Faculty Bibliography

Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental condition in  children and young people worldwide. Robust estimates of its incidence, prevalence, and burden are essential for informing public health policy and planning. Using data from the Global Burden of Disease Study 2021 (GBD 2021), this global population-based analysis assessed ADHD among individuals under 20 years of age across 204 countries and territories from 1990 to 2021. The study examined incidence, prevalence, and disability-adjusted life years (DALYs) associated with ADHD. In 2021, there were an estimated 46,890,733 (95% uncertainty interval [UI]: 32,136,904-67,271,064) prevalent cases and 4,111,621 (2,775,203-5,954,941) incident cases globally in individuals under 20 years. ADHD accounted for 574,979 (294,277-977,557) DALYs, with a global prevalence rate of 1.78% (1.22-2.55%) and an incidence rate of 0.16% (0.11-0.23%). The global DALY rate was 21.8 (11.2-37.1) per 100,000 population. Prevalence and incidence were highest in Australia, with rates of 5.62% (4.16-7.46%) and 0.49% (0.34-0.66%), respectively. Between 1990 and 2021, global prevalence and incidence rates decreased modestly by 6.0 and 5.81%, respectively. Across all GBD regions, prevalence was higher in males than females (2.52 vs 0.99%) and increased with higher socio-demographic index levels. Overall, the GBD 2021 study provides the most comprehensive global estimates of ADHD burden in young people. These findings are important for guiding policymakers and stakeholders, although potential methodological limitations suggest that the prevalence, incidence, and burden of ADHD may be underestimated.

INTRODUCTION/BACKGROUND:A variety of rating scales are currently being used to assess symptom severity and quantify symptoms change in attention-deficit/hyperactivity disorder (ADHD) research and clinical practice. This poses difficulties in interpreting scores from different scales in clinical practice and synthesizing data from studies using different scales. We aimed to develop algorithms for converting scores across the ADHD scales most often used in randomized controlled trials (RCTs) of ADHD medications in children/adolescents and adults, and to develop an online tool for implementing the algorithms. METHODS: RESULTS:We linked six commonly used ADHD scales, such as the ADHD Rating Scale (ADHD-RS-IV; investigator-rated) and the Conners' Parent Rating Scale (CPRS-R:S). Spline models most frequently yielded the lowest prediction error, outperforming alternative conversion algorithms for absolute scores in 6 out of 12 univariable models and 8 out of 12 multivariable models. The tool for scores conversion is available at ADHD_Scale_Conversion_Tool. CONCLUSIONS:Our linkage algorithms enable the comparison and harmonization of findings across studies using different ADHD rating scales. Translating scores across scales improves the interpretability of research findings, facilitates future evidence synthesis across studies, and may support clinical practice. Our online tool supports the practical uptake of our results.

Living in neighborhoods characterized by physical and social disorder (e.g., litter, abandoned buildings, crime) is associated with poorer cognitive functioning. However, much of this work relies on decontextualized laboratory tasks, limiting insight into how everyday environmental experiences shape day-to-day cognitive functioning. Here, we introduce the Neighborhood Errand Task (NET), a novel navigation paradigm designed to approximate memory and information processing during wayfinding within disordered neighborhood contexts. Participants first learned a route through map study and guided practice, then completed navigation trials requiring choices between learned-familiar routes and novel-shortcut routes. Neighborhood disorder was experimentally manipulated via environmental cues and intermittent surprise "robbery" events. A diverse sample of U.S. adults (N = 100) completed the NET alongside self-reports of perceived neighborhood disorder and risky/impulsive behavior. Greater perceived neighborhood disorder was associated with poorer wayfinding in the learned route and shortcut trials, which may reflect differences in information processing, caution, strategy selection, or specific memory processes. Furthermore, inefficient navigation amplified the relationship between perceived neighborhood disorder and engagement in risky/impulsive behavior, suggesting that cognitive inefficiencies and environmental perceptions heighten vulnerability to behavioral dysregulation. By embedding cognition in a realistic, navigable context, the NET highlights how environmental adversity may shape adaptations relevant to survival.

Toxicity of prenatal ethanol leading to fetal alcohol spectrum disorders (FASDs) has been linked to disturbances in retinoic acid (RA) signaling necessary for embryonic development. While ethanol exposure in the postnatal day 7 (P7) mice, which induces immediate neurodegeneration and long-lasting GABAergic cell loss and behavioral deficits, has been used for the third trimester FASD model, involvement of RA signaling in the process has not been well explored. Using RARE-LacZ reporter mice that express β-galactosidase (β-Gal) under the control of retinoic acid response element (RARE), we examined RA signaling activity of the forebrains of P8 and P30 mice with or without P7 ethanol treatment. In all experimental groups, β-Gal was expressed mainly in the hippocampus with the strongest expression in the granule cell layer of dentate gyrus. In addition, β-Gal was expressed in pyramidal neurons and parvalbumin (PV) neurons in CA1-3 pyramidal layer and in astrocytes scattered around the CA1-3 region although PV neurons were only examined at P30 because of the low PV expression at P8. β-Gal was also expressed in the anteroventral/anteromedial (AV/AM) thalamus and the retrosplenial (Rs) and Tbr1-positive (+) layer 6 cortices. β-Gal-expressing PV neurons were also found in the cortex such as Rs, while β-Gal was barely detected in somatostatin neurons in any brain regions examined. Such region and cell specific β-Gal expression was significantly higher in P8 brains than P30 brains in various brain regions. P7 ethanol reduced β-Gal expression in the CA1-3 pyramidal layer, Tbr1 + cortical layer 6, and the AV/AM thalamus at P8 or P30 or both. Although P7 ethanol decreased PV cells in CA2-3 pyramidal layers as reported, it decreased β-Gal+ PV cells more drastically. The active RA signaling found in PV neurons and the effects of P7 ethanol on the signaling suggest that reduced RA signaling by P7 ethanol may disturb PV cell maturation and enhance long-lasting brain abnormalities.

BACKGROUND/UNASSIGNED:This paper provides an overview of adapting a micro-savings program originally developed in the United States to a resource-limited setting in Uganda, highlighting this specific case of adapting a program from one country to another. The program involved opening Child Development Accounts (CDAs) to support saving among adolescents girls and their families. Guided by the asset theory and institutional theory, the paper discusses the challenges and opportunities faced during the adaptation and implementation process. The findings offer insights that can inform efforts to expand similar micro-savings programs in other resource-limited communities. METHODS/UNASSIGNED:This paper utilizes data from the Suubi4Her study (2017-2022), a longitudinal intervention involving 1,260 adolescent girls in Southern Uganda. The analysis focused on saving behaviors among the entire sample and a subsample of 690 participants who opened CDAs. We examined self-reported and administrative savings outcomes over 30 months, encompassing bank savings behavior and savings beyond the initial deposit. Analyses also addressed key sociodemographic and psychosocial factors. A mixed-effect and adjusted logistic regression model were applied. RESULTS/UNASSIGNED:At enrollment, the participant's mean age was 15.37 years. The intervention improved bank saving behavior, evidenced by significant intervention-by-time interaction effects [χ2(2) = 43.38, p < 0.01], demonstrating a substantial increase in the odds of bank saving behavior in the intervention group at Wave 2 (OR = 78.85, 95% CI: 18.76, 331.51, p < 0.01) and Wave 3 (OR = 80.95, 95% CI: 19.31, 339.26, p < 0.01) compared to baseline within the control group. In the analysis of additional saving beyond the initial deposit, participants whose schools were located within 2 km of their home had significantly higher odds of saving (OR = 2.74, 95% CI: 1.72-4.37, p < 0.01), while older participants had lower odds (OR = 0.83, 95% CI: 0.68-0.99, p = 0.04). Living nearer to a bank was associated with increased odds of additional saving (OR = 1.74, 95% CI: 0.84-3.62, p = 0.13), though this association did not reach statistical significance. CONCLUSIONS AND IMPLICATIONS/UNASSIGNED:These findings suggest that, overall, CDA-based micro-saving programs implementation is possible even in resource limited communities like Uganda, and when given the opportunity, families living in low-income households can utilize the CDA "infrastructure" to save. Overall, for the saving intervention to yield its intended benefits, institutional barriers need to be addressed, including bringing the bank services to the people and providing financial literacy training to instill the culture of saving from a young age.

IntroductionBipolar depression is disabling and often inadequately responsive to medication alone. The current efficacy evidence of transcranial magnetic stimulation (TMS) for bipolar depression is conflicting. Therefore, we synthesized randomized controlled trials (RCTs) that tested the efficacy, safety, and tolerability of TMS for bipolar depression.MethodsWe searched MEDLINE/EMBASE/Cochrane/PsycINFO/gray literature (01/10/2025) for RCTs comparing any TMS protocol with sham. Co-primary outcomes were depressive symptoms, all-cause discontinuation; secondary outcomes were response, remission. Risk of bias (RoB) was assessed with RoB-2. Random-effects models estimated standardized mean differences (SMDs) and risk ratios (RRs) with 95% confidence intervals (95%CI), alongside sensitivity, subgroup, and meta-regression analyses.ResultsNineteen comparisons from 17 RCTs (N = 563; TMS = 293, sham = 270; mean N TMS = 15.4, sham = 15.9; mean duration = 2.40 weeks; RoB "low" = 35%, "some concerns" = 65%) were included. Among trials reporting subtypes (k = 13), 41.8% of participants had bipolar I disorder, and 58.2% had bipolar II disorder. The left dorsolateral prefrontal cortex was the most common target (k = 12). TMS reduced depressive symptoms versus sham (SMD = -0.34; 95%CI = -0.58 to -0.11), with no difference in all-cause discontinuation. TMS was favoured for response (RR = 1.41; 95%CI = 1.10 to 1.80) and remission (RR = 1.54; 95%CI = 1.06 to 2.23). However, these effects were not consistently confirmed in sensitivity or subgroup analyses by RoB, TMS type, stimulation site, or treatment resistance. Overall, 15 comparisons (88.2%) did not show superiority of TMS over sham for depressive symptoms at the individual trial level. No seizures or serious adverse events occurred; adverse events did not differ from sham. Meta-regression suggested a greater number of total pulses was associated with greater depressive symptom reduction (β = -0.018; p = .00017).ConclusionsTMS shows a small meta-analytic antidepressant effect and acceptable tolerability in bipolar depression despite most individual trials being negative. However, subgroups and sensitivity findings did not support TMS as an efficacious treatment at current doses. Further testing via larger RCTs with higher-dose protocols is warranted.

Murine studies show that the gut microbiota-the collection of the microbes residing in the large intestine-affects memory performance in the host. However, whether commensal gut bacteria are linked to human episodic memory remains unknown. Here, we investigated whether individual differences in episodic memory performance were associated with differences in the indigenous gut microbiota composition between individuals. We show that greater gut microbiota α diversity was associated with better item recognition and that gut microbiota dissimilarity index (β diversity) between participants was associated with differences in their performance. Finally, our results suggest that Prevotella copri might play a role in the relationship between gut microbiota and human item recognition in healthy individuals. In a sample size larger than previous human studies and examining unmanipulated gut microbiota, we provide evidence that episodic memory in healthy humans is linked to their gut microbiota composition.

Educational initiatives that address the gap between basic/preclinical and clinical practices are important to effectively translate basic science discoveries to benefit patients. The ILAE Neurobiology Commission conducted a pilot project aimed at exposing basic and preclinical scientists engaged in epilepsy research to general clinical issues pertaining to the diagnosis and care of people with epilepsy. This aim was addressed through a two-week-long, on-site clinical training program for 50 basic scientists in 21 epilepsy centers across 18 countries in the six ILAE regions (with a maximum of 3 basic scientists per center). The learning objectives and the training module were discussed and defined by the project organizing committee, which consisted of Neurobiology Commission members and a team of epileptologists representing different geographical regions. The training activities were conducted at each epilepsy center under the local supervision of clinical tutors. Each basic scientist was exposed to 50.3 ± 23.3 (range 16-89) hours of intensive and dedicated clinical training, coordinated by 2-3 tutors per center, assisted by 6.8 ± 3.6 colleagues. A structured test consisting of 17 general clinical epilepsy questions was completed by the trainees before and after the training activity. The learning assessment was based on the comparison between responses to the exit and entry tests. After the on-site clinical exposure, the proportion of correct answers increased to 87% compared to 61% in the entry test. Structured post-training questionnaires demonstrated very high satisfaction of trainees and all involved tutors across the different aspects of the training module. This global pilot study demonstrated that on-site attendance by basic scientists in specialized clinical settings up-scaled their knowledge of clinical epileptology and facilitated networking with clinicians. Expansion of this pilot to further centers should be considered to understand how exposure to clinical practice affects research direction and quality of translational epilepsy research. PLAIN LANGUAGE SUMMARY: Epilepsy research has long benefitted from collaboration between scientists and clinicians. Early exposure of researchers to people with epilepsy and their care teams may strengthen future impact. This pilot study tested a two-week immersive experience where small teams of basic scientists shadowed clinicians during their work at hospitals around the world. Questionnaires showed high satisfaction among both groups. Results support expanding such training, with the backing of the International League Against epilepsy and aligned centers, to build understanding, interest, and long-term commitment, ensuring bench research is informed by and translates to clinical practice and improved quality of life for patients.

[This corrects the article DOI: 10.3389/fpsyt.2025.1623358.].