1. Altunkılıc EF, Alnak A, Karacetın G, Eroglu Iclı H, Kayan Ocakoglu B, Gurel Fıcıcıoglu IE. The Effect of Methylphenidate Treatment on Oxidative Stress Levels in Children Diagnosed with Attention-Deficit/Hyperactivity Disorder: An Observational Study. J Child Adolesc Psychopharmacol;2026 (Mar 24):10445463261436792.

BACKGROUND: Oxidative stress (OS) has been implicated in the pathophysiology of attention-deficit/hyperactivity disorder (ADHD), yet findings-particularly regarding treatment-related changes-remain inconsistent. This study evaluated short-term differences in circulating oxidant/antioxidant markers after methylphenidate (MPH) treatment and explored whether baseline biomarkers predict clinically significant symptom improvement. METHODS: In this single-center, prospective observational cohort study, medication-naïve children aged 6-11 years diagnosed with DSM-5-TR ADHD were assessed at enrollment and after 3 months of conventional MPH treatment. Clinical severity was measured using the Conners’ Parent Rating Scale-Revised: Short Form (CPRS-R:S) and Conners’ Teacher Rating Scale-Revised: Short Form (CTRS-R:S). Serum biomarkers included total oxidant status (TOS), total antioxidant status (TAS), superoxide dismutase (SOD), malondialdehyde (MDA), oxidized LDL (Ox-LDL), and the OS index (OSI = TOS/TAS). Changes were tested with paired analyses; correlations were examined between percent changes in scale scores and biomarkers; and ROC analyses evaluated baseline biomarkers’ ability to identify a >50% reduction in CPRS-R:S and CTRS-R:S total scores. RESULTS: Thirty-nine participants completed both assessments (SOD analyses: n = 37). Significant reductions were observed in CPRS-R:S and CTRS-R:S total and subscale scores (all p < .001). TOS, TAS, SOD, MDA, and Ox-LDL decreased significantly over 3 months, while OSI showed a nonsignificant downward trend (p = 0.066). No significant correlations emerged between percent symptom change and percent biomarker change. In ROC analyses, baseline MDA, Ox-LDL, and TOS significantly discriminated >50% CPRS-R:S improvement (AUC ≈ 0.71-0.74), whereas for >50% CTRS-R:S improvement, several biomarkers demonstrated good discrimination (AUC ≈ 0.82-0.85). CONCLUSIONS: Three months of MPH treatment was associated with robust clinical improvement and parallel reductions in multiple oxidant and antioxidant biomarkers. Baseline OS markers may help identify children most likely to show marked symptom reduction, though findings should be interpreted cautiously, given the sample size.

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2. Burgerhout KM, Hoekstra N, van Ravesteyn LM, Lucassen P, Carpentier PB. [ADHD in adults: more questions for the general practitioner]. Ned Tijdschr Geneeskd;2026 (Mar 26);170

The diagnosis of ADHD remains shrouded in controversy, resulting in alarming reports in (social) media. Danger of underdiagnosis, risk of overdiagnosis, and medicalization of social problems are all mentioned. The diagnostic uncertainty is largely due to the non-specific nature of ADHD symptoms. Yet, an ADHD diagnosis is more than an excuse: its chronic nature makes it a disabling condition when appropriate treatment is not provided. In most cases the general practitioner decides who is referred for further diagnosis; the controversial reporting can contribute to doubt and reluctance. The task in referring, however, is not to make a diagnosis, but to recognize the likelihood of psychiatric problems. This is done by inquiring about the presence and severity of symptoms and the existence of resulting distress. Knowledge of the context (such as work and living situation, family composition) and the patient’s life history helps in distinguishing between temporary overload and chronic dysfunction.

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3. Cai W, Mizuno Y. Dynamic modeling in neurocognitive frameworks of childhood ADHD: a review of inhibitory control and reward systems. Transl Psychiatry;2026 (Mar 23)

Cognitive models of attention deficit hyperactivity disorder (ADHD) have traditionally centered on deficits in inhibitory control and motivation. A substantial body of empirical research supports impairments in both domains: children with ADHD exhibit elevated commission error rates, prolonged stop-signal reaction time, and a strong preference for smaller immediate rewards over larger delayed ones. In the first part of this review, we synthesize key findings from behavioral and task-state functional neuroimaging studies that characterize these deficits, highlighting how deficits in inhibitory control and motivation/reward systems manifest across tasks and contexts. We further examine evidence on the interplay between the two systems and how their interaction is altered in children with ADHD. In the second part, we introduce recent advances in cognitive and computational neuroscience that extend classic neurocognitive models by incorporating dynamic perspectives. Specifically, we describe the dynamic dual-control framework, which distinguishes between proactive and reactive inhibitory control, and highlight dynamics of trial-by-trial adaptive response strategy adjustment. We also review emerging computational models that can identify latent brain states and their evolution during task performance, revealing novel neurodynamic mechanisms that may underlie cognitive instability in ADHD. Additionally, we discuss pharmacological studies that shed light on how the inhibitory control and motivation/reward systems are modulated by medication. Finally, we address current limitations and challenges in ADHD research, with a particular focus on task-state functional neuroimaging, and propose future directions for advancing the field. By integrating dynamic modeling approaches with established neurocognitive frameworks, this review aims to deepen our understanding of the brain mechanisms underlying ADHD and to inform the development of more precise and effective interventions.

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4. Capusan AJ, Zhang L, Larsson H, Brikell I, Martinez D, D’Onofrio BM, Lichtenstein P, Kuja-Halkola R, Chang Z. Discontinuation and reinitiation of pharmacological treatment for ADHD among individuals with ADHD and substance use disorder. BMJ Ment Health;2026 (Mar 23);29(1)

BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) and substance use disorder (SUD) often coexist. ADHD complicates the course of disease in SUD. While recommended in guidelines, ADHD medication for those with comorbid SUD remains controversial. OBJECTIVE: This study aims to explore how comorbid SUD affects ADHD medication discontinuation and reinitiation in individuals with ADHD. METHODS: Using a matched cohort design, we identified 9283 individuals with ADHD and SUD in Sweden between 2006 and 2020, who had ongoing ADHD medication at the time of their first SUD-related event. Controls with ADHD medication but no SUD (n=46 401) were matched 5:1 on sex and birth year. HRs for treatment discontinuation within 1 year from first SUD, and for treatment reinitiation within 1 year from the first discontinuation, were estimated using stratified Cox models. FINDINGS: Individuals with ADHD and SUD were nearly two times as likely to discontinue ADHD treatment within 1 year (HR: 1.99, 95% CI 1.92 to 2.07) and less likely to re-initiate ADHD treatment (HR: 0.82, 95% CI 0.76 to 0.89) compared with controls. Several factors, including male sex, adolescent to young adult age and lower stimulant medication dose, were associated with increased risk for treatment discontinuation, but only adolescent to young adult age was significantly associated with treatment reinitiation in those with ADHD and SUD. CONCLUSIONS: The results suggest less treatment continuity and access for those with ADHD and comorbid SUD. CLINICAL IMPLICATIONS: Treatment providers need to consider the specific needs of individuals with ADHD and comorbid SUD, especially in young males, to improve treatment outcomes for vulnerable groups.

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5. Haimov I, Dan O, Eisenstein S, Asraf K, Cohen A. The effects of stimulant medications on the sleepiness curve of young men with Attention-Deficit Hyperactivity Disorder (ADHD). BMC Psychiatry;2026 (Mar 24)

BACKGROUND: The present study aimed at investigating the effects of sleep deprivation and stimulant medication (methylphenidate and amphetamine) on subjective sleepiness in young adults with ADHD, compared to individuals without ADHD. METHODS: Fifty-nine young men (age 18-35) of whom 39 were diagnosed with ADHD combined type (ADHD-C) and 20 without ADHD. The participants’ sleep was monitored for 5 days via actigraphy. Subsequently, the participants were kept continuously awake in a controlled environment for 25 h (8amtill 9am the next day). Among the ADHD group, 17 participants were medicated with their regular doses of methylphenidate (n = 13) or amphetamine (n = 4) at the start of the experiment (08:00 AM) and again at midnight (00:00), while 22 were unmedicated throughout the study. The sleepiness of the participants was assessed every hour by the Karolinska Sleepiness Scale (KSS) in order to obtain the sleepiness curve of both study groups. RESULTS: Unmedicated ADHD participants reported significantly higher sleepiness throughout the protocol, especially during nighttime and early morning hours. At the end of the 25-hour wakefulness period, their KSS scores were significantly higher than both the control and medicated ADHD groups. No significant difference was found between the medicated ADHD group and controls. Additionally, 88.2% of unmedicated ADHD participants scored above 7 on the KSS (indicating extreme sleepiness), compared to 55% in controls and 36.9% in the medicated ADHD group. CONCLUSIONS: Young adults with ADHD exhibit heightened vulnerability to sleep deprivation, reflected in elevated subjective sleepiness. Stimulant medications effectively attenuate sleepiness in ADHD participants, aligning their alertness levels with those of neurotypical controls. These findings support models of ADHD involving arousal dysregulation and highlight the dual therapeutic role of stimulants in managing both attentional deficits and sleep-related impairments. CLINICAL TRIAL NUMBER: Not applicable.

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6. Haza B, Conty L, Pinabiaux C. Preliminary psychometric evaluation of a nonverbal social cue-following test in children with and without Attention-Deficit/Hyperactivity Disorder (ADHD). J Clin Exp Neuropsychol;2026 (Mar 24):1-15.

OBJECTIVE: Previous research suggests that children with Attention-Deficit/Hyperactivity Disorder (ADHD) have difficulties processing gaze cues, potentially impairing their social interactions. This study evaluated the psychometric properties of TooN, a test designed to assess the ability to follow nonverbal social cues. We examined its clinical validity by comparing performance in children with ADHD and typically developing peers, as well as its internal consistency and test-retest reliability. METHOD: Clinical validity and internal consistency were assessed in 25 children with ADHD (mean age = 105 months, SD = 17; 6 girls) and 100 typically developing children matched for age and sex. Test-retest reliability was examined in an independent sample of 28 typically developing children (mean age = 103 months, SD = 17; 17 girls) who completed the task twice over a three-week interval. RESULTS: Children with ADHD showed longer reaction times and made more errors than typically developing peers. While cueing effects did not significantly differ between groups, only typically developing children showed a reliable gaze cueing effect, and both groups responded to pointing cues. Reaction time measures showed excellent internal consistency in both groups and moderate-to-good test-retest reliability in typically developing children, while cueing effects showed lower reliability. Accuracy measures were highly reliable in the ADHD group but less so in controls, possibly due to ceiling effects. CONCLUSIONS: TooN provides preliminary evidence relevant to assessing nonverbal social cue-following in children with and without ADHD. The absence of a reliable gaze cueing effect in ADHD is consistent with gaze-processing difficulties and supports the task’s relevance for further investigation. However, the limited reliability of cueing effect scores and the absence of test-retest reliability data in ADHD indicate that findings should be interpreted cautiously. Further research should establish test-retest reliability and convergent validity in clinical samples before broader clinical applicability can be determined.

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