BACKGROUND: In attention-deficit/hyperactivity disorder (ADHD), poor inhibitory control is one of the main characteristics, with oculomotor inhibition impairments being considered a potential biomarker of the disorder. While auditory white noise has demonstrated the ability to enhance working memory in this group, visual white noise is still unexplored and so are the effects of both types of white noise stimulation on oculomotor inhibition.
OBJECTIVE: This crossover study aims to explore the impact of auditory and visual white noise on oculomotor inhibition in children with ADHD and typically developing (TD) children. The study will investigate the impact of different noise levels (25% and 50% visual, 78 dB auditory), and performance will be evaluated both with and without noise stimulation. We hypothesize that exposure to white noise will improve performance in children with ADHD and impair the performance for TD children.
METHODS: Memory-guided saccades and prolonged fixations, known for their sensitivity in detecting oculomotor disinhibition in ADHD, will be used to assess performance. Children diagnosed with ADHD, withdrawing from medication for 24 hours, and TD children without psychiatric disorders were recruited for the study.
RESULTS: Data collection was initiated in October 2023 and ended in February 2024. A total of 97 participants were enrolled, and the first results are expected between September and November 2024.
CONCLUSIONS: This study will examine whether cross-modal sensory stimulation can enhance executive function, specifically eye movement control, in children with ADHD. In addition, the study will explore potential differences between auditory and visual noise effects in both groups. Our goal is to identify implications for understanding how noise can be used to improve cognitive performance.
BACKGROUND: ClinicalTrials.gov NCT06057441; https://clinicaltrials.gov/study/NCT06057441.
UNASSIGNED: DERR1-10.2196/56388.

Aim: To compare long-term safety and efficacy outcomes of centanafadine versus lisdexamfetamine dimesylate (lisdexamfetamine), methylphenidate hydrochloride (methylphenidate) and atomoxetine hydrochloride (atomoxetine), respectively, in adults with attention-deficit/hyperactivity disorder (ADHD) using matching-adjusted indirect comparisons (MAICs). Patients & methods: Patient-level data from a centanafadine trial (NCT03605849) and published aggregate data from a lisdexamfetamine trial (NCT00337285), a methylphenidate trial (NCT00326300) and an atomoxetine trial (NCT00190736) were used. Patient characteristics were matched in each comparison using propensity score weighting. Study outcomes were assessed up to 52 weeks and included safety (rates of adverse events [AEs]) and efficacy (mean change from baseline in the Adult ADHD Investigator Symptom Rating Scale [AISRS] or ADHD Rating Scale [ADHD-RS] score). Results: In all comparisons of matched populations, risks of AEs were statistically significantly lower with centanafadine or non-different between centanafadine and comparator; the largest differences in AE rates included upper respiratory tract infection (risk difference in percentage points: 18.75), insomnia (12.47) and dry mouth (12.33) versus lisdexamfetamine; decreased appetite (20.25), headache (18.53) and insomnia (12.65) versus methylphenidate; and nausea (26.18), dry mouth (25.07) and fatigue (13.95) versus atomoxetine (all p < 0.05). Centanafadine had a smaller reduction in the AISRS/ADHD-RS score versus lisdexamfetamine (6.15-point difference; p < 0.05) and no statistically significant difference in the change in AISRS score versus methylphenidate (1.75-point difference; p = 0.13) and versus atomoxetine (1.60-point difference; p = 0.21). Conclusion: At up to 52 weeks, centanafadine showed significantly lower incidence of several AEs than lisdexamfetamine, methylphenidate and atomoxetine; efficacy was lower than lisdexamfetamine and non-different from methylphenidate and atomoxetine.

Background: Alterations in the serum lipid profile have been suspected in many psychiatric disorders, such as schizophrenia and depression. However, studies on lipid status in attention-deficit/hyperactivity disorder (ADHD) are sparse and inconsistent. Methods: Using the nationwide, population-based IQVIA Disease Analyzer database, this retrospective cohort study included 5367 outpatients from general practices in Germany aged ≥18 years with a documented first diagnosis of ADHD between January 2005 and December 2021 and 26,835 propensity score-matched individuals without ADHD. Study outcomes were the first diagnosis of lipid metabolism disorders as a function of ADHD within up to 10 years of the index date. The cumulative 10-year incidence was analyzed using Kaplan-Meier curves and compared using the log-rank test. In addition, univariate Cox regression analyses were performed. Results: In the regression analysis, there was no significant association between ADHD and subsequent lipid metabolism disorders in the total population (HR: 0.94; 95% CI: 0.83-1.08), among women (HR: 1.04; 95% CI: 0.84-1.28), and among men (HR: 0.89; 95% CI: 0.74-1.06). In addition, no significant association was observed in the disease-stratified analyses. Conclusions: The findings of this study indicate that ADHD does not exert an influence on lipid metabolism. However, further investigation is warranted, particularly with respect to pharmacological interventions.

UNASSIGNED: Previous studies exhibited differences in sensory processing, motor coordination, metacognitive executive functions (EF-MI), and sleep quality among adults with neurodevelopmental disorders (NDD). This study aims to find relationships between those abilities and organization-in-time, focusing on emotional responses after decreased organization abilities.
UNASSIGNED: This is a secondary data analysis of a larger sample from three previous studies conducted in one laboratory. Data were collected from 290 adults; 149 with NDD and 141 sex- and age- (20-50 years) matched controls completed the Adolescent/Adult Sensory Profile, Adult Developmental Coordination Disorder, Adults Behavioral Rating Inventory of Executive Functions, Mini Sleep, and Time Organization and Participation questionnaires. Structural equation model (SEM) analysed relationships and variable prediction.
UNASSIGNED: Significant between-group differences were found for all variables; SEM indicated similar paths in both groups. Sensory processing affected EF-MI and sleep quality and significantly correlated with motor coordination, affecting EF-MI; EF-MI affected organization-in-time. Sleep quality significantly affected organization-in-time, affecting emotional responses.
UNASSIGNED: Sensory, motor, EF, and sleep differences were associated with decreased organization-in-time abilities of adults with NDD, adversely affecting their emotional well-being. Early detection of such differences and targeted interventions may improve daily functioning and life quality and prevent negative emotional implications.
Neurodevelopmental disorders (NDD) emerging early in development affect lifelong well-being, and personal, social, academic, and occupational function.Adults with NDD may experience reduced quality of life due to ineffective time organization and life management.Ineffective time organization and consequence negative emotional responses are tied with deficient sensory processing, motor coordination, metacognitive executive function abilities, and sleep quality.Early diagnosis of such deficiencies following by targeted intervention may enhance daily functioning, reduce emotional challenges, and improve overall life outcomes.

BACKGROUND: Sotos syndrome is an autosomal dominant disorder, whereas attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental condition. This report aimed to summarize the clinical and genetic features of a pediatric case of Soros syndrome and ADHD in a child exhibiting precocious puberty.
METHODS: The patient presented with accelerated growth and advanced skeletal maturation; however, she lacked any distinct facial characteristics related to specific genetic disorders. Genetic analyses revealed a paternally inherited heterozygous synonymous mutation [c.4605C>T (p.Arg1535Arg)]. Functional analyses suggested that this mutation may disrupt splicing, and bioinformatics analyses predicted that this mutation was likely pathogenic. After an initial diagnosis of Sotos syndrome, the patient was diagnosed with ADHD during the follow-up period at the age of 8 years and 7 months.
CONCLUSIONS: The potential for comorbid ADHD in Sotos syndrome patients should be considered to avoid the risk of a missed diagnosis.

BACKGROUND: Attention-Deficit/Hyperactivity Disorder (ADHD) is a multifaceted neurodevelopmental psychiatric condition that typically emerges during childhood but often persists into adulthood, significantly impacting individuals\' functioning, relationships, productivity, and overall quality of life. However, the current diagnostic process exhibits limitations that can significantly affect its overall effectiveness. Notably, its face-to-face and time-consuming nature, coupled with the reliance on subjective recall of historical information and clinician subjectivity, stand out as key challenges. To address these limitations, objective measures such as neuropsychological evaluations, imaging techniques and physiological monitoring of the Autonomic Nervous System functioning, have been explored.
METHODS: The main aim of this study was to investigate whether physiological data (i.e., Electrodermal Activity, Heart Rate Variability, and Skin Temperature) can serve as meaningful indicators of ADHD, evaluating its utility in distinguishing adult ADHD patients. This observational, case-control study included a total of 76 adult participants (32 ADHD patients and 44 healthy controls) who underwent a series of Stroop tests, while their physiological data was passively collected using a multi-sensor wearable device. Univariate feature analysis was employed to identify the tests that triggered significant signal responses, while the Informative k-Nearest Neighbors (KNN) algorithm was used to filter out less informative data points. Finally, a machine-learning decision pipeline incorporating various classification algorithms, including Logistic Regression, KNN, Random Forests, and Support Vector Machines (SVM), was utilized for ADHD patient detection.
RESULTS: Results indicate that the SVM-based model yielded the optimal performance, achieving 81.6% accuracy, maintaining a balance between the experimental and control groups, with sensitivity and specificity of 81.4% and 81.9%, respectively. Additionally, integration of data from all physiological signals yielded the best results, suggesting that each modality captures unique aspects of ADHD.
CONCLUSIONS: This study underscores the potential of physiological signals as valuable diagnostic indicators of adult ADHD. For the first time, to the best of our knowledge, our findings demonstrate that multimodal physiological data collected via wearable devices can complement traditional diagnostic approaches. Further research is warranted to explore the clinical applications and long-term implications of utilizing physiological markers in ADHD diagnosis and management.

BACKGROUND: Attention-Deficit/Hyperactivity Disorder (ADHD) is a recognized neurodevelopmental disorder with a complex, multifactorial origin. Lead (Pb) and mercury (Hg) are highly toxic substances that can potentially impair brain development and have been implicated in the development of ADHD. This systematic review aims to analyze the epidemiological literature regarding the association between Pb and Hg exposure and the diagnosis of ADHD.
METHODS: From November 1983 to June 2, 2023, a comprehensive search was conducted in multiple databases and search engines, including PubMed, Web of Science, Scopus, and Google Scholar. Observational studies (case-control, cohort, and cross-sectional) measuring Pb and Hg levels in various biological samples (blood, hair, urine, nail, saliva, teeth, and bone) of children with ADHD or their parents and their association with ADHD symptoms were included.
RESULTS: Out of 2059 studies, 87 met the inclusion criteria and were included in this systematic review. Approximately two-thirds of the 74 studies investigating Pb levels in different biological samples reported associations with at least one subtype of ADHD. However, most studies examining Hg levels in various biological samples found no significant association with any ADHD subtype, although there were variations in exposure periods and diagnostic criteria.
CONCLUSIONS: The evidence gathered from the included studies supports an association between Pb exposure and the diagnosis of ADHD, while no significant association was found with Hg exposure. Importantly, even low levels of Pb were found to elevate the risk of ADHD. Further research is needed to explore the comprehensive range of risk factors for ADHD in children, considering its significance as a neurodevelopmental disorder.

Cognitive disengagement syndrome (CDS) and ADHD are considered distinct but interrelated constructs. This study aimed to investigate the prevalence of elevated CDS symptoms and increased ADHD risk in the general population, and their relationships with emotion regulation difficulty (ERD) and alexithymia. Out of 1166 participants, 142 with known psychiatric conditions were excluded, resulting in 1024 participants. Participants completed various scales including Adult ADHD Self-Report Screening Scale for DSM-5 (ASRS-5), Barkley Adult Sluggish Cognitive Tempo (SCT) Scale, Difficulties in Emotion Regulation Scale-Short Form (DERS-16), and the Toronto Alexithymia Scale (TAS-20). Four groups were formed based on Barkley and ASRS-5 scores: Group 1) No elevated CDS symptoms and Low risk of ADHD, Group 2) No elevated CDS symptoms and Increased risk of ADHD, Group 3) Elevated CDS symptoms and Low risk of ADHD, Group 4) Elevated CDS symptoms and Increased risk of ADHD. Elevated CDS symptoms was found in 10% of participants, and increased ADHD risk in 9.2%. Among probable ADHD cases, 40% had elevated CDS symptoms, while 60% of elevated CDS symptoms cases had increased ADHD risk. Group 4 (elevated CDS symptoms and increased risk of ADHD) had the highest ERD and alexithymia scores, while Group 1(no elevated CDS symptoms and low risk of ADHD) had the lowest. Regression analyses showed that CDS scores predicted ERD (47%) and alexithymia (32%) better than ADHD scores (ERD: 36%, alexithymia: 23%). CDS and ADHD appear as significant concepts that could be involved in the etiology of ERD and alexithymia.

UNASSIGNED: Studies have found maternal smoking during pregnancy was linked to attention-deficit/hyperactivity disorder (ADHD) risk. It is unclear if maternal smoking cessation during pregnancy lowers ADHD and learning disability (LD) risk in offspring. This study aimed to explore the associations between maternal smoking cessation during pregnancy and ADHD and LD risk in offspring.
UNASSIGNED: Data from the National Health and Nutrition Examination Survey 1999-2004 (8,068 participants) were used. Logistic regression was used to analyze the associations between maternal smoking and smoking cessation during pregnancy and ADHD and LD risk in offspring.
UNASSIGNED: Compared to non-smokers\' offspring, maternal smoking during pregnancy increased the risk of ADHD (odds ratios [OR] = 2.07, 95% confidence interval [CI]: 1.67-2.56) and LD (OR = 1.93, 95% CI: 1.61-2.31) in offspring, even if mothers quit smoking later (ORADHD = 1.91, 95%CIADHD: 1.38-2.65, ORLD = 1.65, 95%CILD: 1.24-2.19). Further analysis of the timing of initiation of smoking cessation during pregnancy revealed that, compared to non-smokers\' offspring, maternal quitting smoking in the first trimester still posed an increased risk of ADHD (OR = 1.72, 95% CI: 1.41-2.61) and LD (OR = 1.52, 95% CI: 1.06-2.17) in offspring. Maternal quitting smoking in the second or third trimester also had a significantly increased risk of ADHD (OR = 2.13, 95% CI: 1.26-3.61) and LD (OR = 1.82, 95% CI: 1.16-2.87) in offspring. Furthermore, maternal smoking but never quitting during pregnancy had the highest risk of ADHD (OR = 2.17, 95% CI: 1.69-2.79) and LD (OR = 2.10, 95% CI: 1.70-2.58) in offspring. Interestingly, a trend toward a gradual increase in the risk-adjusted OR for ADHD and LD risk was observed among the three groups: maternal quitting smoking in the first trimester, maternal quitting smoking in the second or third trimester, and maternal smoking but never quitting.
UNASSIGNED: Maternal smoking cessation in the first trimester still poses an increased risk of ADHD and LD in offspring. Furthermore, it seems that the later the mothers quit smoking during pregnancy, the higher the risk of ADHD and LD in their offspring. Therefore, early intervention of maternal smoking in preconception and prenatal care is vital for offspring neurodevelopment.

OBJECTIVE: To investigate the associations among symptoms of attention deficit hyperactivity disorder (ADHD) with binge eating spectrum conditions - BESC - [binge eating disorder (BED), bulimia nervosa (BN), and recurrent binge eating (RBE)], and psychiatric and somatic comorbidity and healthcare utilization in a representative sample of a Brazilian city.
METHODS: A household survey with 2,297 adults and residents in Rio de Janeiro was conducted. The Adult Self-Rating Scale Screener was used to assess ADHD symptoms. BESC was assessed using the Questionnaire of Eating and Weight Patterns 5 and confirmed by telephone interview. Standardized questionnaires were used to assess psychiatric comorbidity. Close-ended questions investigated somatic comorbidity and healthcare utilization.
RESULTS: ADHD symptoms were highly associated with BESC [BED, OR=13.2, 95%CI= 4.3-40.6; BN, OR=27.5, 95%CI= 5.9-128.7; RBE, OR=5.8, 95%CI= 2.9-11.4). However, with further adjustment for psychiatric comorbidity (depression, anxiety, alcohol use and impulsivity), the ORs were no longer significant. Healthcare resource utilization was significantly higher in participants with ADHD and BESC but lost significance after controlling for the psychiatric comorbidity.
CONCLUSIONS: ADHD was associated with an increased prevalence of BESC, and healthcare utilization. Nonetheless, there was an essential interplay among psychiatric comorbidity in the associations of ADHD and BESC.