scholarly journals Neurotherapeutics for Attention Deficit/Hyperactivity Disorder (ADHD): A Review

Cells ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 2156
Author(s):  
Katya Rubia ◽  
Samuel Westwood ◽  
Pascal-M. Aggensteiner ◽  
Daniel Brandeis
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Near Infrared ◽  
Medium Effect ◽  
Hyperactivity Disorder ◽  
Trigeminal Nerve Stimulation ◽  
Relative Safety ◽  
Dorsolateral Prefrontal ◽  
Randomised Controlled ◽  
Meta Analyses

This review focuses on the evidence for neurotherapeutics for attention deficit/hyperactivity disorder (ADHD). EEG-neurofeedback has been tested for about 45 years, with the latest meta-analyses of randomised controlled trials (RCT) showing small/medium effects compared to non-active controls only. Three small studies piloted neurofeedback of frontal activations in ADHD using functional magnetic resonance imaging or near-infrared spectroscopy, finding no superior effects over control conditions. Brain stimulation has been applied to ADHD using mostly repetitive transcranial magnetic and direct current stimulation (rTMS/tDCS). rTMS has shown mostly negative findings on improving cognition or symptoms. Meta-analyses of tDCS studies targeting mostly the dorsolateral prefrontal cortex show small effects on cognitive improvements with only two out of three studies showing clinical improvements. Trigeminal nerve stimulation has been shown to improve ADHD symptoms with medium effect in one RCT. Modern neurotherapeutics are attractive due to their relative safety and potential neuroplastic effects. However, they need to be thoroughly tested for clinical and cognitive efficacy across settings and beyond core symptoms and for their potential for individualised treatment.

scholarly journals Neurotherapeutics for Attention Deficit Hyperactivity Disorder (ADHD): a Review

2021 ◽  
Author(s):  
Katya Rubia ◽  
Samuel Westwood ◽  
Pascal-M. Aggensteiner ◽  
Daniel Brandeis
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Near Infrared ◽  
Medium Effect ◽  
Hyperactivity Disorder ◽  
Trigeminal Nerve Stimulation ◽  
Relative Safety ◽  
Dorsolateral Prefrontal ◽  
Randomised Controlled ◽  
Meta Analyses

This review focuses on the evidence for neurotherapeutics for Attention Deficit Hyperactivity Disorder (ADHD). EEG-Neurofeedback has been tested for about 45 years with latest meta-analyses of randomised controlled trials (RCT) showing small/medium effects compared to non-active controls only. Three small studies piloted neurofeedback of frontal activations in ADHD using functional magnetic resonance imaging or near-infrared spectroscopy, finding no superior effects over control conditions. Brain stimulation has been applied to ADHD using mostly repetitive transcranial magnetic and direct current stimulation (rTMS/tDCS). rTMS has shown mostly negative findings on improving cognition or symptoms. Meta-analyses of tDCS studies targeting mostly dorsolateral prefrontal cortex show small effects on cognitive improvements with only two out of three studies showing clinical improvements. Trigeminal nerve stimulation has shown to improve ADHD symptoms with medium effect in one RCT. Modern neurotherapeutics are attractive due to their relative safety and potential neuroplastic effects. However, they need to be thoroughly tested for clinical and cognitive efficacy across settings and beyond core symptoms and for their potential for individualised treatment.

scholarly journals Neuroimaging and neurotherapeutics for Attention Deficit Hyperactivity Disorder (ADHD)

ANALES RANM ◽  
2021 ◽  
Vol 138 (138(02)) ◽  
pp. 124-131
Author(s):  
K. Rubia
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Near Infrared ◽  
Clinical Symptoms ◽  
Brain Plasticity ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Medium Size ◽  
Functional Near Infrared Spectroscopy ◽  
Hyperactivity Disorder ◽  
Trigeminal Nerve Stimulation

This paper reviews the functional magnetic resonance imaging (fMRI) literature of Attention Deficit Hyperactivity Disorder (ADHD) of the past three decades and the modern neurotherapies that have used these biomarkers as targets for treatment. Meta-analyses of task-based fMRI studies have shown functional abnormalities in different domain-dependent frontal, striatal, parietal, and cerebellar regions in ADHD. Resting state fMRI studies confirm abnormalities in different fronto-striato-parietal cognitive control, dorsal and ventral attention networks. The frontal parts of these networks have been targeted by neurotherapeutics. Only three small-numbered studies so far have applied functional near infrared spectroscopy (NIRS) and fMRI-Neurofeedback to ADHD. Studies have mostly shown feasibility and some promising effects on clinical, cognitive or imaging measures which invite further testing in larger samples. Repetitive transcranial magnetic stimulation (rTMS) of the dorsolateral prefrontal cortex (DLPFC) or inferior frontal cortex (IFC) has not shown promising effects so far on improving cognition or symptoms. Eighteen studies tested the effects of single or multi-session transcranial direct current stimulation (tDCS) of mostly left DLPFC on mostly cognitive functions with fewer studies targeting right DLPFC or IFC. Our meta-analysis of tDCS studies shows relatively small effects of improvement of cognitive function while insufficient studies have tested clinical efficacy. A proof of concept study of trigeminal nerve stimulation (TNS) showed promising medium size effects for improving clinical symptoms but requires replication in larger samples. In conclusion, neurotherapies are attractive due to minimal side effects and potential longer-term effects on brain plasticity which drugs cannot offer; however, they are still in their infancy. They require systematic testing of optimal protocols in large samples, including optimal site of stimulation/neurofeedback, optimal frequency of treatment sessions, or optimal stimulation amplitude. Importantly, they will need to show potential for individualised treatment by providing understanding of treatment response prediction.

scholarly journals Polygenic association between attention-deficit/hyperactivity disorder liability and cognitive impairments

2021 ◽  
pp. 1-9 ◽  
Author(s):  
Isabella Vainieri ◽  
Joanna Martin ◽  
Anna-Sophie Rommel ◽  
Philip Asherson ◽  
Tobias Banaschewski ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Reaction Time ◽  
Response Inhibition ◽  
Attention Deficit ◽  
Random Effect ◽  
Risk Scores ◽  
Time Variability ◽  
Attention Regulation ◽  
Hyperactivity Disorder ◽  
Meta Analyses

Abstract Background A recent genome-wide association study (GWAS) identified 12 independent loci significantly associated with attention-deficit/hyperactivity disorder (ADHD). Polygenic risk scores (PRS), derived from the GWAS, can be used to assess genetic overlap between ADHD and other traits. Using ADHD samples from several international sites, we derived PRS for ADHD from the recent GWAS to test whether genetic variants that contribute to ADHD also influence two cognitive functions that show strong association with ADHD: attention regulation and response inhibition, captured by reaction time variability (RTV) and commission errors (CE). Methods The discovery GWAS included 19 099 ADHD cases and 34 194 control participants. The combined target sample included 845 people with ADHD (age: 8–40 years). RTV and CE were available from reaction time and response inhibition tasks. ADHD PRS were calculated from the GWAS using a leave-one-study-out approach. Regression analyses were run to investigate whether ADHD PRS were associated with CE and RTV. Results across sites were combined via random effect meta-analyses. Results When combining the studies in meta-analyses, results were significant for RTV (R2 = 0.011, β = 0.088, p = 0.02) but not for CE (R2 = 0.011, β = 0.013, p = 0.732). No significant association was found between ADHD PRS and RTV or CE in any sample individually (p > 0.10). Conclusions We detected a significant association between PRS for ADHD and RTV (but not CE) in individuals with ADHD, suggesting that common genetic risk variants for ADHD influence attention regulation.

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