1. Eraydin IE, Marhenke R, Stringer D, Conti AA, Bozhilova N, Johansson L, Mason L, Bilbow A, Mehta MA, Santosh P, Fiori F, Carter B, Cortese S, Rubia K. Effects of External Trigeminal Nerve Stimulation on Neurocognitive Functioning in Children and Adolescents With ADHD: A Phase 2b Multicenter Randomized Controlled Trial. Am J Psychiatry. 2026: appiajp20260002.

OBJECTIVE: Attention deficit hyperactivity disorder (ADHD) is associated with atypical cognition and related autonomic nervous system regulation. Trigeminal nerve stimulation (TNS) received U.S. Food and Drug Administration clearance as neuromodulation treatment for ADHD based on findings of clinical improvements from a pilot trial that were not confirmed in the authors’ larger multicenter UK trial. Effects of TNS on cognition in ADHD, however, are relatively unknown. The authors therefore tested secondary outcomes, that is, short- and longer-term effects of active versus sham TNS in youths with ADHD on a broad neurocognitive task battery, physiological indicators of autonomic nervous system regulation, and head motion. METHODS: In the first confirmatory, multicenter, double-blind, parallel-group, phase 2b randomized sham-controlled trial, 150 youths with ADHD (ages 8-18 years) were assigned to 4 weeks of nightly active (N=75) or sham (N=75) TNS. Cognitive performance was assessed using a comprehensive battery of executive function and attention tasks (inhibition, sustained attention, time estimation, processing speed, and intrasubject response variability) at baseline, posttreatment, and 6-month follow-up. Autonomic nervous system regulation (heart rate, heart rate variability, and electrodermal activity) was measured via a wristband device and head motion with an eye tracker during rest or cognitive testing. RESULTS: Intention-to-treat analysis showed no significant differential treatment effects between active and sham TNS on any cognitive or physiological outcomes after 4 weeks of treatment or on cognitive measures at 6-month follow-up. CONCLUSIONS: TNS does not appear to improve neurocognitive performance, autonomic regulation, or head motion in youths with ADHD, extending negative clinical findings. The findings do not provide evidence to support TNS as a viable treatment to improve cognitive or autonomic nervous system functioning in youths with ADHD.

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2. Kamış GZ, Kurhan F, Alp HH. NADPH Oxidase-driven Oxidative Profile in Adult Attention-deficit/Hyperactivity Disorder: NOX2/NOX4 Activation and Lipid Peroxidation. Clin Psychopharmacol Neurosci. 2026; 24(4): 809-20.

OBJECTIVE: Adult attention-deficit/hyperactivity disorder (ADHD) remains a clinically heterogeneous condition. Oxidative stress has been implicated, but biomarkers with clinical utility remain limited. NADPH oxidase (NOX) isoforms-particularly NOX2 and NOX4-generate reactive oxygen species and may drive lipid peroxidation, indexed by malondialdehyde (MDA). METHODS: Adults with ADHD (n = 79) and healthy controls (n = 63) were enrolled to the study. ADHD diagnosis was established with DIVA-2 and symptom severity assessed with ASRS. Plasma MDA and serum NOX2 (gp91(phox)) and NOX4 levels were measured. Group comparisons, correlation, and ROC analyses were conducted. RESULTS: ADHD patients showed higher MDA, NOX2, and NOX4 levels than controls (all p < 0.001). In ADHD, NOX2 correlated with MDA (r = 0.552) and NOX4 (r = 0.615; both p < 0.01), but not in controls. MDA and NOX2 showed excellent discrimination (AUC 0.942 and 0.915), and NOX4 good discrimination (AUC 0.824); MDA outperformed NOX4 by DeLong's test (p = 0.012). In adjusted models, MDA (aOR 2.84, 95% CI 1.92-4.12) and NOX2 (aOR 2.15, 95% CI 1.54-3.01) remained independently associated with ADHD (both p < 0.001). CONCLUSION: Adult ADHD was associated with a NOX-linked oxidative profile, characterized by elevated NOX2/NOX4 and MDA levels. The NOX2-MDA association supports a pathway linking enzymatic ROS generation to lipid peroxidation. MDA and NOX2 showed strong discrimination and independent associations with ADHD, supporting their potential as adjunct biomarkers; however, given the transdiagnostic nature of oxidative stress, clinical utility requires external validation in independent, clinically representative samples.

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3. Kong Y, Zhou M, Yuan X, Luo X, Huang J, Li Y, Yang L, Wang Y, Sun X, Sun L, Song Y. Susceptibility to task-irrelevant auditory distractors in relation to visual working memory in children with and without attention-deficit/hyperactivity disorder. Child Dev. 2026.

Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder associated with increased distractibility. Previous research has reported that susceptibility to task-irrelevant visual distraction is linked with visual working memory (WM) capacity in adults. Here, we examined how neural susceptibility to task-irrelevant auditory distractors related to visual WM capacity in children with and without ADHD. Across two experiments, electroencephalography (EEG) signals were recorded from 146 Chinese children aged 7-15 (63 with ADHD, 23% girls; collected in 2022-2024), during which they performed visual tasks of varying difficulty with auditory distractors. The mismatch negativity (MMN) amplitude was measured as neural susceptibility to auditory distractors, and a K-score was calculated to assess visual WM capacity. In typically developing (TD) children, those with higher visual WM capacity showed less susceptibility to auditory distractors under high audiovisual competition (r = 0.494), whereas this relation reversed under low competition (r = -0.319). Conversely, in children with ADHD, lower visual WM capacity predicted higher susceptibility under both high (r = 0.442) and low competition (r = 0.326). These findings indicate that susceptibility to task-irrelevant auditory distraction is related to visual WM capacity in children, but the patterns differ between typical and atypical neurodevelopment and are modulated by audiovisual competition. This study investigated how children’s sensitivity to distracting sounds was related to their visual memory capacity, and whether this relation differed between children with and without attention-deficit/hyperactivity disorder. Brain activity was measured while children performed visual tasks under different demand levels with background sounds. In typically developing children, higher visual memory capacity was associated with reduced distraction by sounds when the visual task was more demanding, whereas the relation was reversed when visual task demand was lower. In contrast, children with attention-deficit/hyperactivity disorder who had lower visual memory capacity showed greater auditory distraction, regardless of visual task demand. These findings suggest a close relation between auditory distraction and visual memory capacity in children, depending on both developmental deficit and task contexts. eng.

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4. Lu CC, Lee YH, Lee HJ, Mouri A, Sharmin D, Cook J, Nabeshima T, Sieghart W, Chiou LC. α6GABA(A) receptors as novel targets for ADHD therapy: A proof-of-concept study in MK-801-treated juvenile mice. Eur J Pharmacol. 2026; 1034: 179302.

Cerebellar abnormalities have been associated with attention-deficit/hyperactivity disorder (ADHD) in human studies. Animal models also implicate cerebellar microcircuit dysfunction, particularly reduced inhibitory control of granule cells (GCs) in mice lacking Git1, an ADHD risk gene. Excitatory GCs are the most abundant neuronal population in the cerebellum and are enriched in α6 subunit-containing GABA(A) (α6GABA(A)) receptors. Thus, α6GABA(A) receptor-selective positive allosteric modulators (PAMs), such as pyrazoloquinolinones (PQs), may represent a novel therapeutic approach for ADHD. Here, we tested this hypothesis using PQ Compound 6 in juvenile (P28) ICR mice treated with dizocilpine (MK-801, 0.2 mg/kg, intraperitoneally, i.p.), an NMDA receptor antagonist. In both sexes, MK-801 induced behavioral abnormalities resembling the three core symptoms of ADHD- hyperlocomotion, impulsivity, and inattention-as assessed by locomotor activity, cliff avoidance reaction, and novel object recognition tests, respectively. Compound 6 (3 mg/kg, i.p.) normalized these ADHD-like behavioral impairments. Atomoxetine, an approved ADHD medication, also attenuated ADHD-like phenotypes, although with sedative effects. The therapeutic-like effects of Compound 6 were abolished by intracerebellar microinjection of furosemide, an α6GABA(A) receptor antagonist, and were absent in Gabra6 (α6-encoding gene)-knockout mice, indicating that positive modulation of cerebellar α6GABA(A) receptors underlies the observed behavioral improvements. Together, these findings provide proof-of-concept that enhancing cerebellar α6GABA(A) receptor-mediated inhibition can ameliorate ADHD-relevant behavioral impairments and highlight α6GABA(A) receptor-selective PAMs as a potential pharmacotherapeutic strategy for ADHD.

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5. Rafnsdottir R, Arnadottir MK, Halldorsson F, Haraldsdottir G, Hannesdottir DK. Profiles of Youth With Predominantly Inattentive Attention-Deficit/Hyperactivity Disorder in a Nationwide Clinical Sample in Iceland. Scand J Psychol. 2026.

This study aimed to examine comorbidity, emotional symptoms, and cognitive profiles of youth with predominantly inattentive attention-deficit/hyperactivity disorder (ADHD-I) using a large nationwide clinical sample based on in-person assessments using gold-standard diagnostic procedures. Participants were 2109 children (64.7% male) aged 5-18 (M = 10.10) diagnosed with either ADHD-I (n = 636) or combined presentation (ADHD-C; n = 1473). Diagnoses of ADHD and comorbid psychiatric conditions were determined with the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime version (K-SADS-PL) and the Anxiety Disorders Interview Schedule for Children (ADIS-C/P). Additional measures included the Wechsler Intelligence Scale for Children (WISC-IV) and parent/teacher reports on the Strengths and Difficulties Questionnaire. Children with ADHD-I were, on average, 2 years older at the time of diagnosis than those with ADHD-C. Anxiety disorders, autism, depressive disorders, and tic/Tourette’s disorder were equally prevalent across both the ADHD-I and ADHD-C groups. On cognitive testing, the ADHD-I group scored significantly lower on verbal comprehension (VCI), processing speed (PSI), and working memory (WMI) compared with the ADHD-C group. Findings highlight distinct challenges for youth with ADHD-I in this nationwide clinical sample. These youth are more often identified later and perform worse on certain cognitive tasks. Notably, they have a remarkably higher prevalence of comorbidities, such as anxiety disorders, than the worldwide prevalence of mental disorders in children and adolescents. The results underscore the importance of earlier screening and appropriate interventions for children presenting primarily with inattentive symptoms.

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6. Roberti E, Clavenna A, Graziani V, Marchetti F, Suprani T, Di Bartolo P, Canevini MP, Viganò I, Ricci E, Costantino I, Tessarollo V, Basso E, Scarpellini F, Campi R, Giardino M, Zanetti M, Bonati M. Recommendations for transitioning diabetes, epilepsy, and ADHD youth. The TransiDEA Project. Paediatr Child Health. 2026; 31(7): 771-85.

INTRODUCTION: The transition from pediatric to adult health care is a critical yet often challenging process for young adults with chronic conditions, marked by fragmented communication, scarce resources, and a lack of standardized guidelines. The Italian TransiDEA project aimed to address these gaps by developing tailored transition recommendations for three clinical populations: young adults with Attention-Deficit/Hyperactivity Disorder (ADHD), Type 1 diabetes (T1D), or epilepsy. METHODS: Using a Delphi consensus method, three multidisciplinary panels including clinicians, young adults, caregivers, and association members were conducted in parallel, each addressing one of the three clinical targets. Participants assessed and revised the transition guidelines adapted from international frameworks over two rounds of evaluation. RESULTS: After the first round, the overall agreement was above 75% for all three chronic conditions. The changes made to the statements based on the ratings and suggestions, led to high agreement (100%) in the second round. DISCUSSION: The final recommendations share key elements, including early transition planning (starting around age 16), the assignment of a named transition worker, and using standardized tools (e.g., transition readiness questionnaires). Condition-specific adaptations addressed unique needs, such as psychological support in ADHD, tailoring the process on a case-by-case basis depending on the clinical picture in epilepsy, and extended transition timelines (up to age 22) in T1D. CONCLUSION: The TransiDEA project demonstrates the feasibility of structured yet flexible recommendations for transition pathways across chronic conditions, while encouraging systemic improvements to enhance care continuity. Despite these advances, challenges remain, including the need for future validation of the guidelines and tools and increased resource and institutional support to ensure equitable access.

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7. Zelenski KN, Sasaki J, Bedi N, Chelton A, MacFarlane AJ, Alben MG, Fuller SI. Attention-Deficit/Hyperactivity Disorder Is Associated With Lower Rates of Adhesive Capsulitis, Bursitis, Shoulder Stiffness, and Revision Shoulder Arthroscopy After Arthroscopic Rotator Cuff Repair. Sports Health. 2026: 19417381261497018.

BACKGROUND: Arthroscopic rotator cuff repair (RCR) success is dependent on adherence to a structured postoperative rehabilitation protocol. Attention-deficit/hyperactivity disorder (ADHD) is associated with worse outcomes after certain orthopaedic surgeries, but its impact on rehabilitation after RCR remains unclear. This study compared short-term outcomes after arthroscopic RCR in patients with and without ADHD. HYPOTHESIS: Patients with ADHD will experience higher rates of postoperative complications within the first 12 months after arthroscopic RCR. STUDY DESIGN: Retrospective cohort study. LEVEL OF EVIDENCE: Level 3. METHODS: Using the TriNetX Research Network, arthroscopic RCR cases from 113 healthcare organizations between January 2006 and January 2026 were identified and stratified by a preoperative ADHD diagnosis. Cohorts were propensity score-matched 1:1 for age, sex, obesity, type 2 diabetes mellitus, mood disorders, anxiety and stress-related disorders, and nicotine dependence. Outcomes at 3 months included revision shoulder arthroscopy, adhesive capsulitis, bursitis, and shoulder stiffness; 1-year outcomes also included deep infection and wound disruption. A Benjamini-Hochberg (BH) correction was applied to address multiple comparisons. RESULTS: After propensity score matching, 4740 patients were included per cohort. At 3 months, patients with ADHD demonstrated lower odds of bursitis (odds ratio [OR], 0.733; 95% CI, 0.592-0.908; P = 0.004; BH-adjusted P = 0.009) and shoulder stiffness (OR, 0.729; 95% CI, 0.629-0.844; P < 0.001; BH-adjusted P < 0.001). At 1 year, the ADHD cohort demonstrated lower odds of revision shoulder arthroscopy (OR, 0.798; 95% CI, 0.655-0.972; P = 0.03; BH-adjusted P = 0.04), adhesive capsulitis (OR, 0.676; 95% CI, 0.550-0.831; P < 0.001; BH-adjusted P < 0.001), bursitis (OR, 0.681; 95% CI, 0.578-0.802; P < 0.001; BH-adjusted P < 0.001), and shoulder stiffness (OR, 0.716; 95% CI, 0.625-0.820; P < 0.001; BH-adjusted P < 0.001). CONCLUSION: ADHD was associated with lower 3-month rates of bursitis and shoulder stiffness, and lower 1-year rates of adhesive capsulitis, bursitis, shoulder stiffness, and revision shoulder arthroscopy after arthroscopic RCR. CLINICAL RELEVANCE: In contrast to previous literature, ADHD was not associated with worse outcomes after arthroscopic RCR and was associated with lower rates of stiffness-related complications. These findings suggest further research is needed to inform patient counseling and surgical decision-making.

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8. Zhu F, Dong Z, Kuang D, Zhu X, Bi X, Li Z, Yang L, Wang Y, Chen J, Xu B, Lin S, Zhou H, Ren Y. Effects of a Multicomponent App-Based Exercise Program on Motor Skill Development in Children With Attention Deficit Hyperactivity Disorder: A Secondary Outcome Analysis of a Three-Arm Randomized Controlled Trial. Scand J Med Sci Sports. 2026; 36(11).

Motor skill deficits are common in children with attention deficit hyperactivity disorder (ADHD), while traditional face-to-face exercise interventions are often limited by cost and accessibility. This secondary outcome analysis of a three-arm randomized controlled trial examined the effects of a multicomponent app-based exercise program on motor skill outcomes in children with ADHD. A total of 145 children aged 6-10 years were assigned to an app-based exercise group (Experimental Group 1, EG1; n = 53), a traditional offline exercise group (Experimental Group 2, EG2; n = 45), or a minimal-intervention control group (CG, n = 47). Both intervention groups received a 12-week program (3 sessions/week, 45-60 min/session) involving integrated physical and cognitive exercises, delivered either through a custom-developed WeChat applet (« LeDongYing ») or through coach-led in-person sessions. Motor skills were assessed using the Test of Gross Motor Development, Third Edition (TGMD-3) for locomotor and ball skills, and the Movement Assessment Battery for Children, Second Edition (MABC-2) for manual dexterity, aiming and catching, and balance. Intervention effects were examined using linear mixed-effects models. Both EG1 and EG2 showed significant improvements across all motor skill domains (all p < 0.01), whereas the CG showed no significant changes. Pairwise comparisons showed that both intervention groups were superior to the CG on all motor skill outcomes (all p < 0.05), with no statistically significant differences between EG1 and EG2. These findings support the short-term efficacy of a multicomponent app-based exercise intervention for motor-test performance in children with ADHD compared with minimal intervention, suggesting potential as an alternative delivery when access to face-to-face exercise services is limited.

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