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Core symptoms of ADHD, such as impulsivity, are caused by an interaction of genetic and environmental factors. Epigenetic modifications of DNA, such as DNA methylation, are thought to mediate the interplay of these factors. Tryptophan hydroxylase 2 (TPH2) is the rate-limiting enzyme in brain serotonin synthesis. The TPH2 gene has frequently been investigated in relation to ADHD, e.g., showing that <jats:italic>TPH2 G-703T<\/jats:italic> (rs4570625) polymorphism influences response control and prefrontal signaling in ADHD patients. In this (epi)genetic imaging study we examined 144 children and adolescents (74 patients, 14 females) using fMRI at rest and during performing a waiting impulsivity (WI) paradigm. Both, <jats:italic>TPH2 G-703T<\/jats:italic> (rs4570625) genotype and DNA methylation in the 5\u2019 untranslated region (5\u2019UTR) of <jats:italic>TPH2<\/jats:italic> were associated with wavelet variance in fronto-parietal regions and behavioral performance, taking <jats:italic>TPH2<\/jats:italic> genotype into account. In detail, comparisons between genotypes of patients and controls revealed highest wavelet variance and longest reaction times in patients carrying the T allele [indicative for a gene-dosage effect, i.e., the WI phenotype is a direct result of the cumulative effect of ADHD and <jats:italic>TPH2<\/jats:italic> variation]. Regressions revealed a significant effect on one specific DNA methylation site in ADHD patients but not controls, in terms of a significant prediction of wavelet variance in fronto-parietal regions as well as premature responses. By the example of the <jats:italic>TPH2 G-703T<\/jats:italic> (rs4570625) polymorphism, we provide insight into how interactive genetic and DNA methylation affect the ADHD and\/or impulsive endophenotype.<\/jats:p>","DOI":"10.1371\/journal.pone.0282813","type":"journal-article","created":{"date-parts":[[2023,4,27]],"date-time":"2023-04-27T17:39:59Z","timestamp":1682617199000},"page":"e0282813","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":10,"title":["Serotonergic modulation of normal and abnormal brain dynamics: The genetic influence of the TPH2 G-703T genotype and DNA methylation on wavelet variance in children and adolescents with and without 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