1. Abi-Jaoude E, Gorman DA, Sandor P. Beneath the tip of the iceberg: treatment of neuropsychiatric comorbidities in tic disorders. Handb Clin Neurol;2026;215:311-326.

While Tourette syndrome (TS) is defined by tics, comorbidities are very much part of the clinical presentation – 90% of patients having a least one associated condition, most prominently obsessive-compulsive disorder (OCD) and attention-deficit/hyperactivity disorder (ADHD), but also learning disabilities, anxiety, depression, rage outbursts, autism spectrum disorder, sensory hypersensitivities, and sleep difficulties. Moreover, the associated symptoms often are more problematic than tics, or interact with the tics such that the different symptoms exacerbate each other, adding complexity to the clinical picture. Thus, to provide optimal care to patients with TS, it is essential that clinicians consider and address associated symptoms as part of their management. In this chapter, we review the treatment of the common neuropsychiatric comorbidities in TS, focusing especially on OCD and ADHD. We describe cognitive, behavioral, and pharmacologic interventions, with the aim of making these clear and applicable for the nonspecialist clinician. The goal is for clinicians to provide holistic care that includes understanding the impact of various symptoms and collaboratively prioritizing targets for intervention while favoring conservative approaches, in order to improve the quality of life of patients with TS.

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2. Benbir Senel G, DelRosso LM. A Response to: « Letter to the Editor regarding ‘A preliminary analysis of large muscle group movements in adults with attention deficit hyperactivity disorder' ». Sleep Med;2026 (Jan 27);140:108812.

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3. Brandt V, Perroud NA, Plessen KJ. Attention-deficit/hyperactivity disorder in individuals with primary tic disorders and Tourette syndrome. Handb Clin Neurol;2026;215:85-96.

The co-occurrence of tic disorders and ADHD (attention-deficit/hyperactivity disorder) is common; however, the significant overlap in their symptoms and underlying mechanisms frequently poses questions for diagnosis and treatment. The interaction between tic disorders and ADHD involves intricate genetic and neurobiologic factors, particularly related to inhibitory processes and cortico-striato-thalamic pathways in the brain. While both conditions present shared and specific challenges, studies suggest that ADHD symptoms often pose a greater burden on patients than tics. Therefore addressing ADHD symptoms alongside tics is essential for achieving optimal outcomes and those may differ with respect to the developmental stage and/or age of the individual. Psychoeducation, as well as behavioral and psychopharmacologic treatment strategies, have evolved during the last decade, demonstrating that managing both conditions concurrently can be done safely and effectively. This approach involves comprehensive evaluations and prioritizing treatments that target both tic symptoms and those of ADHD. By focusing on therapies that address these overlapping issues, individuals may experience improved overall outcomes.

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4. Cheng S, Tang L, Jin J, Li S, Hou H, Wang N, Huang Y, Mao G, Wei F. Effects of computerized cognitive training on brain function in children with ADHD: A longitudinal neuroimaging study based on fALFF. Behav Brain Res;2026 (Feb 4);497:115895.

BACKGROUND AND OBJECTIVE: Attention-Deficit/Hyperactivity Disorder (ADHD) is a common neurodevelopmental condition characterized by inattention, hyperactivity, and impulsivity. Emerging evidence suggests that ADHD is linked to hypofunction of the prefrontal-parietal attention network, accompanied by compensatory hyperactivation in the cerebellum and brainstem. However, the underlying neural mechanisms remain insufficiently understood. In recent years, computerized cognitive training has gained attention as a promising non-pharmacological intervention for alleviating ADHD symptoms, though its mechanisms of action and effects on neural plasticity remain contentious. This study utilized longitudinal neuroimaging to investigate abnormal brain function in individuals with ADHD, assess the effects of personalized computerized cognitive training (PCCT) on core symptoms, and examine the relationship between functional brain changes and behavioral improvements. MATERIALS AND METHODS: Sixteen children with ADHD (ADHD group) and sixteen age- and sex-matched healthy controls (HC group) were recruited. All participants underwent resting-state functional magnetic resonance imaging (rs-fMRI) within three days of clinical assessment. The fractional amplitude of low-frequency fluctuations (fALFF) was calculated to evaluate spontaneous neural activity. The ADHD group received a 16-week PCCT intervention consisting of interference inhibition, sustained inhibition, and dominant inhibition training, administered once per week for 60 min per session. Baseline differences in fALFF between the groups were examined, along with pre- and post-intervention changes in clinical scores and fALFF values within the ADHD group. Correlation analyses were conducted between changes in fALFF and behavioral measures. RESULTS: 1.At baseline, the ADHD group showed significantly higher scores than the healthy control (HC) group in SNAP (hyperactivity/inattention rating scale), CPT (Continuous Performance Test), and MMFT (Memory Function Test) (P < 0.05). fALFF analysis revealed decreased fALFF values in the precuneus, angular gyrus, and postcentral gyrus, and increased fALFF values in the cerebellum and brainstem in the ADHD group (P < 0.05, GRF-corrected).2.Effects of PCCT: Following the intervention, the ADHD group demonstrated significant reductions in SNAP-IV, CPT, and MMFT scores (P < 0.05), along with improved performance in all three inhibitory control tasks. fALFF values increased in the precuneus and lingual gyrus and decreased in the cerebellum and hippocampus, indicating modulation of abnormal neural activity.3.Correlation Analysis: The fALFF value in the right cerebellar lobule IX was positively correlated with CPT scores (r = 0.715), and the fALFF value in the left hippocampus was also positively correlated with CPT scores (r = 0.642). In contrast, the fALFF value in the right superior temporal gyrus was negatively correlated with MMFT scores (r = -0.721). These findings suggest that the cerebellar-prefrontal circuit, hippocampus, and superior temporal gyrus play important roles in the regulation of cognitive functions in children with ADHD. CONCLUSION: This study revealed widespread functional abnormalities in the brains of children with ADHD, characterized by inefficiencies in the prefrontal-parietal network and compensatory hyperactivation in the cerebellum and brainstem. PCCT effectively improved core ADHD symptoms and induced neuroplastic changes in specific brain regions, including reduced activity in the cerebellum and hippocampus and increased activity in the precuneus and lingual gyrus. Furthermore, fALFF changes in the cerebellar lobule IX, hippocampus, and superior temporal gyrus were closely associated with cognitive improvements, supporting the central role of the cerebellar-prefrontal circuitry in modulating executive functions in ADHD. These findings provide new evidence for neural compensation mechanisms and non-pharmacological treatment strategies for ADHD. Future studies may explore precision interventions targeting the cerebellar-prefrontal network, such as combining neuromodulation with cognitive training, to optimize long-term outcomes in ADHD.

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5. Hlutkowsky CO, Yan X, Shapiro ZR, Feldman JS, Huang-Pollock C. A diffusion model analysis of task set inertia and task set reconfiguration in ADHD. J Int Neuropsychol Soc;2026 (Feb 4):1-10.

OBJECTIVE: Switching is one of three primary executive functions alongside inhibitory control and updating but remains relatively understudied in childhood attention-deficit/hyperactivity disorder (ADHD) compared to investigations into working memory and inhibitory control deficits. Where extant literature in adults suggests that switch costs are due to a combination of task set inertia and task set reconfiguration costs, it is not clear which of these is most relevant to explaining ADHD-related atypicalities in performance. METHODS: Children with (N = 34) and without ADHD (N = 28) aged 8-12 (average age = 9.45) completed a 192-trial computerized cued switching paradigm. Diffusion model decomposition of the data was performed to identify cognitive subprocesses responsible for the switch. RESULTS: Consistent with the switching literature in adults, switch costs for children were due to a combination of both task set inertia (reduced drift rate) as well as slower task set reconfiguration (Ter) on switch versus repeat trials. Children with ADHD were less accurate than non-ADHD controls, but the ADHD × Switch interactions were not significant for any variable, indicating that the deficit was general and not switch-specific. Lower accuracy was in turn attributed to slower general drift rate among children with ADHD. CONCLUSIONS: This study contributes to a growing literature finding that the performance deficits in children with ADHD across executive and non-executive function tasks are related to lower-level perceptual decision-making weaknesses that have downstream effects on higher-order processing.

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6. Luyens B, Felgueroso-Bueno F, Everard A, Massat I. Gut-brain axis in Attention Deficit Hyperactivity Disorder (ADHD): A narrative review of the links between gut microbiota and ADHD pathophysiology. J Psychiatr Res;2026 (Jan 28);195:199-211.

Characterized by developmentally inappropriate levels of inattention, hyperactivity, and impulsivity, Attention-Deficit Hyperactivity Disorder (ADHD) is the most prevalent neurodevelopmental disorder, posing a significant public health concern. Its etiopathogenesis is considered multifactorial with complex determinism but remains unclear. Recent research highlights the gut microbiota and the gut-brain axis as promising avenues for understanding and potentially treating ADHD, with a growing number of studies exploring alterations in gut microbiota composition among affected individuals. This narrative review examines the current literature on the role of the gut microbiota in ADHD and focuses on key findings about bacterial composition, how it may be linked to ADHD symptomatology, and the possible mechanisms involved. While studies consistently report changes in microbial composition and diversity in individuals with ADHD, results remain heterogeneous across taxonomic levels. Some compelling evidence also suggests a link between gut microbial profiles and ADHD symptom severity. The involvement of microbiota in influencing neurodevelopment is proposed to be mediated through mechanisms related to SCFA production, immune modulation, and neurotransmitter synthesis. These findings pave the way for microbiota-targeted interventions as adjunct therapies for ADHD. This review evaluates areas of consensus and discrepancies between studies, while addressing the methodological limitations present in this field of research. Although the gut microbiota appears to play a meaningful role in the complex and multifactorial origins of ADHD, more rigorous and comprehensive studies are needed to confirm these findings and translate them into effective clinical applications. This could ultimately improve both our understanding and treatment of this heterogeneous disorder.

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7. Smaniotto L, Tolentino A, Barros FMR, Barreto E, Colnaghi B, Ker L, Celeri E, Della-Torre O, Azevedo RCS. Non-suicidal self-injury in individuals with attention-deficit/hyperactivity disorder: A systematic review and Meta-analysis with Age- and Sex-stratified findings. Psychiatry Res;2026 (Jan 23);358:116975.

BACKGROUND: Non-suicidal self-injury (NSSI) is a significant mental health concern that often co-occurs with attention-deficit/hyperactivity disorder (ADHD). Although growing evidence suggests a link between ADHD and NSSI, the prevalence and moderating factors of this association remain unclear. METHODS: We conducted a systematic review and meta-analysis to quantify the prevalence of NSSI in individuals with ADHD and to examine age- and sex-stratified differences across studies conducted in clinical, community, convenience, and population-based samples. A comprehensive search was performed across MEDLINE, EMBASE, and PsycINFO. Fourteen studies met inclusion criteria. Pooled prevalence estimates and odds ratios (ORs) were calculated using random-effects models. Subgroup analyses were performed by age group (adolescents vs. adults) and sex. RESULTS: The overall pooled prevalence of NSSI among individuals with ADHD was 27% (95% CI: 19%-37%), with similar rates among adolescents (28%) and adults (25%). Compared to individuals without ADHD, those with ADHD had twice the odds of engaging in NSSI (OR = 2.26, 95% CI: 1.69-3.00). Sex-stratified analysis, based on three eligible studies, suggested a higher risk in females with ADHD compared to males with ADHD (OR = 4.07, 95% CI: 3.09-5.36). High heterogeneity was observed across studies, potentially attributable to differences in diagnostic criteria, assessment tools, sample characteristics, and sociocultural contexts. CONCLUSIONS: Individuals with ADHD show elevated rates of NSSI across developmental stages, with preliminary evidence indicating a potentially greater risk among females. However, these sex-specific findings should be interpreted cautiously due to the limited number of studies. Future research should investigate underlying mechanisms and longitudinal trajectories to better inform targeted interventions and prevention strategies. PROSPERO: CRD420251017948.

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8. Travis LM, Prasad S, Khan FA, Samineni AV, Mei C, Grottkau B. Impact of Pediatric Neuropsychiatric Disorders on Postoperative Outcomes Following Common Nonspine Orthopedic Surgeries. J Pediatr Orthop;2026 (Mar 1);46(3):e288-e296.

BACKGROUND: Pediatric fractures are common injuries, and the increasing prevalence of neuropsychiatric conditions like ADHD, autism, anxiety, and depression may complicate postoperative outcomes. Understanding how these diagnoses affect surgical recovery is essential for optimizing care in this vulnerable population. METHODS: This study analyzed data from the 2019 and 2022 Kids Inpatient Database. Children undergoing common nonspine orthopedic procedures were identified and matched one-to-one by age, sex, ethnicity, and severity of illness. Primary outcomes included postoperative complications, such as infection and mechanical implant failures; secondary outcomes were length of stay and total hospital charges. Logistic regression models were used to adjust for potential confounders. RESULTS: Among 4931 ADHD-matched pairs, patients with ADHD had longer mean hospital stays (5.07 vs. 4.69 d, P=0.041) and significantly increased risk of osteomyelitis (OR: 1.42, P=0.0017) and soft tissue infection (OR: 1.39, P=0.009). For 5673 anxiety-matched pairs, anxiety correlated with higher mean length of stay (7.16 vs. 5.54 d, P<0.01) and elevated odds of soft tissue infections (OR: 1.55, P<0.01), mechanical implant complications (OR: 1.28, P=0.036), and constipation (OR: 2.03, P<0.01). Depression (2950 matched pairs) was associated with longer stays (8.31 vs. 6.00 d, P<0.01) and greater risk of osteomyelitis (OR: 2.04, P<0.01). Among 2322 autism-matched pairs, autism did not significantly impact length of stay but increased pneumonia risk (OR: 1.76, P=0.025) and postoperative ileus (OR: 1.71, P=0.040). CONCLUSION: These findings demonstrate the significant impact of neuropsychiatric comorbidities on pediatric orthopedic recovery. Behavioral factors, such as impulsivity or anxiety-driven movement avoidance, and physiological mechanisms, including altered immune function, may drive elevated complication rates. Tailored perioperative management, including mental health screening, specialized communication strategies, and enhanced caregiver support, could improve adherence and reduce morbidity for these patients. Further research should focus on targeted interventions, medication considerations, and strategies that foster cooperation among orthopedic, mental health, and rehabilitative services. Addressing these challenges can ultimately enhance the quality of care and reduce disparities for pediatric patients with coexisting orthopedic injuries and neuropsychiatric diagnoses. LEVEL OF EVIDENCE: Level III-retrospective comparative study.

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9. Vestergaard M, Faergemann Hansen R, Thomsen PH, Hoiberg Bentsen A, Falch-Joergensen AC. Comorbidities and comedication among individuals in treatment for ADHD: a Danish nationwide study. BMC Psychiatry;2026 (Feb 4)

OBJECTIVES: To examine the prevalence of comorbidities and the use of psychiatric comedication among individuals in medical treatment for attention deficit hyperactivity disorder (ADHD), in comparison to a matched control group from the general population. METHODS: This nationwide case-control study included 1,082,378 Danish individuals aged 7-64 of whom 98,398 had at least one prescription of ADHD medication during 2023. Data was collected over an observation period spanning from 2013 to 2023. Cases were matched to controls (1:10) from the general population on birth year and sex. Data were obtained and accessed through The Danish Health Data Authority. Associations were estimated using conditional logistic regression models. RESULTS: Somatic and particularly psychiatric comorbidities were more common among individuals in ADHD treatment across all age groups. Among those in ADHD treatment 46.7% had at least one comorbidity compared to 23.3% in the control group. The use of psychiatric comedications (besides ADHD medication) was likewise more common among individuals in ADHD treatment (32.7%) compared to the controls (7.2%). The association estimates from conditional logistic regression revealed a higher likelihood of somatic and psychiatric comorbidities among those in ADHD treatment in all age groups. Females in ADHD treatment had 4.48-4.50 times higher odds of comorbidities compared to females not in ADHD treatment (OR(7 - 17 years) = 4.48, 95% CI: 4.27-4.70; OR(18 - 29 years) = 4.50, 95% CI: 4.37-4.64). Similar patterns were observed for males but with slightly lower ORs (OR(7 - 17 years) = 2.35, 95% CI: 2.27-2.44; OR(18 - 29 years) = 3.38, 95% CI: 3.28-3.50). CONCLUSION: This study reveals that both prevalence of somatic and psychiatric comorbidities and the use of psychiatric comedication are significantly higher among individuals in ADHD treatment. The highest occurrence is seemingly among females aged 7-17 year and 18-29 years. The coexistence of ADHD with other somatic and psychiatric conditions can constitute a more complex disease burden, necessitating enhanced disease management strategies to reduce complications and enhance quality of life. Longitudinal studies are needed to confirm the temporal association of these results.

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