Understanding ADHD: Toward an Innovative Therapeutic Intervention

Abstract

Attention deficit hyperactivity disorder (ADHD) is a pervasive condition affecting persons across all age groups, although it is primarily diagnosed in children. This neurological condition affects behavior, learning, and social adjustment and requires specific symptomatic criteria to be fulfilled for diagnosis. ADHD may be treated with a combination of psychological or psychiatric therapeutic interventions, but it often goes unattended. People with ADHD face societal bias challenges that impact how they manage the disorder and how they view themselves. This paper summarizes the present state of understanding of this disorder, with particular attention to early diagnosis and innovative therapeutic intervention. Contemporary understanding of the mind–brain duality allows for innovative therapeutic interventions based on neurological stimulation. This paper introduces the concept of neurostimulation as a therapeutic intervention for ADHD and poses the question of the relationship between patient adherence to self-administered therapy and the aesthetic design features of the neurostimulation device. By fabricating devices that go beyond safety and efficacy to embrace the aesthetic preferences of the patient, it is proposed that there will be improvements in patient adherence to a device intended to address ADHD.

Adherence-Promoting Design Features in Pediatric Neurostimulators for ADHD Patients

“…The use of medical devices for the treatment of pediatric ADHD is an expanding sphere of research, with significant attention being paid to non-pharmacotherapeutic options for use in a home environment [9,10]. Neurostimulation has emerged as a key device-based, non-pharmacotherapeutic innovation for the treatment of ADHD in children [11] and adults [12]. 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.…”

“…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]. In eTNS, small electrical currents are delivered transcutaneously via supraorbital electrode(s) adhesively attached to the skin over the ophthalmic nerve [11]. When stimulated, electroceuticals, such as catecholamines, may be released that potentiate ADHD symptoms [14,15].…”

Neurotherapeutics for ADHD: Do they work?

“…Furthermore, there is evidence that both techniques can lead to increased levels of catecholamines (Rubia et al, 2021 ; Westwood, Radua, & Rubia, 2021a ), which are known to be abnormal in ADHD (Cortese et al, 2018 ). The “electroceutical theory” of neurostimulation suggests that nascent biochemicals (such as dopamine and noradrenaline) are enhanced by the electrical stimulation, which can alter the activity of communication between specific nerve fibers to achieve therapeutic effects, while the “augmentation theory” of neurostimulation suggests that therapeutic benefits arise from physicochemical means, such as changes to the transmembrane potentials, membrane permeability, or electroactivity of receptors or receptands, under the influence of the applied electric field (Camp et al, 2021 ). For both rTMS and tDCS it seems that the combination with cognitive training, which primes the areas to be stimulated with a cognitive task, is more effective than stimulation alone, due to the synergistic effects of functional targeting (Westwood, Criaud, et al, 2021b ; Westwood, Radua, & Rubia, 2021a ).…”