Psychoendocrine and psychoneuroimmunological mechanisms in the comorbidity of atopic eczema and attention deficit/hyperactivity disorder
Abstract
Epidemiological data indicate that atopic eczema (AE) in infancy significantly increases the risk for attention deficit/hyperactivity disorder (ADHD) in later life. The underlying pathophysiological mechanisms of this comorbidity are unknown. We propose that the release of inflammatory cytokines caused by the allergic inflammation and/or elevated levels of psychological stress as a result of the chronic disease interfere with the maturation of prefrontal cortex regions and neurotransmitter systems involved ADHD pathology. Alternatively, increased stress levels in ADHD patients may trigger AE via neuroimmunological mechanisms. In a third model, AE and ADHD may be viewed as two separate disorders with one or more shared risk factors (e.g., genetics, prenatal stress) that increase the susceptibility for both disorders leading to the co-occurrence of AE and ADHD. Future investigation of these three models may lead to a better understanding of the mechanisms underlying the observed comorbidity between AE and ADHD and further, to targeted interdisciplinary primary prevention and treatment strategies.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
ADHD is associated with higher rates of inflammatory and autoimmune disorders such as eczema, asthma, rheumatoid arthritis, type 1 diabetes, and hypothyroidism.
“atopic immune disorders such as eczema (Buske-Kirschbaum et al., 2013; Liao et al., 2016; Lin et al., 2016; Schmitt et al., 2009), asthma (Fasmer et al., 2011; Instanes et al., 2017; Lin et al., 2016), rheumatoid arthritis (Instanes et al., 2017), type 1 diabetes (Instanes et al., 2017), and hypothyroidism (Instanes et al., 2017) have been associated with higher rates of ADHD diagnosis.”
From Neuroinflammation as a risk factor for attention deficit hyperactivity disorder (2019) · cites this paper as Buske-Kirschbaum et al., 2013
Cites
Willcutt, E. G., Doyle, A. E., Nigg, J. T., Faraone, S. V., & Pennington, B. F. (2005) · Biological Psychiatry · doi:10.1016/j.biopsych.2005.02.006 · Cited by 3,568 · see citing works
Stress signalling pathways that impair prefrontal cortex structure and function
Arnsten, A. F. T. (2009) · Nature Reviews Neuroscience · doi:10.1038/nrn2648 · Cited by 3,299 · see citing works
Cytokines sing the blues: inflammation and the pathogenesis of depression
Raison, C. L., Capuron, L., & Miller, A. H. (2006) · Trends in Immunology · doi:10.1016/j.it.2005.11.006 · Cited by 3,009 · see citing works
Wegmann, T. G., Lin, H., Guilbert, L., & Mosmann, T. R. (1993) · Immunology Today · doi:10.1016/0167-5699(93)90235-d · Cited by 2,852 · see citing works
Maternal antenatal anxiety and children's behavioural/emotional problems at 4 years
O'Connor, T. G., Heron, J., Golding, J., Beveridge, M., & Glover, V. (2002) · British Journal of Psychiatry · doi:10.1192/bjp.180.6.502 · Cited by 1,070 · see citing works
Meta-analysis of structural imaging findings in attention-deficit/hyperactivity disorder
Valera, E. M., Faraone, S. V., Murray, K. E., & Seidman, L. J. (2007) · Biological Psychiatry · doi:10.1016/j.biopsych.2006.06.011 · Cited by 891 · see citing works
Pruessner, J. C., Champagne, F., Meaney, M. J., & Dagher, A. (2004) · The Journal of Neuroscience · doi:10.1523/jneurosci.3422-03.2004 · Cited by 709 · see citing works
The blood-brain barrier and immune function and dysfunction
Banks, W. A., & Erickson, M. A. (2010) · Neurobiology of Disease · doi:10.1016/j.nbd.2009.07.031 · Cited by 523 · see citing works
Early programming of the hypothalamo–pituitary–adrenal axis
MATTHEWS, S. (2002) · Trends in Endocrinology and Metabolism · doi:10.1016/s1043-2760(02)00690-2 · Cited by 513 · see citing works
LEWIS-JONES, S. (2006) · International Journal of Clinical Practice · doi:10.1111/j.1742-1241.2006.01047.x · Cited by 478 · see citing works
Cytokine-specific central monoamine alterations induced by interleukin-1, -2 and -6
Zalcman, S., Green-Johnson, J. M., Murray, L., Nance, D. M., Dyck, D., Anisman, H., & Greenberg, A. H. (1994) · Brain Research · doi:10.1016/0006-8993(94)90006-x · Cited by 439 · see citing works
Lara, C., Fayyad, J., de Graaf, R., Kessler, R. C., Aguilar-Gaxiola, S., Angermeyer, M., Demytteneare, K., de Girolamo, G., Haro, J. M., Jin, R., et al. (2009) · Biological Psychiatry · doi:10.1016/j.biopsych.2008.10.005 · Cited by 420 · see citing works
Molecular Genetics of Attention Deficit Hyperactivity Disorder
Faraone, S. V., & Mick, E. (2010) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2009.12.004 · Cited by 411 · cited 3× · see citing works
“Meta-analyses point to a particular role of the candidate genes coding for DRD4, DRD5, SLC6A3, SNAP-25, HTR1B and NET which are associated with neurotransmission and synaptic plasticity in the dopaminergic, serotonergic and noradrenergic system (Faraone and Mick, 2010; Gizer et al., 2009).”
The Dopamine Transporter and Attention-Deficit/Hyperactivity Disorder
Madras, B. K., Miller, G. M., & Fischman, A. J. (2005) · Biological Psychiatry · doi:10.1016/j.biopsych.2004.10.011 · Cited by 393 · see citing works
Murmu, M. S., Salomon, S., Biala, Y., Weinstock, M., Braun, K., & Bock, J. (2006) · European Journal of Neuroscience · doi:10.1111/j.1460-9568.2006.05024.x · Cited by 278 · see citing works
Peripheral and central proinflammatory cytokine response to a severe acute stressor
O'Connor, K. A., Johnson, J. D., Hansen, M. K., Wieseler Frank, J. L., Maksimova, E., Watkins, L. R., & Maier, S. F. (2003) · Brain Research · doi:10.1016/j.brainres.2003.08.006 · Cited by 247 · see citing works
Pauli-Pott, U., Darui, A., & Beckmann, D. (1999) · Psychotherapy and Psychosomatics · doi:10.1159/000012309 · Cited by 100 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Genetics of attention deficit hyperactivity disorder
Faraone, S. V., & Larsson, H. (2019) · Molecular Psychiatry · doi:10.1038/s41380-018-0070-0 · Cited by 1,338 · see citing works
The oxytocin receptor: from intracellular signaling to behavior
Jurek, B., & Neumann, I. D. (2018) · Physiological Reviews · doi:10.1152/physrev.00031.2017 · Cited by 999 · see citing works
Comorbidities and the impact of atopic dermatitis
Silverberg, J. I. (2019) · Annals of Allergy, Asthma & Immunology · doi:10.1016/j.anai.2019.04.020 · Cited by 431 · see citing works
Neuroinflammation as a risk factor for attention deficit hyperactivity disorder
Dunn, G. A., Nigg, J. T., & Sullivan, E. L. (2019) · Pharmacology Biochemistry and Behavior · doi:10.1016/j.pbb.2019.05.005 · Cited by 299 · see citing works
Kim, J. H., Kim, J. Y., Lee, J., Jeong, G. H., Lee, E., Lee, S., Lee, K. H., Kronbichler, A., Stubbs, B., Solmi, M., et al. (2020) · The Lancet Psychiatry · doi:10.1016/s2215-0366(20)30312-6 · Cited by 258 · see citing works
Role of Oxidative Stress and Neuroinflammation in Attention-Deficit/Hyperactivity Disorder
Corona, J. C. (2020) · Antioxidants · doi:10.3390/antiox9111039 · Cited by 163 · see citing works
Nielsen, P. R., Benros, M. E., & Dalsgaard, S. (2017) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2016.12.010 · Cited by 131 · see citing works
Comorbidities of Atopic Dermatitis: Beyond Rhinitis and Asthma
Andersen, Y. M. F., Egeberg, A., Skov, L., & Thyssen, J. P. (2017) · Current Dermatology Reports · doi:10.1007/s13671-017-0168-7 · Cited by 62 · see citing works
Lewis, N., Villani, A., & Lagopoulos, J. (2025) · Neuroscience · doi:10.1016/j.neuroscience.2025.01.031 · Cited by 25 · see citing works
- Authors
- Buske-Kirschbaum, A., Schmitt, J., Plessow, F., Romanos, M., Weidinger, S., & Roessner, V.
- Affiliations
- Technische Universität Dresden (DE)
- University Hospital Carl Gustav Carus (DE)
- Universitätsklinikum Würzburg (DE)
- Christian-Albrechts-Universität zu Kiel (DE)
- Corresponding author
- Buske-Kirschbaum, A.
- Venue
- Psychoneuroendocrinology
- Publisher
- Elsevier BV
- Published
- 2013-01
- Volume
- 38
- Issue
- 1
- Pages
- 12-23
- ISSN
- 0306-4530 (ISSN-L)
- OpenAlex
- W2153298564
- Cited by
- 179
- References
- 17
- Citations by year
- 2026: 7 · 2025: 11 · 2024: 15 · 2023: 10 · 2022: 17 · 2021: 15 · 2020: 15 · 2019: 18 · 2018: 23 · 2017: 13 · 2016: 20 · 2015: 8 · 2014: 5 · 2013: 2
- FWCI
- 0.65
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychoneuroendocrinology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Health Sciences › Medicine › Dermatology › Dermatology and Skin Diseases
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Keywords
- atopic dermatitis, attention deficit hyperactivity disorder, comorbidities, inflammatory cytokines, allergic inflammation, psychological stress, prefrontal cortex maturation, neurotransmitter systems, neuroimmunology, prenatal stress, shared risk factors, primary prevention
- MeSH terms
- Filaggrin Proteins, Attention Deficit Disorder with Hyperactivity, Brain Chemistry, Dermatitis, Atopic, Dopamine, Female, Gyrus Cinguli, Humans, Hypothalamo-Hypophyseal System, Immunoglobulin E, Infant, Intermediate Filament Proteins, Pituitary-Adrenal System, Pregnancy, Prenatal Exposure Delayed Effects, Psychoneuroimmunology, Risk, Skin, Neuroimmunomodulation, Comorbidity, T-Lymphocyte Subsets, Cytokines, Prefrontal Cortex, Genetic Predisposition to Disease
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
