Gut-brain axis in Attention Deficit Hyperactivity Disorder (ADHD): A narrative review of the links between gut microbiota and ADHD pathophysiology

Feb 3, 2026Journal of psychiatric research

Gut bacteria and their possible links to brain function in ADHD

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Abstract

Changes in microbial composition and diversity are observed in individuals with Attention-Deficit Hyperactivity Disorder (ADHD).

The gut microbiota is increasingly recognized for its potential role in ADHD.
Reports indicate alterations in gut microbial profiles among individuals with ADHD, although results vary across different bacterial types.
Some evidence suggests a relationship between specific gut microbial profiles and the severity of ADHD symptoms.
Proposed mechanisms for the gut microbiota's influence on neurodevelopment include the production of short-chain fatty acids, immune system regulation, and neurotransmitter synthesis.
Methodological limitations in current research highlight the need for more rigorous studies to validate these findings.

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Characterized by developmentally inappropriate levels of inattention, hyperactivity, and impulsivity, Attention-Deficit Hyperactivity Disorder (ADHD) is the most prevalent neurodevelopmental disorder, posing a significant public health concern. Its etiopathogenesis is considered multifactorial with complex determinism but remains unclear. Recent research highlights the gut microbiota and the gut-brain axis as promising avenues for understanding and potentially treating ADHD, with a growing number of studies exploring alterations in gut microbiota composition among affected individuals. This narrative review examines the current literature on the role of the gut microbiota in ADHD and focuses on key findings about bacterial composition, how it may be linked to ADHD symptomatology, and the possible mechanisms involved. While studies consistently report changes in microbial composition and diversity in individuals with ADHD, results remain heterogeneous across taxonomic levels. Some compelling evidence also suggests a link between gut microbial profiles and ADHD symptom severity. The involvement of microbiota in influencing neurodevelopment is proposed to be mediated through mechanisms related to SCFA production, immune modulation, and neurotransmitter synthesis. These findings pave the way for microbiota-targeted interventions as adjunct therapies for ADHD. This review evaluates areas of consensus and discrepancies between studies, while addressing the methodological limitations present in this field of research. Although the gut microbiota appears to play a meaningful role in the complex and multifactorial origins of ADHD, more rigorous and comprehensive studies are needed to confirm these findings and translate them into effective clinical applications. This could ultimately improve both our understanding and treatment of this heterogeneous disorder.

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Gut-brain axis in Attention Deficit Hyperactivity Disorder (ADHD): A narrative review of the links between gut microbiota and ADHD pathophysiology

Abstract

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