This study aims to better understand the biological mechanisms involved in attention deficit hyperactivity disorder (ADHD) and to clarify why some children and adolescents respond well to methylphenidate (MPH)-the most commonly prescribed medication-while others do not. Although MPH is effective for many patients, a significant number experience limited benefits or problematic side effects such as appetite loss and sleep difficulties. Recent research suggests that inflammation and oxidative stress in the body may play an important role in ADHD. Some animal studies also indicate that MPH itself might trigger inflammatory processes, but this has never been examined directly in humans.
The main goal of this research is to determine whether children with ADHD show differences in their nutritional, immune, and inflammatory profiles compared to children without ADHD, and whether these biological factors influence symptom severity, digestive problems, and response to treatment. The study also seeks to understand whether MPH has a measurable inflammatory effect in young patients and whether this could be linked to treatment tolerability.
To answer these questions, the study combines several approaches. First, a case-control comparison will examine differences between children/adolescents with ADHD and age- and sex-matched controls. Second, a one-year follow-up of the ADHD group will evaluate changes over time and help identify biological predictors of treatment response and side effects. Finally, a cross-sectional analysis will investigate the role of polyphenols-natural antioxidant compounds found in food-in relation to inflammation, treatment outcomes, and gender differences.
The primary focus is on comparing levels of the inflammatory marker IL-6 between children with ADHD and controls. Secondary objectives include assessing additional inflammatory and immune indicators, nutritional status, gastrointestinal symptoms, ADHD severity, irritability, and MPH tolerability.
By identifying specific inflammatory and immune markers associated with ADHD and treatment response, this study hopes to improve understanding of the disorder and guide more personalized and effective treatment strategies for young patients. It will also provide the first human data on whether psychostimulant medications may have inflammatory effects.
Children or adolescents aged 7 to 17 years.
Meet DSM-5 diagnostic criteria for Attention-Deficit/Hyperactivity Disorder (ADHD), assessed using the K-SADS interview.
Currently treated with psychostimulant medication.
Stabilized on psychostimulant treatment for at least one month prior to inclusion.
Presence of a progressive neurological disorder, intellectual developmental disorder, or clinically significant suicide risk.
Presence of an immunological or chronic inflammatory disease.
Inability to comply with medication-free periods of at least two weeks.
Absence of parental consent.
Crossover
Clinical and Biological Evaluation - ADHD Cases
Other interventionChildren and adolescents with ADHD undergo diagnostic confirmation (K-SADS if not completed within 6 months), behavioral and functional questionnaires (ADHD-RS for cases only, P-ARI, R4PDQ, KIDMED), clinician-rated scales (CGI-S/I, PAERS), and venous blood sampling for plasma and PBMC analysis. They complete two assessments: one during stabilized medication and one after a minimum two-week medication interruption, consistent with clinical practice guidelines. Assessments occur during the school period to reduce confounding factors.
Clinical and Biological Evaluation - Controls
Other interventionChildren and adolescents without psychiatric disorders undergo behavioral and functional questionnaires (P-ARI, R4PDQ, KIDMED)and venous blood sampling for plasma and PBMC analysis.
Circulating IL-6 Levels in ADHD vs. Controls
Comparison of IL-6 levels between children and adolescents with ADHD and age- and sex-matched typically developing controls at baseline (V1).
CRP Levels in ADHD vs. Controls
Comparison of CRP levels between ADHD participants and matched controls at V1.
IL-1β Levels in ADHD vs. Controls
Comparison of IL-1β levels between ADHD participants and matched controls at V1.
IL-6 Levels in ADHD vs. Controls
Comparison of IL-6 levels between ADHD participants and matched controls at V1.
IL-10 Levels in ADHD vs. Controls
Comparison of IL-10 levels between ADHD participants and matched controls at V1.
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University Hospital, Montpellier
Lead sponsor
INRAE Bordeaux
Collaborator
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