Attention Deficit-Hyperactivity Disorder Clinical Trial
Official title:
Biomarker Research in ADHD: the Impact of Nutrition (BRAIN). An Open-label Trial to Investigate the Mechanisms Underlying the Effects of a Few-foods Diet on ADHD Symptoms in Children
Attention deficit hyperactivity disorder (ADHD) is the most common childhood behavioural
disorder, causing significant impediment to a child's development. The exact aetiology of
ADHD is still unknown. It is a complex disorder with numerous contributing (epi)genetic and
environmental factors. Currently, treatment predominantly consists of behavioural and
pharmacological therapy. However, medication use is associated with several side effects and
concerns about long-term effects and efficacy exist. Therefore, there is considerable
interest in the development of alternative treatment options.
Double-blind research investigating the effect of a few-foods diet (FFD) has demonstrated
large improvements in ADHD symptoms. However, following an FFD requires great effort of both
the child and parents. To make this treatment easier or potentially obsolete, it is important
to understand how and in which children an FFD affects ADHD symptoms.
The investigators hypothesise that an FFD affects brain function and behaviour, including
ADHD symptoms, via the complex network of communication between the microbiota, gut and
brain, i.e. the MGB axis. The aim of this study is to identify potential mechanism(s)
underlying the impact of an FFD on ADHD symptoms and to identify biomarkers that predict the
response to the FFD.
100 boys with ADHD will follow the FFD for 5 weeks. After inclusion, all participants will
start with a baseline period, during which they will maintain their regular diet. The
baseline period ends at the end of week 2. Thereafter, participants will follow a 5-week FFD,
preceded by a 1-week transition period. The FFD period ends at the end of week 8.
At the end of the baseline period (i.e. at the end of week 2) and at the end of the FFD (i.e.
at the end of week 8), fMRI scans will be made, blood and buccal saliva will be collected,
and stool and urine will be handed in. Children will do computer tasks and parents will
complete questionnaires to monitor ADHD and physical complaints. All samples will be analysed
by researchers blinded to behavioural responses to the FFD. To assess the impact of the FFD
on brain function and the MGB axis, associations between ADHD behavioural changes and changes
in other primary and secondary study outcomes will be analysed.
This study may lead to the identification of biomarkers that can predict the response to an
FFD. Understanding which changes - induced by an FFD - lead to improvements in ADHD symptoms
may provide new avenues for developing treatments. Ultimately, the findings may enable
personalised intervention strategies based on an individuals' configuration of the MGB axis.
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