The function of hypothalamus–pituitary–adrenal axis in children with ADHD
Abstract
Objective To explore the relationship between hypothalamus-pituitary-adrenal (HPA) axis and Attention Deficit Hyperactivity Disorder (ADHD) in non-stress states. Method 128 male children with ADHD aged between 6 and 14 years old were recruited, while 30 healthy male children were chosen as a control group. The diagnostic material was based on DSM-IV. The included ADHD children were further classified into the three sub-groups: ADHD-predominantly inattention type (ADHD-I) (n=44), ADHD-predominantly hyperactive impulsive type (ADHD-HI) (n=32), and ADHD-combined type (ADHD-C) (n=52). The levels of cortisol and adrenocorticotropin hormone (ACTH) were evaluated by the automatic particle enzyme immunoassay and electrochemiluminescence respectively per morning (8:00 am). Intelligence test was assessed by the Raven's Standard Progressive Matrices. Results The children with ADHD had significantly lower intelligence quotient (IQ) (84.5±11.3) in contrast to the control group (98.6±12.4, P 0.05), or between sub-groups in ADHD (P>0.05). Conclusion In the non-stress states, the existence of dysfunction of the HPA axis (lower plasma cortisol) in children with ADHD might be due to the under-reactivity of the HPA axis ; the low plasma cortisol level might contribute less to the outcomes of cognitive behavior of ADHD children and instead more closely relate to the core domains of attention deficit, hyperactivity and impulsive behavior of ADHD patients.
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Low cortisol promotes an imbalance in pro-inflammatory Th1/anti-inflammatory Th2 cytokine profile making a more pro-inflammatory environment in ADHD, which can be related to a defective Treg regulation.
“This promotes an imbalance in pro-inflammatory T helper 1 cell (Th1)/anti-inflammatory T helper 2 cell (Th2) cytokine profile making a more pro-inflammatory environment in ADHD [60, 102], which can be related to a defective regulatory T cell (Treg) regulation.”
From Molecular Characterisation of the Mechanism of Action of Stimulant Drugs Lisdexamfetamine and Methylphenidate on ADHD Neurobiology: A Review (2022) · cites this paper as [102]
In ADHD, low levels of cortisol have been observed in children.
“In ADHD, low levels of cortisol, an important hormone in the hypothalamus–pituitary–adrenal (HpA) axis, have been observed in children [102–105].”
From Molecular Characterisation of the Mechanism of Action of Stimulant Drugs Lisdexamfetamine and Methylphenidate on ADHD Neurobiology: A Review (2022) · cites this paper as [102]
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Biomarkers and Attention-Deficit/Hyperactivity Disorder: A Systematic Review and Meta-Analyses
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“This promotes an imbalance in pro-inflammatory T helper 1 cell (Th1)/anti-inflammatory T helper 2 cell (Th2) cytokine profile making a more pro-inflammatory environment in ADHD [60, 102], which can be related to a defective regulatory T cell (Treg) regulation.”
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“, 2009), whereas others found reduced baseline cortisol levels in non-comorbid ADHD (Van West et al., 2009; Ma et al., 2011) and one study found no effect of DBD comorbidity within an ADHD sample (Isaksson et al.”
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Salivary Cortisol Levels in Abused Children with Attention Deficit Hyperactivity Disorder
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- Authors
- Ma, L., Chen, Y.-H., Chen, H., Liu, Y.-Y., & Wang, Y.-X.
- Affiliations
- Fujian Medical University (CN)
- ORCID
- Ma, Liang
- Venue
- Brain Research
- Publisher
- Elsevier BV
- Published
- 2011-01
- Volume
- 1368
- Pages
- 159-162
- ISSN
- 0006-8993 (ISSN-L)
- OpenAlex
- W2087226254
- Cited by
- 100
- References
- 4
- Citations by year
- 2026: 7 · 2025: 8 · 2023: 6 · 2022: 6 · 2021: 9 · 2020: 5 · 2019: 4 · 2018: 9 · 2017: 7 · 2016: 6 · 2015: 6 · 2014: 8 · 2013: 5 · 2012: 12
- FWCI
- 4.14
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Brain Research (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Advanced Research of Fujian Medical University for Professor (JS07008)
- The Key Program of Scientific Research of Fu Jian Medical University (2009D064)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Keywords
- attention deficit hyperactivity disorder, hypothalamic-pituitary-adrenal axis, cortisol, ACTH, children, ADHD subtypes, inattention, hyperactivity/impulsivity, combined type ADHD, intelligence quotient, HPA axis dysregulation, stress response
- MeSH terms
- Adolescent, Adrenocorticotropic Hormone, Attention Deficit Disorder with Hyperactivity, Child, Humans, Hydrocortisone, Hypothalamo-Hypophyseal System, Impulsive Behavior, Intelligence, Intelligence Tests, Male, Pituitary-Adrenal System
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