Attention deficit hyperactivity disorder (ADHD) is associated with poor educational outcomes that can have long-term negative effects on the mental health, wellbeing, and socio-economic outcomes of university students. Mental health provision for university students with ADHD is often inadequate due to long waiting times for access to diagnosis and treatment in specialist National Health Service (NHS) clinics. ADHD is a hidden and marginalised disability, and within higher education in the UK, the categorisation of ADHD as a specific learning difference (or difficulty) may be contributing to this.This consensus aims to provide an informed understanding of the impact of ADHD on the educational (or academic) outcomes of university students and highlight an urgent need for timely access to treatment and management.The UK Adult ADHD Network (UKAAN) convened a meeting of practitioners and experts from England, Wales, and Scotland, to discuss issues that university students with ADHD can experience or present with during their programme of studies and how best to address them. A report on the collective analysis, evaluation, and opinions of the expert panel and published literature about the impact of ADHD on the educational outcomes of university students is presented.A consensus was reached that offers expert advice, practical guidance, and recommendations to support the medical, education, and disability practitioners working with university students with ADHD.Practical advice, guidance, and recommendations based on expert consensus can inform the identification of ADHD in university students, personalised interventions, and educational support, as well as contribute to existing research in this topic area. There is a need to move away from prevailing notions within higher education about ADHD being a specific learning difference (or difficulty) and attend to the urgent need for university students with ADHD to have timely access to treatment and support. A multimodal approach can be adapted to support university students with ADHD. This approach would view timely access to treatment, including reasonable adjustments and educational support, as having a positive impact on the academic performance and achievement of university students with ADHD. Going to university can be an exciting experience, but it is also a daunting and stressful experience for new and returning students. The pressure to do well academically and cope with an array of lifestyle changes, can impact on the mental health and wellbeing of university students, especially students with ADHD who are transitioning from adolescence into adulthood . This trattainment of information and skills learnt, grades obtained on continuous assessments such as standardised examinations or coursework) and academic performance   were facing a number of, often shared, challenges ...” (p.132), which included dealing with a rising numbers of university students with ADHD and complex mental health needs. One provider quoted by the IES said that:The influence of Burt’s work on educational policy and provisions for students with special educational needs was profound . It was nd 1980” , p.16–17nd 1980” , diagnosnd 1980” . There and 1980” . These vnd 1980” . This IE“… the support provisions for disabled students is understandably being affected by external factors. How to manage that impact is a focus for the disability and dyslexia team… this includes… the number of students with ADHD which has grown dramatically in recent years. This group of students are very challenging to support for both the service and for academic staff. The disability and dyslexia service need training and development to enable them to both support these students and the academic staff working with them ...” [hem ...”  p.134).In the UK, across Europe and worldwide, there is a paucity of research about university students with ADHD. Previous studies mostly seem to originate from North America, where research activity in this topic area has been ongoing since the 1990s, and the impact of ADHD on the educational outcomes of college (or university) students is more widely understood. A comprehensive review of these studies was conducted by Sedgwick , and a sThe relevance of intellectual giftedness to university students with ADHD was considered by the expert group. Intellectual giftedness is another contested concept variously defined as exceptional intellectual ability, academic talent, or high-potential learners, with concurrent traits of creativity, curiosity, effort, and self-motivation –56. Inteadults with IQ scores in and above superior range have often sought evaluation and treatment for chronic difficulties with organizing their work, excessive procrastination, inconsistent effort, excessive forgetfulness, and lack of adequate focus for school and/or employment. They question whether they might have an attention deficit disorder, but often they have been told by educators and clinicians that their superior intelligence precludes having ADHD” [Intellectual giftedness in students with ADHD is thought to be under-identified by parents, educators, psychologists, and physicians. Brown et al., for instance, reported that “ng ADHD” , p.161).Intellectual giftedness does not preclude having ADHD, and in some university students with ADHD it could mitigate some deficits in executive function and allow them to flourish academically or to go on and have successful careers –69. SomeIn sum, this report presents a selective review of previously published literature on ADHD in university students and consensus based on expert opinions. It aims to critically examine and discuss the impact of ADHD on educational outcomes of university students and provide evidence-based, practical advice and guidance on how best to support these students during their programme of studies. Expert consensual advice and guidance in relation to screening and diagnostic assessments for ADHD in adults, specific interventions for university students with ADHD, a potential model for service provision, staff training and development, will contribute to existing research in this topic area.www.UKAAN.org) in July 2017. UKAAN is an organisation founded in 2009 by a group of mental health specialists, responding to NICE guidelines [Is ADHD a hidden disability within higher education institutions (HEIs)?What are the similarities and differences between ADHD, specific learning (difficulties) or differences & other mental health conditions?What is the impact of stigma?Is ADHD a specific learning (difficulty) or difference?Service provisionScreening & diagnostic testingPharmacological & non-pharmacological interventionsStaff training and developmentWhat constitutes best practice for supporting university students with ADHD?The purpose of the expert consensus meeting was to formulate practical advice, guidance, and recommendations for supporting medical, mental health, educational and disability practitioners who work with university students with ADHD. This report is based on previously published literature that was identified, selected, collated, and critically reviewed using a framework for scoping studies , as wellidelines , and recidelines , 80, forMeeting attendees included the authors and 48 other mental health, neurodiversity, and disability practitioners, learning assessors and 2 university students with ADHD from England, Wales, and Scotland. The authors who attended the meeting represented a multidisciplinary group of prescribing and non-prescribing clinicians, practitioners, and academics, with extensive experience and expertise in working with adults with ADHD, including university students. Attendees engaged in conversations throughout the day with the aim of achieving consensus. The meeting was structured around presentations on relevant topics that are listed below, and the personal accounts from the 2 university students with ADHD, followed by questions, and answers (Q&As).The effectiveness of stimulant medication in treating ADHD.Academic coaching for university students with ADHD.The SpLD Assessment Standards Committee (SASC) guidelines for the assessment of ADHD in university students.Tele-psychiatry: Internet based treatment services for university student with ADHD.The student experience: What is it like to be a university student with ADHD?The first author facilitated discussions among the attendees to elicit verbal accounts of experience and to reach a consensus position on the topic being discussed. At the end of the meeting, the first author presented a summary of the main points previously agreed  consolidated the presentations, data from the transcripts and notes relevant to the main points agreed in the meeting, into a manuscript that was circulated amongst the authors for review, revision, final agreement, and approval. This manuscript reflects the clinical experience and expertise of the authors and is supported by published literature.The series of questions and summary of main points addressed during the meeting were collated and are discussed below. A summary of the main recommendations is listed in Table n = 343), and in the USA (n = 283), ADHD was reported to be around 5% in the USA cohort and 8% in the Chinese cohort [Only one study was found that reported on the prevalence of ADHD in UK university students. In this study Pope et al.  used thee cohort . These de cohort . Howevere cohort  did seeme cohort .widening participation (WP) strategy that forms a major component of higher education policy in the UK [G – Specific Learning Difference e.g., dyslexia, dyspraxia, or ADHD.” The Higher Education Statistical Agency  also collect, process, and publish data about disabled students within higher education in the UK. Figure UK domiciled students’ enrolments by disability and sex” based on a total number of 307,975 for the academic years 2014/15–2018/19 [University students with ADHD are part of a much bigger group of disabled students that are represented within the n the UK . The WP –2018/19 . From thFigure The expert group recommends that ADHD should no longer be subsumed under the category of a SpLD in HESA data return categories or by university services and should be coded or categorised separately. If ADHD continues to be coded or categorised as an SpLD then no specific data about the numbers of university students who declare ADHD as a disability within UK HEIs will be collected. ADHD is a mental health condition and not a SpLD. ADHD has specific diagnostic criteria within the DSM-5 , and ICDDyslexia, dyscalculia, dysgraphia, and dyspraxia (or DCD) and ADHD are all categorised as SpLDs within UK HEIs. However, in the DSM-5, dyslexia, dyscalculia, and dysgraphia are grouped together under a single diagnostic category of “specific learning disorder” , whilst DCD is classified separately as a motor disorder and ADHD as a neurodevelopmental disorder . SpLDs adecoding the speech sounds of words and structure of language , fluency (an inability to ready quickly with appropriate expression) and processing speed [The Baddeley and Hitch  conceptung speed , 93, 102an ability to quickly come up with an answer and retrieve information from memory”, may take longer to complete, hence these students tend to be awarded extra writing time for examinations as a reasonable adjustment [Processing speed (PS) is not an EF per se, rather it is said to be a cognitive ability that describes the amount of time it takes to identify, understand, react, or respond to information received, whether it be visual (letters and numbers), auditory (language) or movement . Since Pjustment , p4). PSjustment , the comjustment , 118. Hijustment , 119–121Comorbidity between ADHD and other neurodevelopment disorders, which include SpLDs, adversely impacts on academic functioning. The expert group therefore recommends screening for ADHD as part of routine practice for university students who report learning difficulties that seem to be associated with dyslexia, dyscalculia, dysgraphia, dyspraxia and/or ASD, not only because these conditions are highly likely to co-occur , 11, 14,It is equally important to differentiate ADHD from other mental health conditions and to consider the impact of these conditions on university students with ADHD when they do co-occur. Year-on-year increases in the number of students declaring a mental health condition at university have been observed, with current prevalence estimates of 27% amongst university students who declare a mental health disability before or during their programme of studies see Fig. . A studygeneralised anxiety disorder, social anxiety, specific phobias, agoraphobia, panic disorder, substance/medication induced anxiety), or depressive disorders , were discussed in relation to ADHD. Major depressive disorder (MDD) does show some overlap with ADHD symptoms such as poor concentration and working memory performance, but in MDD these characteristics are episodic and only arise during periods of low mood, anhedonia (loss of interest/enjoyment in ordinary experiences), or when there are ruminations dominated by negative content, and appetite disturbances, which are not characteristic of ADHD [During the consensus meeting the discussion mostly focused on university students who frequently reported anxiety and depression. Different types of anxiety , particularly when they are taking medication and there is no or only limited improvements in their mental state. For students that screen positive for ADHD, a referral for treatment and management by a suitably qualified mental health professional , is important.Stigmata are the beliefs, attitudes and structures that interact at an individual, group, or institutional level, to discriminate against a person based on a perceivable social characteristic that sets them aside from others . ADHD, aSome professionals may fear treating a “fake disease” or causing a drug dependency by prescribing stimulant medication, even though there is no empirical evidence to support these views , 164. MiThe expert group recommends that targeted programmes of training for university student support staff should include psychoeducation, how to screen for ADHD and use recommended strategies for supporting university students with ADHD. This training can also be used to raise awareness about the potential stigma associated with ADHD, its consequences and potential impact on the screening and diagnostic process, willingness to disclose ADHD at university and accept treatment.In the UK, clinical guidance recommends that the medical diagnosis of ADHD must be done by a suitably qualified practitioner, and with primary care staff providing support through shared care protocols . The expIn one systematic review of 176 studies about the long-term educational outcomes of untreated versus treated ADHD, academic outcomes were found to be worse in students with untreated ADHD when compared to their non-ADHD peers, after controlling for IQ . AnotherThe expert group recommends that a rapid access pathway of care for university students with ADHD be developed collaboratively between university central support services, and NHS primary and secondary care, or private providers. University disability services currently fund diagnostic assessments for SpLDs. This budget could also be made available to university students with ADHD to enable them to at least obtain a diagnostic assessment and reasonable adjustments. The expert group provides an example of a potential support pathway for university students with ADHD, which is presented in Fig. Screening tools are used to indicate if symptoms of ADHD and/or any other co-occurring conditions that are likely to complicate the learning problems that university students with ADHD are present or not. Screening for ADHD and other potential comorbidities is done routinely in clinical practice, because it’s important to differentiate the conditions underlying the student’s presenting symptoms and consider whether they may or may not require additional reasonable adjustments or support from other services . A widely used screening tool for ADHD based on DSM-5 diagnostic criteria, is the World Health Organisation Adult ADHD Self-Report Scale (ASRSv1.1) , now updpractitioner psychologists and specialist teacher assessors who have relevant training can identify specific learning difficulties and patterns of behaviour that together would strongly suggest a student has ADHD; and in this situation they can make relevant recommendations for support at Further and or Higher Education institutions. Such diagnostic assessments should be accepted by SFE in support of an application for Disabled Students’ Allowance” [The SpLD Assessment and Standards Committee (SASC) guidance for the assessment of ADHD, also states that “lowance” , p.2). Tlowance” . In a felowance” . For insThere are effective screening tools for anxiety, depression and substance misuse that can be used with university students with ADHD. The 10-item Kessler Psychological Distress Scale (K10) can be used to screen for anxiety and depression , or the Some students may have additional problems related to a SpLD  or ASD. Useful screeners for these conditions are the Adult Dyslexia Checklist which is available for free from the British Dyslexia Association website , and theAt present there are no neuroimaging, genetic, neurochemical, or neuropsychological diagnostic tests for ADHD that are sufficiently sensitive or specific. Neuropsychological tests such as Stop Signal Reaction Time, IQ, or various computerised tests of executive functions  or QB-Test, can however, complement a diagnostic assessment for ADHD and provide additional information about cognitive performance . Some auADHD in adults is diagnosed when 5 or more symptoms of inattention and/or hyperactivity-impulsivity are present, and with several of them being present before 12 years old. These core symptoms must have persisted for at least 6 months, and in clinical practice the expectation is of a chronic trait-like course from the age of onset during childhood or early adolescence. The symptoms of ADHD should be to a degree that is inconsistent with the developmental level for that individual and must cause functional impairments in 2 or more settings  .Table 9PPractitioners and assessors need to be aware that ADHD symptoms and functional impairments present differently in each student and their impact can also change over the course of their programme of studies . The expIn most cases of ADHD an individual is unable to identify a clear age of onset and they have the perception that the symptoms were always present. A typical response is that the symptoms have been present for as long as they can recall. Remembering symptomatic behaviours in childhood is especially hard when the student’s parents or other care givers have given them a lot of support during their academic career, or provided them with structure and routine, or when the student, had predominantly inattentive symptoms in childhood, that were not noticed either by their parents or teachers. This is more likely in females (and some men) with ADHD, who tend to present with predominantly inattentive symptoms and few hyperactive-impulsive symptoms or less disruptive behaviour , 175. Thif the student did not put in extra effort to be organised then what would happen?). Students with severe ADHD may be easier to screen and diagnostically assess, but if these students have developed good compensatory strategies , it can be hard to determine how severe and impairing their ADHD symptoms are in other functional domains . It may also be at a time when compensatory strategies are sufficient to mitigate ADHD related impairments, but this may not always be the case as their programme of studies progresses. Some students may present with “subthreshold symptoms” of ADHD , yet they appear to be significantly impaired by these symptoms and therefore need additional support, and perhaps treatment. The experience of the expert group is that impairments are also informed by co-morbidities and that several sub-threshold comorbidities  can be more impactful than a single disorder above the diagnostic threshold [During face-to-face diagnostic assessments, compensatory strategies can be minimised. For instance, the student may not recognise that sustaining attention or organisation is problematic for them, when a more objective appraisal suggests that this is a persistence problem. This can occur because symptoms of ADHD reflect lifelong traits, or because the student has well developed compensatory strategies. When this happens, it’s best to assess the degree of effort that the student needs to put into maintaining a compensatory strategy . A list of standardised screening and diagnostic tools are presented in Table Following initial psychoeducation about ADHD and its impact, NICE guidance  recommenNICE guidance  recommenThe first randomised controlled trial of lisdexamphetamine with a sample of 24 university students diagnosed with ADHD was conducted by DuPaul et al., . In thisThe view of the expert group is that non-pharmacological interventions are particularly important for university students who want or need to learn how to best manage their ADHD and overcome the learning difficulties that they experience. Medication alone maybe sufficient for a subgroup of university students, but persistent difficulties are more often seen, and additional support maybe required. Non-pharmacological interventions begin with psychoeducation. The experience of the expert group is that newly diagnosed students are keen to have a conversation about their diagnosis, including whether or not to disclose it to academic staff or future employers, the benefits, and drawbacks of taking medication, including flexible dosing, “drug holidays”, effects of medication on alcohol or other drugs, the positive attributes of ADHD , psychological interventions and reasonable adjustments. Research about the effectiveness of non-pharmacological interventions for adults with ADHD is mixed and inconclusive, but positive effects have been reported for mindfulness on core symptoms of ADHD including mind wandering , dialectn = 119) or a Delayed Treatment Control (DTC) group (n = 131). The findings revealed that the ACCESS program group participants self-reported significant improvements in their knowledge of ADHD, symptoms of inattention, EF, utilisation of disability accommodations (or reasonable adjustments), as well as a moderate decline in maladaptive thinking, when compared to DTC group participants. However, neither ACCESS program and DTC group participants reported significant improvements in their interpersonal functioning and educational outcomes (grade point average/GPA and course grade completion). The authors concluded that the ACCESS program made a large difference to the participants core symptoms of ADHD and EF.Although research about non-pharmacological interventions for university students with ADHD is limited, new studies have been published. For instance, Anastopoulos et al.  and Eddysteep temporal discounting may play a key role in the daily life challenges that university students with ADHD encounter. Temporal discounting (TD) describes how the subjective value of a reward significantly declines when the said reward is delayed [steep TD was not only associated with combined type ADHD, specifically the hyperactivity-impulsivity symptom domain, but also with poor utilisation of learning and/or study skills. TD was therefore postulated to be an important target for EF interventions for university students with or without ADHD [Indeed, as noted previously, EF deficits have been shown to mediate the association between ADHD and impairments in academic functioning . The fin delayed . In a pi delayed , steep Tout ADHD , more soout ADHD . Findingout ADHD  showed nThe report that the ACCESS program made a large difference to the students’ core symptoms of ADHD, seems to contradict what the World Federation of ADHD international consensus statement acknowledged about good treatments for ADHD being available, but even the best treatments are only partially effective . OverallHence academic coaching, which tends to be a derivative of CBT, could be another useful intervention for optimising coping strategies in university students with ADHD. For instance, coaching has been used to help identify study goals, develop study plans and strategies for achieving these plans, monitoring their progress towards attaining them and to foster self-determination . In one The expert group recommends multimodal interventions for university students with ADHD, that comprise a variety of interventions including environmental modifications, psychoeducation, medication, academic coaching, DBT, CBT, counselling and/or mindfulness-based interventions. University counselling and disability services do tend to offer a range of psychosocial interventions for students, whether delivered online, face-to-face or in a group.specific learning difficulties and patterns of behaviour that together would strongly suggest that a student has ADHD” (p.11). The need for staff training and development was discussed during the consensus meeting, and it included training in how to liaise with and refer university students with ADHD to a suitably qualified practitioner for a diagnostic assessment . Practitioners and assessors seemed keen to receive “certified training” as a way to achieve the SASC recommendations for “appropriate training”. A certified educational programme about ADHD at university level 6 or 7, could be developed and delivered for example online, as a post-qualification professional training or continuous professional development (CPD). But at present, no such course/programme exists in the UK. UKAAN offers training for healthcare professionals and can deliver bespoke training to practitioners and assessors who work with university students, and some disability services have already done so. During the consensus meeting some practitioners and assessors said they often gained relevant experience by having previously worked, or currently working, with university students with ADHD or through their own personal lived experiences, and that they made use of these experiences in their role.In the Institute for Employment Studies report to the Office for Students, practitioners working in university disability services identified a need for training and development to enable them to both support university students with ADHD and the academic staff working with them . The SpLThe expert group recommends that staff training, and development be prioritised under the inclusive practice agenda in higher education. This training should include psychoeducation, procedures for screening and assessing for ADHD, and useful strategies for supporting university students with ADHD. This will enhance the knowledge and skills of practitioners and assessors who work with and/or support university students with ADHD.online learning has allowed me to engage with my course more positively”, and the findings revealed that 59% of disabled students compared with 55% of non-disabled students disagreed with the statement. This also suggests that just under-half of these students agreed with the statement. In another study, 79 university students in one Faculty of Life Sciences were surveyed and participated in focus groups about how they experienced the sudden shift to online learning during the lockdown [This was a report of the UKAAN expert consensus meeting about university students with ADHD, which was held before the COVID-19 pandemic. Since then, the pandemic has altered higher education in a monumental way. When lockdown was first imposed in the UK, university campuses were suddenly closed. Students and staff had to quickly adapt to online delivery of lectures and classes, and there was uncertainty about being able to access digital technologies and quite places to study or work at home. There was also confusion among students about study expectations, assessments, workloads, retention, and completion –204. Undlockdown . This stlockdown .The findings of existing studies do suggest that during the COVID-19 lockdown, virtual learning for some university students may have had benefits such as enabling greater attendance, engagement, and participation in teaching sessions, especially for students who previously felt anxious about asking questions in front of others or some disabled students . Student(the extent to which students can gain entrance to different types of HEIs), retention (the likelihood of continuing or withdrawing from a programme of studies), attainment , and progression (successful transitions within a programme of studies and afterwards into employment or further study)” [Evidence is stronger for poor education (or academic) performance and achievement having a long-term negative impact on mental health, wellbeing, and socio-economic outcomes . Even th study)” , p.5). E study)” .In summary, UKAAN convened an expert consensus meeting to provide an informed understanding about the impact of ADHD on the educational (or academic) outcomes of university students and to highlight an urgent need for timely access to treatment and management. An overview of key issues, as well as expert advice and guidance has been offered. In Table


The problem of diagnosis and treatment of ADHD in adults in the Russian Federation remains very relevant. Unfortunately, very little time is devoted to the topic of adult ADHD in standard and advanced training programs. In connection with these problems, it is important to study the prevalence of ADHD in the Russian population.To determine the prevalence of an increased risk of adult ADHD on the example of Russian Instagram users.In the professional blog of one of the authors of the article in Instagram (@gentlepsydoc), a link was posted to an anonymous survey conducted using Google docs, in which patients filled out the Adult ADHD Self-Report Scale (ASRS v1.1) in the author’s translationA total of 144 people took part in the screening, 87.5% of them were women, the average age of the participants was 35.5±12.3 years (from 20 to 56). An increased risk of ADHD according to the indicators of the ASRS scale was detected in 13.2 % of participants.Among Instagram users, the prevalence of an increased risk of ADHD was higher than according to epidemiology data. This indicator could be influenced by a sample of patients, mainly consisting of subscribers of a professional blog of a psychiatrist, as well as the prevalence of women among the participants. In any case, these data speak in favor of the importance of diagnosing this condition in the Russian population, as well as including information about adult ADHD in training programs for mental health professionals.No significant relationships.


Attention-deficit/hyperactivity disorder (ADHD) and bipolar disorder (BD) are neurodevelopmental disorders that commonly persist into adulthood. ADHD in adults can resemble, and often co-occurs with, bipolar disorder (BD), which might lead to diagnostic errors, ineffective treatment and potentially serious adverse consequences.To review on the overlaps and differences in the psychopathology of the two entities and particularities of the management when they occur comorbidely.The Medline database through the Pubmed search engine was used with the following keywords: “adhd” and “bipolar disorder”.ADHD has an estimated prevalence of 10-30% in adults with BD. Despite the symptomatic similarities, there are some important differences. In the ADHD/BD comorbidity, symptoms like attention-deficit, distractibility, irritability, impulsiveness and hyperactivity that may present in (hypo)manic and/or depressive episodes, tend to persist after clinical stabilization. While adult patients with ADHD typically experience ceaseless mental activity and wandering mind, BD patients may have racing thoughts and perceive them as making sense. ADHD patients may have poor socio-occupational achievement that may lead to low self-esteem, low self-confidence and depressed mood. Features like course of illness, psychiatric family history and treatment response may help differentiate the two entities. The treatment must start with mood stabilization and then proceed to the treatment of ADHD symptoms.A complete clinical history, with particular focus in the neurodevelopmental history, is important but sometimes is not enough for an accurate diagnosis of this comorbidity. As so, clinicians should be aware of the high comorbidity rates to prevent misdiagnosis and provide the best care for both disorders.No significant relationships.


ADHD is a neurodevelopmental disorder displaying inattention, hyperactivity, and impulsivity as core symptoms. It can affect several areas of life including sexual health. Clinicians have often made assumptions concerning the bound of specific ADHD symptoms affecting sexual desire by increasing its frequency and intensity. Yet, there is still a lack of knowledge about the comorbidity between ADHD, hypersexuality, and paraphilias. A recent literature review could show that some individuals who suffer from ADHD report about hypersexual and paraphilic fantasies and behaviors, but as far as we know, no clear empirical data has emerged supporting the idea that hypersexuality and paraphilias are more frequent in individuals with ADHD.The present investigation aimed to compare several sexuality related aspects between individuals with and without ADHD.Therefore, we designed an extensive online survey based on established questionnaires, such as the Hypersexual Behavior Inventory (HBI). The survey was implemented in a outpatient sample, ADHD specific fora as well as other general online channels.In total, N = 238 individuals participated in the survey (n = 160 with ADHD). Thereby, individuals with ADHD reported significantly more often about a wide range of hypersexual fantasies and behaviors in comparison to individuals without ADHD. Furthermore, individuals with ADHD reported significantly more often about paraphilic fantasies and behaviors including fetishistic and sadistic sexual fantasies. No differences were found concerning other paraphilias. Further results regarding other facets of sexuality, such as sexual orientation, are to be presented and discussed.The present study contributes to closing the knowledge gap regarding sexuality in individuals with an ADHD.No significant relationships.


Background: Plantar fibromatosis, known as Ledderhose disease, is a neoplastic disease characterized by a locally-aggressive bland fibroblastic proliferation. Although Pacinian corpuscles alterations are commonly described in palmar fibromatosis, there are still no references about Pacinian corpuscles alterations in the rarer plantar version. Methods: We present a case report where a wide cutaneous resection, including the plantar fascia was performed, allowing a detailed study of Pacinian corpuscles. Pacinian corpuscles were analyzed using immunohistochemistry for neurofilament proteins, S100 protein, CD34, vimentin, glucose transporter 1, epithelial membrane antigen, neural-cell adhesion molecule, actin, desmin, type IV collagen, and high-affinity neurotrophin Trk-receptors. Moreover, the density and the size of the corpuscles were determined. Results: A clear increase in the number (hyperplasia) of Pacinian corpuscles was evidenced in the Ledderhose disease plantar fascia in comparison with similarly aged normal subjects. Pacinian hypertrophy was not demonstrated, but a significant decrease in the number of corpuscular lamellae was noted, with a subsequent increase in the interlamellar spaces. Pacinian corpuscles from the pathological plantar fascia showed an abnormal structure and immunohistochemical profile, generally without identifiable axons, and also absence of an inner core or an intermediate layer. Moreover, other molecules related with trophic maintenance of corpuscles were also absent. Finally, a vascular proliferation was commonly noted in some corpuscles, which involved all corpuscular constituents. Conclusion: The observed Pacinian corpuscles hyperplasia could be considered a diagnostic clue of plantar fibromatosis. Fibromatosis is a well-stablished soft tissue neoplasm characterized by a locally infiltrative fibroblastic proliferation . Under tPalmar/plantar fibromatosis was proposed to be a reactive process rather than a clonal neoplasm , histoloSuperficial plantar fibromatosis is more infrequent than the palmar, which has made the study of this rare disease difficult. Thus, palmar fibromatosis affects up to 2% of general population, while plantar fibromatosis is included in the National Institute of Health’s list of rare diseases, with an imprecise incidence, affecting in any case <200,000 people ,14, and Here we analyze the Pacinian corpuscles of one case of plantar fibromatosis, initially diagnosed as a sarcoma. The differential diagnosis between fibromatosis and sarcoma may be difficult in both directions ,3,24, anA 67-year-old woman visited the Plastic Surgery Department of Donostia University Hospital due to a plantar retraction, which was previously biopsied, with an initial histopathologic diagnosis of low grade leiomyosarcoma. After the initial diagnosis, a thickening of the plantar fascia was apparent on an MRI, concordant with plantar fasciitis. Exploration showed a retracted and a firm plantar surface, without ulceration or deformities. Finally, the patient was submitted to surgery, and a wide excision was performed due to the suspicion of a sarcoma. The final diagnosis of the patient in the resection specimen was plantar fibromatosis. During two years of follow up, no recurrences were found. The excised specimen measured 11.5 × 5 × 2 cm, while the cutaneous surface measured 10.5 × 2.5 cm. The piece was fixed in 10% formaldehyde and completely embedded in 2–3 mm thick paraffin blocks.Two control cases, covering most of the plantar surface and including epidermis, dermis, hypodermis, and fascia, were also completely included in paraffin blocks to compare both the morphology and the density of the corpuscles. Controls came from wide tumoral resection pieces due to malignant neoplasms in the heel, corresponding to Donostia University Hospital and Salamanca University Hospital. The first control was a plantar skin sample of 9.5 × 4 cm and the second control was a plantar skin sample of 20.5 × 6.5 cm, including the five fingers; these samples did not have neoplastic involvement, neither macroscopically nor microscopically. Patients were 60- and 62-year-old males. These samples followed the same technical procedures as fibromatosis, sampling the whole pieces in paraffin blocks.When the material was embedded in paraffin, several diagrams were made correlating the topography of each tissue block in order to constitute comprehensive maps of the plantar surface. Each paraffin block was cut in 5 and 20 µm thick consecutive sections, covering an approximate thickness of 100 µm; the first and the last slide were stained with hematoxylin-eosin (HE), leaving several blank slides  to perform immunohistochemistry later on. Any identifiable corpuscle in the HE slides was counted, based on its onion-like lamellar structure, and included in the map of the sole of each case. Each corpuscle had its maximum diameter measured and its lamellae manually counted under photomicrographs. Corpuscles from the toes and the ball of the foot were excluded for comparison purposes. Photographs were taken with a Nikon Eclipse Ci microscope , equipped with Plan Apo λ objectives  and a MD-U3-10 microphotography camera .The automated diagnostic platform Roche-VentanaTM Benchmark Ultra  was used for immunohistochemistry for diagnostic purposes and also in the 5 µm slides with identifiable sensory corpuscles. Antibodies used for diagnostic purposes of fibromatosis were both types of actin, desmin, S100 and CD34, among others. Antibodies were also directed against the main corpuscular constituents ,26, and In the fibromatosis specimen, a widespread fibrous paucicellular proliferation was present, involving the dermis and, particularly, the hypodermis a, consisPacinian corpuscles were identified in all the cases investigated. Corpuscles from control specimens were located in the subcutis and surrounded by fatty tissue, with a preserved structure that was consistent with normality b.Comparing the distribution between normal and pathological conditions, a striking tendency to form clusters in the fibrous areas of the fibromatosis case b was appThe arrangement of various corpuscular constituents, including central axon, inner core, intermediate layer, and outer core capsular complex, was severely altered in almost all corpuscles (approximately 90%), with an absence of immunostaining for NFP  µm, with a p = 0.17. Regarding the lamellae count, the fibromatosis case had a mean of 18,2 (C.I. 95% 15.7–20.7), while the controls had a combined mean of 25 (C.I. 95% 23.2–26.9), meaning a difference of 6.8 (C.I. 3.8–9.9) lamellae between both, with a p < 0.001.Statistical comparison was performed through Student’s Our observations regarding the distribution of Pacinian corpuscles in normal plantar fascia and in plantar fibromatosis are in good agreement with the normal anatomy, previously described with different approaches ,21,22,23As far as we know, publications reporting histologic evaluations of plantar fibromatosis did not mention Pacinian corpuscles ,30,31. IAs it occurs in the Pacinian corpuscles of palmar fibromatosis , we obseTo explain the peripheral nervous system changes in palmar fibromatosis, a hypothesis was proposed based on increased nerve growth factor levels ,9,34. ToThanks to the improvement on imaging techniques, Pacinian corpuscles and Pacinian corpuscle hyperplasia can now be diagnosed by MRI ,36. This


Alzheimer’s disease (AD) is the most common neurodegenerative disorder with the majority of patients classified as sporadic AD (sAD), in which etiopathogenesis remains unresolved. Though sAD is argued to be a polygenic disorder, apolipoprotein E (APOE) ε4, was found three decades ago to pose the strongest genetic risk for sAD. Currently, the only clinically approved disease-modifying drugs for AD are aducanumab (Aduhelm) and lecanemab (Leqembi). All other AD treatment options are purely symptomatic with modest benefits. Similarly, attention-deficit hyperactivity disorder (ADHD), is one of the most common neurodevelopmental mental disorders in children and adolescents, acknowledged to persist in adulthood in over 60% of the patients. Moreover, for ADHD whose etiopathogenesis is not completely understood, a large proportion of patients respond well to treatment , however, no disease-modifying therapy exists. Interestingly, cognitive impairments, executive, and memory deficits seem to be common in ADHD, but also in early stages of mild cognitive impairment (MCI), and dementia, including sAD. Therefore, one of many hypotheses is that ADHD and sAD might have similar origins or that they intercalate with one another, as shown recently that ADHD may be considered a risk factor for sAD. Intriguingly, several overlaps have been shown between the two disorders, e.g., inflammatory activation, oxidative stress, glucose and insulin pathways, wingless-INT/mammalian target of rapamycin (Wnt/mTOR) signaling, and altered lipid metabolism. Indeed, Wnt/mTOR activities were found to be modified by MPH in several ADHD studies. Wnt/mTOR was also found to play a role in sAD and in animal models of the disorder. Moreover, MPH treatment in the MCI phase was shown to be successful for apathy including some improvement in cognition, according to a recent meta-analysis. In several AD animal models, ADHD-like behavioral phenotypes have been observed indicating a possible interconnection between ADHD and AD. In this concept paper, we will discuss the various evidence in human and animal models supporting the hypothesis in which ADHD might increase the risk for sAD, with common involvement of the Wnt/mTOR-pathway leading to lifespan alteration at the neuronal levels. The orchestration of brain development, maturation, plasticity, repair, and survival is highly complex, in which any imbalance in one or more of these processes may induce disruptions manifested at different stages of life, from the neurodevelopmental disorders at the early stages to neurodegeneration of the brain in late stage . These oBefore delving deep into our hypothesis, some comparisons between ADHD and AD are presented in In the current paper, we present our hypothesis of the Wnt/mTOR pathway playing a role both in ADHD and sAD pathophysiology, which may explain the recent findings of ADHD as a risk for sAD . FurtherAlzheimer’s disease is a neurodegenerative disorder and the most common form of dementia with an estimated number of 55 million people currently suffering from AD worldwide, predicted to reach 78 million in 2030 and 139 million in 2050 . The welBrain insulin resistance is characterized by a reduced response to insulin signaling downstream of the insulin receptor (IR) in the brain, consequently leading to metabolic alteration, neurodegeneration, and cognitive impairment . 18F-fluvia the intranasal route to bypass the blood-brain barrier) to elicit a neuroimaging  or neurophysiological  appears to be an early and common feature in human AD patients   linked to the Wnt pathways  were found to be associated with ADHD  . Moreove2) . As foun2) , as wellith ADHD . Interesith ADHD .Although the etiopathology of the disorder is still unknown, several hypotheses have been suggested , proposiIn summary, although an effective treatment exists for ADHD, the long-term effects of drug treatment, the consequences of persistent ADHD in adult patients, as well as the etiopathology of the disorder are not fully understood. Nevertheless, metabolic and Wnt/mTOR pathway alterations may be a common factor in ADHD and AD, and a potential target for preventive measures in both diseases.n = 40), MCI = (n = 29), and controls (N = 37) (n = 26), MCI (n = 40) and controls (n = 41), that ADHD individuals have poorer performance than controls in episodic memory and executive function. These findings were comparable between MCI and ADHD for all domains, which, for clinicians, may result in misdiagnosis . Nevertheless, although there are only a handful of studies investigating the association between ADHD and AD in humans, some evidence point to a possible link suggesting that ADHD might increase the risk for AD. Earlier clinical research on the frequency of ADHD in the aging population suggested that attentional deficits in geriatric subjects with cognitive impairment might not necessarily imply the existence of an underlying neurodegenerative disorder . However(N = 37) . In the (N = 37) . Howeveriagnosis . Then agThe current epidemiological and clinical association studies on ADHD, MCI, and AD, provide some evidence that those suffering from ADHD may be at an increased risk for the development of MCI and, thereafter, AD, possibly mediated by a common mechanism. However, there is still a great need for studies that may elucidate common pathways and provide an explanation for the temporal pattern of occurrence of ADHD, MCI, and AD in long-lasting longitudinal prospective cohorts.Recent evidence suggests the dysregulation of the Wnt/mTOR signaling pathways as a potential common mechanism in the etiopathogenesis of both ADHD and AD . Based oA pivotal role of Wnt signaling in physiological processes implies that its imbalance may be significant in the pathophysiology of both neurodevelopmental disorders including ADHD  and neurNLGF/NLGF mouse model (depicting a knock-in of the hAPP Swedish mutation of a fAD), and concomitantly increase Sirtuin2-induced deacetylation  linked to the Wnt-pathways  were found to be associated with ADHD, further supporting a role of this pathway  and mTOR complex 2 (mTORC2). mTORC1 integrates signals from multiple growth factors, nutrients, and energy supply, to promote cell growth when energy is sufficient, and catabolism in the absence of nutrients. The mTOR pathway has been found to hold a central role in a variety of cell processes, ranging from promoting protein synthesis to determining the extent of autophagy, and is consequently largely implicated in disease; dysregulation of the pathway has been confirmed in the aging process, cancer, and metabolic disorders like diabetes . mTORC1 Ser636 and pGSK3βSer9, and hyperactivation of the Akt/mTOR/p70S6K pathway was reported in neuronal-derived extracellular vesicles from patients with Down syndrome (via a negative feedback mechanism that inhibits IRS1 (via the tumor necrosis factor-α (TNFα) /c-Jun N-terminal kinases (JNK) pathway, which, in AD, is activated by Aβ oligomers and misfolded Tau that consequently alter the IRS1/mTOR signaling pathway  and non-transgenic (STZ-icv rat and mice) AD models . DownregConversely, inhibition of mTOR was studied for the mitigation of AD symptoms in different AD models. Improvement of cognitive functions and reduction of cortical Aβ levels were found in hAPP(J20) mice after rapamycin  treatment, along with restoration of neurovascular coupling . IncreasFRAT1/FRAT2 gene regulating the Wnt signaling pathway. In a multi-step analysis aimed to identify and characterize modules of co-expressed genes associated with ADHD using data from peripheral blood mononuclear cells, both RICTOR and MTOR genes were found to be significantly upregulated in ADHD patients compared to controls further internal discussion with authors regarding data presented in CACNA1H, PKD1, DYNC2H1, LRP6, and RGS11. The CACNA1H gene encodes for the α1-subunit of the T-type low voltage-dependent calcium (Ca2+) channel Cav3.2  animal model (InsG3680) and P301S AD mouse model . As ADHDl Cav3.2 , and mTOl Cav3.2 . Other tl Cav3.2 . Only a l Cav3.2 .Therefore, a growing body of evidence points to a harmful vicious cycle in which impaired Wnt/mTOR-signaling is intertwined with the major AD and ADHD pathophysiology hallmarks at the protein and gene level for each of the pathways and individual diseases, respectively. However, searching for the alterations of those Wnt/mTOR signaling-related parameters found both in AD and ADHD, might reveal a common point of weakness in their respective etiopathogenesis and thus not only help clarify the overlap of sAD and ADHD pathophysiology at the molecular level but also offer possible shared target(s) for disease-modifying drug intervention in their therapy. Elucidation of the Wnt/mTOR signaling dysfunction underlying ADHD-AD overlapping pathophysiology is very important also as a contribution to understanding its role in the pathophysiology of other neurodegenerative disorders like Parkinson’s disease .Although most animal models of ADHD and AD do not fulfill all the validation criteria , they aRegardless of the aforementioned limitations, animal models sometimes offer unexpected insight into diseases with shared molecular pathobiology offering the opportunity for a better understanding of genetic and environmental risk factors and co-morbidities, as well as the development of new working models and identification of novel (shared) drug targets. Here we propose that a careful evaluation of ADHD and AD models, particularly from the perspective of face validity, provides evidence for potentially shared pathomechanisms and risk factors.As the etiopathogenesis of ADHD remains largely unknown , most animal models focus on replicating the symptomatology , which classically consists of hyperactivity, impulsivity, and inattention , i.e., eA link between ADHD and AD may be found in the dysfunction of working memory as one of the core executive functions . In 2000In The aforementioned cognitive deficits developing at a later age provide face validity to the hypothesis that, with age, an ADHD model may serve as a sAD model, and the neuropathological markers found therein thought to be closely related to AD, lend construct validity. Unfortunately, there is little data on therapies in older ADHD model animals to provide a statement on predictive validity.Accumulating evidence suggests that animal models of AD demonstrate some phenotypic traits resembling ADHD. Pronounced locomotor hyperactivity of AD animal models has been reported by different groups, as it was recognized as an important confounder precluding valid behavioral analysis. For example, Jankowsky et al. generated a tetracycline-responsive transgenic APP mouse model to study the effects of Aβ production arrest expected from the treatment with inhibitors of secretases. However, mice overexpressing APP throughout their development demonstrated severe locomotor hyperactivity (with 100% penetrance), incompatible with cognitive testing . InteresBehavioral alterations in the non-transgenic STZ-icv rat model of sAD provide additional evidence in support of the overlapping phenotype of ADHD and AD in animal models with the advantage of the absence of altered gene expression during brain development (as is often the case with transgenic models). In the STZ-icv model, a complex phenotype characterized by a combination of ADHD and AD-like symptoms develops after icv administration of a diabetogenic compound (streptozotocin) in the period in which neural circuits are already fully formed . The STZ-icv model is characterized by a chronic and progressive cognitive decline  AD face, neuroinIn summary, although a more thorough exploration of the pre-cognitive ADHD-like behavioral phenotype of the STZ-icv model is needed, it seems that non-transgenic models of AD may also recapitulate the behavioral aspect of the hypothesized ADHD-AD continuum . ExperimAltogether, data from both ADHD and AD animal models support the hypothesis of overlapping pathophysiology and the existence of the ADHD-AD continuum. In both cases, the strongest evidence comes from the experiments reporting a complex ADHD/AD phenotype , however, the data on construct and predictive validity are still scarce. One of the reasons, for the paucity of construct and predictive validity evidence, may be a time-period restricted use of ADHD and AD models and consequent failure to acknowledge the overlapping symptoms and identify them as a rationale to explore molecular patterns of AD in ADHD and vice versa , and test ADHD drugs in AD models and vice versa . The animal models of ADHD are mostly examined when the animals are relatively young to faithfully mimic human disease that usually presents at a relatively young age in most patients. Accordingly, most researchers use old animals to model the AD-like phenotype in rodents. Consequently, most research on ADHD models is done at a time point in which cognitive deficits are not yet evident, and most animal studies with AD models fail to acknowledge a potential early ADHD-like stage of the disease. The evidence supporting this hypothesis comes from relatively rare longitudinal studies on ADHD models with behavioral follow-up after dissipation of the hyperactive phenotype , and theSummarizing the aforementioned, the analysis of behavioral traits and phenotypes in animal models of ADHD and AD provides additional evidence in favor of the hypothesis of shared etiopathogenesis. Furthermore, considering molecular similarities, primarily related to Wnt and mTOR pathways (described in detail in chapters 5.1 and 5.2), data from animal models support the existence of a common pathophysiological phenomenon involved in the development of both AD and ADHD . As studd = 0.20–0.73) with linear dosing effects (n = 145), it was shown that MPH treatment is associated with small improvements (in apathy scores) in AD patients (n = 156), an increase in cognitive scores (MMSE) was found alongside improvement of apathy (n = 301), MPH improved apathy scores compared to placebo, with improved Alzheimer’s Disease Cooperative Study Clinical Global Impression at 6 months (n = 15) demonstrated a beneficial effect of MPH on memory tests . Moreover, the common Wnt/mTOR pathways that have been altered both in ADHD and AD, and the fact that some drug treatments may influence them, should be studied more in-depth, to explore the possibilities of prevention and/or rescue in these two frequent neurological disorders. Although out of scope of the current hypothesis paper, it should be noted that neurodevelopmental disorders in general also were argued to be linked to sAD (Following the aforementioned evidence regarding ADHD-AD being a continuum, with several overlapping pathways and mechanisms, it would be of high urgency to move into research over the lifespan in humans and animal models, as well as at the molecular and cellular levels modeling both disorders d to sAD  while ned to sAD . In partThe original contributions presented in this study are included in this article/EG, JH, PR, CT, and MS-P contributed to the conception and substantiation of the hypothesis. AB, VD, AK, and JO collected the literature evidence on animal modeling. PR, SW, EG, CT, and MS-P collected the literature evidence on clinical aspects. EG wrote the first draft of the manuscript. EG, JH, AB, VD, AK, JO, CT, and MS-P wrote sections of the manuscript. All authors contributed to the manuscript revision, read, and approved the submitted version.


HSPG2 mutations were associated with favorable tumor immunogenicity and immunotherapeutic efficacy. Our study provides a potential clinical molecular biomarker for evaluating ICI therapy responses.Immune checkpoint inhibitors (ICIs) markedly improve the survival benefits of advanced melanoma and non-small cell lung cancer (NSCLC). Nevertheless, only a subset of patients could benefit from such a therapy. Novel and effective clinical biomarkers are needed to assess ICI treatment efficacy. Heparan sulfate proteoglycan 2 (HSPG2) is frequently mutated in melanoma and NSCLC. In this study, we comprehensively integrated the pretreatment somatic mutational profiles and clinical information of both tumors and observed that HSPG2 mutations in melanoma and NSCLC. A total of 631 melanoma samples and 109 NSCLC samples with both somatic mutational profiles and clinical immunotherapy data were curated. In addition, by using The Cancer Genome Atlas data, genomic and immunological traits behind HSPG2 mutations were elucidated. Melanoma patients with HSPG2 mutations had a markedly extended ICI outcome than other patients. An association between HSPG2 mutations and the improved outcome was further confirmed in NSCLC. In addition, an elevated ICI response rate was presented in HSPG2-mutated NSCLC patients . Subsequent analyses revealed that HSPG2-mutated patients had a favorable abundance of response immunocytes, an inferior abundance of suppression immunocytes, enhanced mutational burden, and interferon response-relevant signaling pathways. We uncovered that HSPG2 mutations were predictive of a better ICI response and associated with preferable immunogenicity, which may be considered as a genomic determinant to customize biotherapy strategies.Immune checkpoint inhibitors (ICIs) markedly promote the survival outcome of advanced melanoma and non-small cell lung cancer (NSCLC). Clinically, favorable ICI treatment efficacy is noticed only in a smaller proportion of patients. Heparan sulfate proteoglycan 2 (HSPG2) frequently mutates in both tumors. Herein, we aim to investigate the immunotherapeutic and immunological roles of  Surgery, radiotherapy, chemotherapy, and targeted therapy are commonly used clinical treatment methods for cancer patients. However, for patients at advanced or metastatic stages, the above treatment modalities may be unsatisfactory . In recePOLE [JAK1/2 [B2M [MUC16 mutations [At present, multiple biomarkers are determined to evaluate cancer immunotherapeutic efficacy. Programmed cell death 1 ligand 1 (PD-L1) is the first approved molecular biomarker for predicting anti-PD-1/L1 treatment response . Its elePOLE , JAK1/2  [JAK1/2 , B2M [10utations ), specifutations ), and moutations .HSPG2 mutations with immunological features and ICI treatment efficacy in cancers.Heparan sulfate proteoglycan 2 (HSPG2) encodes the perlecan protein, which comprises a central protein to which three long chains of glycosaminoglycans (heparan sulfate or chondroitin sulfate) are attached. It has been revealed that the perlecan protein exhibits vital roles in multiple biological behaviors via the interaction with prolargin, laminin, collagen type IV, transthyretin, etc. Several recent studies have demonstrated that HSPG2 overexpression was associated with invasion, metastasis, and an inferior survival outcome in triple-negative breast cancer , acute mHSPG2 alterations. This immunogenomic research might provide useful clues for customizing cancer immunotherapy strategies.Taking into account that ICI treatments are most commonly used for melanoma and NSCLC patients, in this work, we comprehensively integrated the pretreatment somatic mutational profiles from melanoma and NSCLC; furthermore, clinical information after immunotherapy of both tumors was also obtained. Finally, based on 631 melanoma and 109 NSCLC samples, we investigated the immunological and clinical immunotherapeutic implications of From previous publications, we integrated a total of 631 melanoma ,27,28,29http://xena.ucsc.edu/ accessed on 1 May 2022), we obtained a total of 457 melanoma and 995 NSCLC samples with genomic mutation data, transcriptomic expression profiles, and clinical information. Especially, the log2 transformed and normalized gene expression profiles of both tumors were applied to explore the potential immunological mechanisms behind HSPG2 mutations. The detailed flowchart of this research is shown in From The Cancer Genome Atlas (TCGA) project , with W indicating the detected specific mutational signatures and H representing the mutational activities for each signature. The number of columns of matrix W is the number of mutational signatures. The rows of matrix A are the 96 mutational contexts, and its columns are the integrated samples of both cohorts. The 96 mutational contexts are derived from combinations of 6 mutational types  and their 5′ and 3′ adjacent bases. The rows and columns of matrix H indicate the individual signatures and their corresponding mutational activities, respectively. The pruning process is performed by introducing the weight parameter λk, which is associated with the kth column of W and the kth row of H. All extracted mutational signatures were then compared with well-annotated signatures stored in the COSMIC database  using cosine similarity.Mutational signatures were extracted using mutational profiles of melanoma and NSCLC samples based on a method proposed by a recent study . In thisHSPG2 mutant and wild-type groups, we employed CIBERSORT and the Angelova et al. algorithm to evaluate infiltrating levels of distinct immunocytes. CIBERSORT uses the LM22 signature, which includes 547 representative genes to assess tumor-infiltrating levels of 22 immunocytes [To elucidate the different immune cell infiltrating abundances between unocytes . The Angunocytes . The detRecent research presented multiple molecular signatures associated with immune infiltration and tumor immunogenicity. We thus curated the relevant signatures as follows: (1) immune/stromal cell signatures ; (2) an HSPG2-mutant and wild-type groups. All t values extracted from the differential result were then considered as the input variable to conduct GSEA and acquire specific biological circuits of HSPG2 mutations. Hallmark pathways were applied as the background comparison circuits.Single sample gene set enrichment analysis (ssGSEA) was utilized to evaluate enriched levels of collected immunocyte- and immunogenicity-relevant signatures under the GSVA R package . R DESeqTumor mutation burden (TMB) was defined as the log2 transition of total non-synonymous mutations per megabase in both integrated and TCGA datasets. Neoantigen burden (NB) was calculated according to a recent method  for 224 HSPG2 subgroups. Survival plots were obtained using the Kaplan–Meier method, and the Logrank test was applied to evaluate significant differences. Multivariate logistic and Cox regression models with multiple confounders taken into consideration were performed using the forest model package. The relationships of continuous and categorical factors with HSPG2 mutations were estimated with the Wilcoxon rank sum test and Fisher’s exact test, respectively. The detailed sample size and cohorts used for specific HSPG2-related analyses are shown in R software was utilized to conduct relevant analyses. Mutational features of specified genes were exhibited with a waterfall plot, which is embedded in the maftools package . The pheHSPG2 mutations are illustrated in HSPG2 is frequently mutated, accounting for 80 of 631 patients (12.7%). Amino acid changes produced by HSPG2 alterations are illustrated with a lollipop plot  exhibited the ICI status of complete response (CR) or partial response (PR); 430 (68.1%) had the response of stable disease (SD) or progressive disease (PD), and immunotherapy response data of the remanent samples (1.3%) were not available. The mutational landscape of these melanoma samples was characterized by C > T substitutions . Mutatiopop plot .HSPG2 mutations presented a significantly more prolonged outcome than HSPG2 wild-type patients  patients. A prognosis analysis showed that HSPG2 mutations predicted a significantly improved ICI outcome in NSCLC  harbored the CR/PR immunotherapeutic responses. HSPG2 mutations with the mutational burden in NSCLC. The results show that a markedly higher TMB was observed in patients with HSPG2 mutations . Further GSEA analysis verified the results that interferon gamma and alpha responses were enriched in patients with HSPG2 mutations  and decreased infiltration levels of immune suppressive cells  were observed in NSCLC patients harboring HSPG2 mutations  and a decreased infiltration of immune suppressive cells  were enriched in HSPG2- mutated patients, which suggests that HSPG2 mutations mediate a favorable immune infiltration and tumor microenvironment.Activated, central/effector memory CD4/8 T cells were previously demonstrated to play a positive role in promoting tumor immune responses ,48. Two POLE [NLRP3 [COL3A1 [PTPRT [HSPG2 mutations were also determined to link with an elevated mutational burden and a preferable ICI efficacy in melanoma and NSCLC, which indicates that HSPG2 mutations may be a possible indicator for TMB and cancer immune treatment response.Multiple studies have revealed the potential implications of TMB for evaluating cancer immunotherapeutic efficacy ,12,13,53POLE , NLRP3 [E [NLRP3 , COL3A1 1 [PTPRT  could prHSPG2 mutations were connected with an improved outcome in melanoma and NSCLC patients under an immunotherapy setting. We then investigated whether HSPG2 mutations play roles in the above two cancers treated with conventional chemotherapies in the TCGA cohort. The results demonstrate that no significant associations between HSPG2 mutations and patient prognosis were observed in both two tumors (multivariate-adjusted both p > 0.05; HSPG2 mutations play a predictive role regarding cancer immunotherapeutic efficacy rather than a prognostic role.The findings derived from this work show that HSPG2 mutations were predictive of a favorable ICI treatment outcome, which provides evidence for customizing immunotherapeutic strategies. By using the same pooled melanoma and NSCLC cohorts [FAT1, COL3A1, NRAS, NARS2, DCC, and PTPRT were associated with better ICI response and outcome. In addition, the ICI efficacy-related mutational signatures and molecular subtypes were also determined. The above findings emphasize the importance of clinically expanded cohorts to uncover novel molecular determinants of response to immunotherapies.In this study, based on the integrated ICI-treated 631 melanoma and 109 NSCLC samples, we observed that  cohorts ,54,56, wHSPG2 mutations and ICI efficacy lacked functional experiments and in-house verification.There are several limitations to this study. First, the integration of melanoma and NSCLC data was based on multiple distinct datasets, which might produce some biases during data analyses. Second, only two cancer types were included in this study, and no more available cancers were used for validation. Three, the connection between HSPG2 mutations were associated with better tumor immunogenicity and ICI treatment efficacy. The results from this genomic association study suggest that HSPG2 mutations may be considered as a possible molecular biomarker for assessing immune treatment responses.Collectively, based on the aggregated melanoma and NSCLC immunotherapeutic cohorts, we discovered that


Substance use disorder (SUD) in patients with ADHD symptoms is associated with a poorer treatment prognosis. The study is aimed to investigate psychosocial risks factors for developing SUD in patients with ADHD.To examine the associations between self-reported weak academic performance, repetition of a grade, single – parent family, self-reported quality of parent – child relationship, conduct problems in childhood and SUD in adulthood in a sample of outpatients with ADHD symptoms of an addiction medicine clinic in Riga, Latvia.Self-report surveys, containing Adult ADHD Self-Report Scale (ASRS-v I.I), were completed by outpatients of addiction clinic, including healthy control subjects . Patients then were examined in relation to childhood risk factors.Survey was compleated by 341 outpatients – 98  healthy controls and 243  patients with SUD . 62  patients were tested positive for ADHD, of whom 12  were healthy subjects and 50  were with SUD. Data shows connection between conduct problems in childhood , single - parent family , repetition of a grade  and SUD in adults with ADHD symptoms. Comparing patients with and without ADHD symptoms, there was found no significant association between these factors, except for conduct problems .The study found preliminary evidence that adults with ADHD symptoms who experienced single – parenthood in childhood, had conduct problems or repeated a grade are more likely to develop SUD. Futher investigation is required.


Concentration of production on a few commercial pig breeds has led to the marginalization of many native, numerically small breeds, increasing their risk of endangerment. In the UK, one such rare breed is the British Lop, a lop-eared breed, of similar origin to the Welsh breed. The objective of the present study was to address the genomic status of the British Lop and its relationship with other breeds and identify a small set of genomic markers that uniquely characterize and distinguish British Lop animals. Results have shown that the British Lop is a relatively distinct population with reduced genomic diversity and effective size consistent with its status as a rare breed. Furthermore, we demonstrated the genetic closeness of the British Lop to phenotypically similar breeds such as Landrace and Welsh as well Large White, Middle White and Pietrain. Finally, a set of 75 Single Nucleotide Polymorphisms distributed across multiple chromosomes were identified and validated as markers that can consistently distinguish British Lops from other closely related breeds. Results may inform breeding and management strategies aiming to enhance diversity as well as the development of a breed purity test. Globalization in the latest decades has led to an increasing demand of livestock products, with the pig industry accounting for between 35% and 40% of the worldwide meat production . IncreasAt the same time, several traditional autochthonous breeds have been marginalized, leading to endangerment according to the Rare Breeds Survival Trust (RBST); examples of such breeds include the British Lop, Tamworth and Berkshire . HoweverThe use of genomics may be particularly helpful to farmers and breed societies. For example, the use of genomic data can complement the information provided from existing pedigrees, to increase the accuracy of inbreeding and effective population size estimates and underpin relevant genomic breeding schemes. Furthermore, genomics tools can also be used to confirm if individual animals belong to a certain breed. In a previous study , a genomThe British Lop pig is a numerically small native breed  classifiThe present study aims to genomically explore the British Lop, one of the rarest UK native breeds and provide insights that may underpin future breeding schemes. Three main specific objectives are addressed within this aim: i) perform a genomic characterization of the British Lop breeding population; ii) investigate the genomic relationship of the British Lop with commercial populations and other UK pig breeds and iii) identify a set of genomic markers that distinguish the British Lop pigs from other breeds.Hair samples were obtained from 190 British Lop pigs from 40 farms that are members of the British Lop Pig Society. These animals represent a significant cross-section of the current breeding population. All available animal pedigree records were also obtained, consisting of 2,901 records including historic data.Hair samples were genotyped using the Illumina PorcineSNP60v2 BeadChip, comprising 61,565 Single Nucleotide Polymorphisms (SNPs) spread throughout the entire genome.https://doi.org/10.5061/dryad.c2124) [Additional genotypes of 348 pigs representing 13 other UK pig breeds and commercial populations were obtained from the public domain  was estimated as FROH = LROH /LAUTO, where LROH is the total length of ROH on autosomes and LAUTO is the total length of the autosomes covered by SNPs [Subsequently, individual ROH-based inbreeding  described above was applied in this step to account for genotyping errors, leading to a dataset of 176 genotypes and 36,048 SNPs.In-house software was used to estimate the genomic relationship matrix calculated with the SNP information, and individual inbreeding coefficients were calculated from its diagonal. Two methods were used for this purpose: i) the VanRaden’s method 2 , assuminThe historic effective population size was estimated from SNP data using the SNeP software  with theThe second aim of the present study was to assess the genomic relationship of the British Lop with other UK pig breeds and populations. This was achieved by i) inspecting the IBS genetic distances between the different breeds, ii) identifying potential historic migration events that might have taken place between breeds and iii) inferring the current degree of admixture per individual and the number of ancestral breeds.In order to avoid bias due to the over-representation of the British Lop breed, 33 representative British Lop samples were kept for these analyses. These samples were selected using the Multi-Dimensional Scaling analysis implemented in the R-package “BITE” through the function “representative.sample” [2 threshold of 0.3, window sizes of 50 SNPs and shifting steps of five SNPs. Furthermore, SNPs with at least one missing genotype were removed using VCFtools [Subsequently, the 33 representative British Lop samples were combined with genotypes from the other UK traditional and commercial breeds described above (between 24 to 34 samples per breed). Quality control for this combined dataset included the removal of SNPs with minor allele frequencies lower than 0.02. To avoid potential bias due to missing genotypes and strong LD among SNPs, LD pruning was performed using PLINK  assumingVCFtools . These sIBS genetic distances between samples were estimated in PLINK  for 100 Allele frequencies for each breed were estimated in PLINK  and usedThe degree of admixture per individual and the number of ancestral breeds were assessed with the maximum likelihood method implemented in the software ADMIXTURE . To estiThe third aim of the present study was to identify a unique subset of SNPs that could be easily used to distinguish the British Lop from the other UK breeds included in this study.Twenty representative samples were selected from each breed to constitute the training set, using the Multi-Dimensional Scaling approach described above. Sixteen additional independent validation sets were created, not containing any samples present in the training set. Each of these validation sets included British Lop samples randomly chosen plus 6–14 samples per each of the other breeds. Furthermore, the last two validation sets also included one of the two British Lop outliers identified in the initial PCA of genotypes.2 threshold of 0.2, window sizes of 50 SNPs and shifting steps of five SNPs) and removal of all SNPs with at least one missing genotype. These edits led to a training dataset containing 120 genotypes and 3,417 variants.When comparing two populations, a common procedure involves selecting SNPs that are likely to be fixed within one of them. However, the fixation index alone may not be the appropriate way to assess marker informativeness when the number of populations is greater than two . As the st analyses between British Lop and every other breed in the training dataset using PLINK [st were selected, separating British Lop from at least one other breed. In the second step, these preselected SNPs were further filtered by keeping the smallest combination of SNPs that fully distinguished the British Lop from all other breeds. This was achieved with a Canonical Discriminant Analysis within each chromosome, using the R-package “MASS” [In the first step to identify the best markers that distinguish British Lop animals from the others, low-informative markers were removed following pairwise Fng PLINK . In eache “MASS” . In thesTo assess the effectiveness of the selected SNPs in separating the British Lop from the other breeds, cluster analyses were performed on each of the validation sets based on the genomic relationship matrix estimated from these 75 SNPs, using the GEMMA software . ClusterIn addition, the predictive capacity of the final set of 75 SNPs was tested in a series of Canonical Discriminant Analyses, using the genotypes as predictive variables and the binary outcome (British Lop or other) as the response variable. These analyses were performed using the R-package “MASS” , with thEstimates of genetic diversity were reflective of a population with a relatively small effective size and under significant drift effects. The population showed a low nucleotide diversity average of 5.53e-06 per Mb , with a standard deviation of 2.84e-06 and minimum and maximum values of 5.68e-09 and 1.57e-05, respectively. This nucleotide diversity was lower than the observed for Large White (6.37e-06 per Mb), Pietrain (6.23e-06 per Mb), Welsh (6.16e-06 per Mb) and Landrace (5.83e-06 per Mb), but slightly higher than for Middle White (5.47e-06 per Mb).The estimate of Tajima’s D in British Lop was positive and significantly different from zero , with aThe ROH analysis detected 11,306 ROH, with an average size of 8,073 Kb and a standard deviation of 9,713 Kb. Individual ROH varied largely in size . On average, 64.2 ROH were detected per individual with a standard deviation of 7.6 and minimum and maximum of 24 and 83, respectively. Inbreeding estimates in the British Lop population are summarized in 2 = 0.999) to the most recent 54 generations , indicating that the current estimated effective size of the population would be approximately 40. This genomic estimate of the current effective population size was in line with a pedigree-based estimate of around 45, associated with an observed increase in inbreeding of animals with complete generations.The historic effective population size trend estimated with SNP information for the British Lop is presented in The consensus tree based on IBS distances is presented in Preliminary Evanno analyses aiming to identify the optimal number of potential migration patterns between breeds showed that 12 edges in the maximum-likelihood tree would explain 99.4% of the variance . Howeverth population was the result of an underlying substructure in the Welsh samples. Relevant admixture proportions are shown in The unsupervised admixture analysis  resultedThe third aim of this study was to identify SNPs that would consistently distinguish British Lops from the closest related UK breeds identified in the previous analyses .st comparisons. Canonical Discriminant Analyses were then performed within each chromosome, further reducing the set of unique SNPs to 75.The starting set of 3,417 LD pruned variants was reduced to 630 SNPs based on pairwise FIn all subsequent validation analyses, the use of Hierarchical Clustering methods with these 75 SNPs consistently separated the British Lop cluster from other breed clusters, with the two known British Lop outliers correctly placed outside the British Lop cluster. Furthermore, the Canonical Discriminant Analyses conducted to test the predictive ability of these SNPs always identified correctly an animal as British Lop or not.The names and positions of the selected 75 SNPs are provided in the The development of worldwide intensive livestock production systems has stimulated rigorous genetic selection and the formation of a few high producing commercial breeds to respond to increasing market demands. This, in turn, has led to the decline of many native pig breeds in recent years. However, the conservation of rare pig breeds is extremely important as they constitute useful reservoirs of genetic variability. Such breeds may also possess certain desirable traits for niche markets and/or be of cultural heritage importance.The focus of the present study was on the British Lop, which serves as a typical example of a rare pig breed. The genomic characterization of this breed revealed a small effective population size and possible strong effects of genetic drift. The nucleotide diversity was lower than in other breeds and Tajima’s D values were positive and significantly different from zero. While previous studies on mitochondrial DNA  have repGenomic inbreeding and runs of homozygosity in the British Lop were in line with other rare autochthonous European breeds such as Apulo-Calabrese, Casertana and Nero Siciliano , 10. TheAdmittedly, the commercial array used in the present study for animal genotyping may have underrepresented rare variants pertaining to rare breeds. This could affect the estimation of genomic homozygosity levels . NeverthPedigree-based inbreeding reported in the present study was probably an underestimate due to lack of complete historic pedigree data. Therefore, our estimates of genomic inbreeding and homozygosity are collectively of higher value for the management of this genetic resource than the estimates based on pedigree.Ne = (4NsiresNdams) / (Nsires + Ndams), relying on the assumptions of random mating, non-overlapping generations and a Poisson distribution of number of offspring [Estimates of the effective population size in the British Lop were generally similar to those reported in other rare breeds in previous studies . Howeverffspring . In the The above results of the genomic characterization of the British Lop are in line with the current status of a priority breed at risk . With onLandrace and Welsh were the two breeds most closely related to the British Lop. These results are concordant with both the origin of the breed from lop-eared white breeds, like the Welsh, in the southwest of the UK  and withAs in previous studies , HampshiA small number of SNPs were identified in the present study that distinguish British Lop pigs from other UK breeds. These SNPs may enable traceability of British Lop animals and their products. The development and practical implementation of this genomic tool can be useful for farmers interested in testing animals with unknown or uncertain origin. Based on our results, relevant prediction accuracy is expected to be 100%, thereby attesting to their utility in developing a breed purity test. In such a case, possible changes in allelic frequencies in future generations need to be considered. While in the present study the selected SNPs exhibited high variability, genetic drift leading to random changes in the allelic frequencies may be expected, thereby affecting their efficacy in future generations. Therefore, a re-evaluation of the set of distinctive markers is recommended every few generations. This is common practice in genomic selection and management programs. In this respect, the methodology described here is relatively simple and can be easily implemented at a low cost.As previously discussed, the present study used a commercial SNP array for animal genotyping that may have underrepresented certain rare variants in the British Lop and other rare breeds. Nevertheless, our results suggest that this array is still suitable for the identification of the unique SNPs distinguishing the population of study. Various commercial arrays have also been used successfully in previous genomic studies of other rare breeds of pigs , 12, 52 Results of the present study may collectively inform genetic management strategies for the British Lop considering genetic drift and inbreeding depression, while maintaining the unique characteristics of the breed and potential rare variants of interest. Regarding the latter, whole-genome sequencing would be a useful, albeit costly, approach. A potential alternative would be to use the existing genome-wide SNP arrays to identify rare segregating haplotypes in the breed. Admittedly, in a population under strong genetic drift these regions could be associated to deleterious mutations segregating in the genome. Therefore, rare haplotypes should be considered in association with fitness-related animal traits.Genetic management strategies of the breed would vary depending on the objective of the breeding program. Under a conservation approach, strategies such as equal contributions of parents can be applied to minimize global co-ancestry and assure all breeding animals contribute to the ensuing generations , 57. SomIn conclusion, the present study of the British Lop as a typical example of a numerically small autochthonous pig breed, revealed relatively high levels of inbreeding and reduced genetic diversity compared to larger commercial breeds. Despite previous reports of potential introgression from other breeds, very little admixture has been detected, even with closely related breeds such as Landrace and Welsh. A set of 75 SNPs was identified that, combined, uniquely characterize the British Lop and may be used to develop a breed purity test to distinguish them from other breeds with similar phenotypic characteristics. This low-cost genomic tool may be used in conjunction with other management practices for the future conservation, maintenance and improvement of the breed. Moreover, such a tool could also be commercially utilized by food inspection agencies for product traceability and consumer protection.S1 FigNucleotide diversity (A) and Tajima’s D (B) estimates in the British Lop population per chromosome. Boxplots per chromosome for nucleotide diversity and Tajima’s D, estimated in windows of 1 Megabase using 176 British Lop samples and 44,315 SNPs. For nucleotide diversity, genome-wide minimum and maximum values were on chromosomes 1 and 8 , and chromosomal average ranged from 4.393e-06 (chromosome 15) to 6.773e-06 (chromosome 17). For Tajima’s D, genome-wide minimum and maximum values were detected on chromosomes 5 and 14 , and chromosomal average ranged from 2.132 (chromosome 11) to 2.916 (chromosome 17).(TIF)Click here for additional data file.S2 FigThe maximum number of generations traced for each individual was calculated based on the existing pedigree of 2,901 animal records including historic data.(TIF)Click here for additional data file.S1 TableSus scrofa 11.1 assembly.SNPs are presented per chromosome, indicating their position in base pairs and all the available calling systems . Forward strand allele calls correspond to the genome assembly 10.2; map positions have been updated accordingly with the (XLSX)Click here for additional data file.


Objective: ADHD and its associated inhibition deficits might promote creativity. However, results in the literature are conflicting, possibly due to the heterogeneity of ADHD. To control for this heterogeneity, creativity, and inhibition were investigated in the predominantly inattentive (ADHD-I) and combined (ADHD-C) presentations. Method: Participants were males/females aged 18 to 51, diagnosed with ADHD-I (n = 21), ADHD-C (n = 19), or without ADHD (n = 43). Self-rated Kaufman Domains of Creativity Scale and evaluator-rated figural Torrance Test of Creative Thinking (TTCT) were used for measuring creativity, Stroop task for inhibition, and Conners’ Adult ADHD Rating Scales for ADHD symptoms. Results: The ADHD-C group reported higher self-rated creativity than other groups and made more original drawings paired to more abstract titles in the figural TTCT than controls. Conclusion: ADHD-C participants were the most creative. This result was more importantly associated with higher degrees of ADHD symptoms rather than poorer inhibition. ADHD is a neurodevelopmental disorder with a childhood onset affecting 2.58% of the global adult population . It leadAlthough this is disputed , most stTaken altogether, these pieces of evidence lead to believe that the ADHD population could be highly creative. To verify this, two particular dimensions of the 4P framework of creativity were investigated: the “Person”  and the “Process” , as defined by The case-control study in adults with ADHD of The most prevalent presentations of ADHD are combined (ADHD-C) and predominantly inattentive ADHD-I;  and the As just mentioned, ADHD is a heterogeneous disorder in terms of behavioral symptoms  andcertaThus, the first objective of this study was to explore creativity as measured by self-report scales and DT tasks in the two most prevalent presentations of ADHD in adults: ADHD-I and ADHD-C , in compAside from the behavioral and cognitive heterogeneity observed in ADHD, some methodological inconsistencies could also account for the variability of the results found in the literature on creativity in ADHD. Medication for ADHD is not consistently controlled, despite evidence that psychostimulants may interact with creativity . Creativn = 20) and female (n = 63), within the age of 18 to 51 , took part in the study. The control group counted 43 participants and the clinical groups were composed of participants who had an official diagnosis of ADHD given by a licensed psychiatrist, physician, neuropsychologist, or psychologist. Twenty-one participants were diagnosed with ADHD-I and 19 were diagnosed with ADHD-C. Demographic data of our groups are presented in n = 1, ADHD-C group: n = 4) reported having dyslexia. Three participants of the ADHD-C group reported having an anxiety or mood disorder. Our results were not affected by the inclusion of these participants. Finally, a portion of the testing was carried out during the COVID-19 pandemic. Three participants from the ADHD-I group and one from the ADHD-C group were assessed by teleconference. Again, our results were not affected by their inclusion.Eighty-three participants from the region of Montreal, male  is a 50 items questionnaire assessing self-perceived creative abilities . ExamineThe figural Torrance Tests of Creative Thinking TTCT;  are threThe Stroop Color and Word Task . In our first objective, groups were compared on K-DOCS domains and measures of the figural TTCT  with one-way analyses of variance (ANOVAs). For our second objective, bilateral Pearson’s correlations were used to evaluate if creativity scores in figural TTCT or K-DOCS were related to completion time and the number of errors in the color-word condition of the Stroop Task additionally to the CAARS symptom scales. To limit the number of analyses, correlations were only conducted in groups and in measures where significantly higher creativity scores were found priorly in the results of Objective 1.p > .05) was confirmed by Levene’s test. Tuckey’s correction was used to control for the number of comparisons and the criterion for statistical significance was set at p < .05. As indicated by one-way ANOVAs, groups were equivalent on age  and estimated non-verbal intelligence ; Control group: M = 11.62, SD = 2.58; ADHD-I group: M = 11.38, SD = 3.20; ADHD-C: M = 11.42, SD = 2.32). Chi-squared test showed that groups were equivalent on sex, X2  = 2.799, p = .247, V = 0.184, and academic level, X2  = 3.385, p = .184. V = 0.202.Scores were distributed normally in all groups. Homogeneity of variances  were calculated to estimate interrater reliability of its measures on a subset of 20 randomly chosen copies rated at different time points by our two scorers. ICCs estimates and their 95% confidence intervals were calculated with two-way random-effect models based on single ratings and absolute agreement. According to the guidelines of T scores of every CAARS scale . We also verified if superior creativity between groups was related to higher ADHD symptoms and lower executive inhibition. Our results provide evidence that creativity varies between ADHD presentations, and we propose it might be mainly explained by differences in behavioral symptoms.Our first finding was that participants with ADHD-C self-rated their creativity higher than the other groups on the K-DOCS, more precisely on the Performance domain, which encompassed music, theater, and dance. r = .420, p = .074). Interestingly, these symptoms are linked to extraversion . Perhaps, curvilinear analyses would be more adequate for measuring the relation between the behavioral symptoms of ADHD and creativity.More self-reported hyperactive and impulsive symptoms were not linearly associated with better performances to the DT task in participants with ADHD-C, contrarily to the findings of other studies in participants without ADHD . In ADHDThe ADHD-I group was not creatively superior to the other groups. This is coherent with previous works suggesting that the main drivers of ADHD are hyperactivity/impulsivity , two symr = .390, p = .099), which echoes the findings of Finally, there is little evidence in our results supporting our hypothesis that higher DT scores would be related to poorer executive inhibition. In ADHD-C, poorer executive inhibition was marginally and positively, but not significantly, related to a higher score in the Performance domain  the tendencies we underlined. We particularly had difficulties recruiting male participants, especially in our clinical groups. Moreover, our groups were also almost nonequivalent regarding age. Fortunately, most studies report no gender-based differences in creativity . While aAt the time of writing, this was the first study that compared creativity between clinical samples of individuals officially diagnosed with ADHD-I and ADHD-C. Taken together, our results suggest there are variations of creativity between these two presentations, with higher creativity scores exclusively being found in ADHD-C. These higher scores appeared to be linked more importantly to behavioral symptoms than poorer executive inhibition. Our results are novel and have several important implications for future research on ADHD and creativity. They highlight the importance of considering the presentations of ADHD in research on creativity. ADHD presentations are associated with different sets of behavioral symptoms, and some appear to contribute better than others to certain facets of creativity. This is not to say individuals with ADHD-I are not highly creative. The domain or in which they exude creativity might simply be unknown yet. Moreover, if mind-wandering and inattentiveness are the entryways of creativity in ADHD-I, time-constrained tasks may not be the best suited for measuring this ability in this population. Future work should recognize the heterogeneity of ADHD but also aim to refine the identification of the domains and the contexts in which individuals with different presentations of ADHD may excel creatively. It will then be possible to better orient this group toward success.