Pubmed (TDAH) du 09/06/26
1. Robaey P, Rogers MA, Schachar RJ. Advances in the management of ADHD in children and adolescents. Bmj;2026 (Jun 8);393:e082507.
This review synthesizes evidence on managing attention deficit/hyperactivity disorder (ADHD) in children and adolescents, focusing on studies published between 2019 and 2025. Recent research supports a dimensional, pleiotropic model of ADHD characterized by heterogeneity, developmental fluctuation, and frequent comorbidity. ADHD is a chronic, fluctuating condition, underscoring the need for sustained and individualized care. Diagnostic strategies favor semi-structured interviews over rating scales, with neuroimaging or biological tests offering limited diagnostic utility. Neuropsychological testing situates symptoms within broader cognitive developmental profiles. Psychosocial interventions-particularly behavioral parent training, school focused interventions, and cognitive behavioral therapy-produce small but meaningful improvements in functioning, with outcomes strongly shaped by rater, expectancy, and context. Lifestyle interventions targeting physical activity and sleep show modest adjunctive benefits. Cognitive training does not generalize beyond trained tasks, and effects on neurofeedback are predominantly non-specific and contextual. Digital tools are expanding, but few are rigorously validated. Pharmacological treatment remains central, with stimulants showing robust short term efficacy and non-stimulants providing effective second line options. Advances in titration strategies, formulation design, and pharmacogenetics support movement towards precision oriented and personalized prescribing. Overall, the evidence supports a multimodal, pragmatic approach to care aligned with current international guidelines.
Lien vers le texte intégral (Open Access ou abonnement)
2. Ünal K, Taş Torun Y, Erol ME, Özbaş C, Kurt ZK. Linkage of kynurenine pathway metabolites to neuroinflammation in drug-naive children with attention-deficit/hyperactivity disorder: A cross-sectional, case-control study. World J Clin Pediatr;2026 (Jun 9);15(2):115284.
BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) is a neurobehavioral disorder that causes psychological, social, academic, and occupational impairments. Despite numerous studies, its etiopathogenesis remains incompletely understood. AIM: To compare serum kynurenine pathway (KP) metabolite levels and metabolite ratios between drug-naive children with ADHD and healthy controls. METHODS: The study included 51 drug-naive children with ADHD and 36 age- and gender-matched healthy controls. Serum tryptophan, kynurenine (KYN), kynurenic acid (KYNA), and quinolinic acid (QUIN) levels were measured. Ratios reflecting the activities of KP enzymes, namely KYN/tryptophan, KYNA/KYN, and QUIN/KYN, were measured, and the neurotoxic (QUIN/KYNA) and neuroprotective (KYNA/QUIN) indices were calculated. RESULTS: Compared with controls, serum KYNA levels and the KYNA/QUIN ratio (neuroprotective index) were significantly lower in the ADHD group, while the QUIN/KYNA ratio (neurotoxic index) was significantly higher (P = 0.023, 0.025, and 0.029, respectively). There were no significant differences between groups in other KP metabolites or their ratios (P > 0.05). CONCLUSION: These findings support the hypothesis that neuroinflammatory imbalance in the KP contributes to the pathogenesis of ADHD and highlight the importance of new biomarkers for the development of targeted therapies.
