ADHD肠道菌群及脑电变化相关性研究进展

Research Progress on the Correlation between Gut Microbiota and EEG Changes in ADHD

摘要: 注意力缺陷/多动障碍(attention-deficit hyperactivity disorder, ADHD)是一种常见的儿童神经发育障碍，其最典型的症状表现为与年龄不相称的注意力不集中、多动和冲动。该病通常在儿童时期起病，会对患儿的学业、社交和家庭生活等产生多种负面影响，如果没有适当的干预，这些负面影响可能会持续到成年，对社会造成不良的影响。目前全球范围内青少年的患病率超过5%，并且有逐年上升趋势。近年来新诊断的ADHD儿童越来越多，儿童ADHD仍然是一个持续且不断扩大的公共卫生问题。尽管多年来研究者对ADHD的探索不断深入，但目前其确切的病因和发病机制尚未完全明确。近年来，微生物–肠–脑轴研究的突破进展揭示了肠道菌群与ADHD发病机制的密切联系。而脑电图(electroencephalogram, EEG)作为一种无创、实时监测大脑电活动的技术，能精准捕获前额叶皮层、海马体等关键脑区的神经元同步化放电特征，为揭示ADHD的神经生理机制提供了重要窗口。微生物、脑电变化之间的联系越来越密切，越来越多的证据表明肠道微生物群是调节脑电变化的重要外周因素。此前的多项研究已经证实，肠道菌群可通过脑肠轴远程调控中枢神经系统(CNS)电生理活动，但肠道菌群如何影响脑电变化，及其影响机制，各类研究均有异质性，基于近年微生物–肠–脑轴研究的背景，此综述综合了肠道菌群改变及脑电变化在ADHD中的现有证据，研究探讨了二者如何通过神经通路、化学代谢通路、神经炎症、小胶质细胞极化、血脑屏障动态调节、表观遗传及神经振荡等中介机制促进ADHD的发展。未来需深化多维度研究的整合，明确关键菌群、代谢产物、神经递质与脑电节律的调控网络，为ADHD提供兼具诊断价值与治疗潜力的创新性方案，推动从机制研究到临床应用的跨越。

Abstract: Attention-deficit hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder in children, characterized by core symptoms of developmentally inappropriate inattention, hyperactivity, and impulsivity. The disorder typically onsets during childhood and exerts multifaceted adverse effects on affected children’s academic performance, social interactions, and family functioning. Without appropriate interventions, these negative impacts may persist into adulthood and incur detrimental consequences to society. Currently, the global prevalence of ADHD among adolescents exceeds 5%, exhibiting an upward trend year by year. In recent years, an increasing number of children have received new diagnoses of ADHD, rendering pediatric ADHD an ongoing and expanding public health concern. Despite decades of intensive research efforts, the exact etiology and pathogenesis of ADHD remain incompletely elucidated. In recent years, groundbreaking advances in microbiome-gut-brain axis research have unveiled a close association between dysbacteriosis and the pathogenesis of ADHD. Electroencephalography (EEG), as a non-invasive technique for real-time monitoring of cerebral electrical activity, can precisely capture the synchronous neuronal firing characteristics of key brain regions such as the prefrontal cortex and hippocampus. It thus serves as a crucial window for unraveling the neurophysiological mechanisms underlying ADHD. Mounting evidence indicates an increasingly tight link between intestinal flora and electroencephalographic alterations, with intestinal flora emerging as a vital peripheral modulator of brain electrical activity. Multiple studies have confirmed that intestinal flora can remotely regulate the electrophysiological functions of the central nervous system (CNS) via the gut-brain axis. However, substantial heterogeneity exists across studies regarding the specific pathways through which intestinal flora influence EEG patterns and the underlying mechanisms. Against the backdrop of recent advances in microbiome-gut-brain axis research, this review synthesizes the existing evidence regarding alterations in the gut microbiota and EEG changes in ADHD. It investigates how these two factors contribute to the progression of ADHD via a suite of intermediate mechanisms, including neural pathways, chemical metabolic pathways, neuroinflammation, microglial polarization, dynamic regulation of the blood-brain barrier (BBB), epigenetics, and neural oscillations. Future research should deepen the integration of multi-dimensional studies, clarify the regulatory networks linking key gut microbial taxa, metabolites, neurotransmitters and EEG rhythms, thereby providing innovative strategies with both diagnostic value and therapeutic potential for ADHD, and facilitating the translation from mechanistic research to clinical application.