two factors that can increase oxidative damage, whereas the comorbidity between ADHD and inflammatory disorders, altered immune response, genetic and environmental associations, and polymorphisms in inflammatory-related genes can increase neuroinflammation. Evidence of an association with these factors has become valuable for research on ADHD. Such evidence opens up new intervention routes for the use of natural products as antioxidants that could have potential as a treatment against oxidative stress and neuroinflammation in ADHD.
Highlights
Clinical diagnosis of Attention-deficit/hyperactivity disorder (ADHD) is based on the presence of six or more symptoms that include inattention and hyperactivity/impulsivity and, according to the criteria of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), should be carried out when symptoms impair academic, occupational, and social behavior, the onset is before 12 years of age and the symptoms can be observed in multiple settings in the clinical interview, including the gestational, developmental, and family history [9]
The role of oxidative stress and neuroinflammation as possible factors involved in the pathophysiology of ADHD is discussed, along with a possible link to the medications used for treatment that may increase these factors
The pathophysiology of ADHD is associated with oxidative stress and neuroinflammation, due to the imbalance between oxidants and antioxidants, catecholaminergic dysregulation, medications used for treatment, genetic and environmental factors, and all those factors could be producing oxidative stress and neuroinflammation which further increases the symptoms and as a result, triggering a vicious circle
Summary
Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder in children characterized by inattention, hyperactivity, and/or impulsivity [1,2,3] that impairs the psychological, social, academic, and occupational function [4]. Clinical diagnosis of ADHD is based on the presence of six or more symptoms that include inattention and hyperactivity/impulsivity and, according to the criteria of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), should be carried out when symptoms impair academic, occupational, and social behavior, the onset is before 12 years of age and the symptoms can be observed in multiple settings in the clinical interview, including the gestational, developmental, and family history [9]. ADHD is a childhood disorder, a large percentage of children continue to have symptoms in adolescent life, and approximately 45% have symptoms as adults [1,14,15]
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