Neurotherapeutics for ADHD: Do they work?

Abstract

This paper reflects on the use of neurotherapeutics for attention‐deficit/hyperactivity disorder (ADHD). ADHD is the most imaged child psychiatric disorder, with over 3 decades of magnetic resonance imaging (MRI) research. Findings are relatively homogeneous compared to other psychiatric conditions with consistent evidence for differences, albeit small, relative to healthy controls in the structure and function of several frontal, parietotemporal, and striatal brain regions as well as their inter‐regional structural and functional connections. The functional deficits have been targeted with modern neurotherapeutics, including neurofeedback (using most commonly electroencephalography and more recently functional near‐infrared spectroscopy and functional MRI) and non‐invasive brain stimulation (such as repetitive transcranial magnetic stimulation, transcranial direct current stimulation, or external trigeminal nerve stimulation). Except for electroencephalography‐neurofeedback, the majority of neurotherapeutic studies have been relatively small, with very heterogenous research protocols and outcome measures and—likely as a consequence—inconsistent findings. Furthermore, most brain stimulation studies have tested effects on cognitive functions rather than clinical symptoms. So far, findings have not been very promising. Future studies require systematic testing of optimal protocols in large samples or homogenous subgroups to understand response prediction that could lead to individualized treatment.

Exploring the effects of repetitive transcranial magnetic stimulation on co-morbid sleep disorders in preschool children with ADHD

“…rTMS has been used for a long time in the treatment of ADHD its co-morbidities, and reports of adverse effects of rTMS are uncommon. Occasionally, pressure and allergy due to the device being worn the head have been reported (Rubia, 2022). This detail also into account in this study, so that the adaptation time and adjustment time for paediatric patients was increased, and consequently no discomfort was reported by the paediatric patients their parents during or after the treatment.…”

“…). In addition, low-frequency rTMS promotes ipsilateral hippocampal nerve regeneration and reduces apoptosis, increasing its functionality and plasticity, which also facilitates the adjustment of sleep-wake disorders (Guo et al, 2017;Rubia, 2022). rTMS has been used for a long time in the treatment of ADHD its co-morbidities, and reports of adverse effects of rTMS are uncommon.…”

Electrophysiological underpinnings of dysfunctional inhibitory control in adults with attention-deficit/hyperactivity disorder: evidence for reduced NoGo anteriorization

“…Furthermore, the fact that the P3 NoGo anteriorization is a reliable and simple-to-use measure may pave the way for a clinical application of novel neuromodulation treatments based on NGA, in order to modify altered neural activity in ADHD. These treatments, including neurofeedback or non-invasive brain stimulation are increasingly being viewed as promising in targeting the key neurobiological abnormalities associated with ADHD (Rubia 2022 ).…”

Adherence-Promoting Design Features in Pediatric Neurostimulators for ADHD Patients

“…Neurostimulation is the use of exogenously applied electric fields for the intentional modulation of the nervous system's activity using invasive (e.g., deep brain stimulating microelectrodes) or non-invasive (e.g., transcranial stimulation) methods. Despite relatively small clinical trials to date, transcranial direct current stimulation (tDCS) and external trigeminal nerve stimulation (eTNS) represent quite promising interventions for the treatment of ADHD [8,13,14]. Both tDCS and eTNS methods involve application of external electrodes to specific anatomical locations on the patient, and use of an on-body pulse generator [8].…”