scholarly journals Noninvasive brain stimulation in children and adults with attention-deficit/hyperactivity disorder: a systematic review and meta-analysis

2020 ◽  
Vol 46 (1) ◽  
pp. E14-E33
Author(s):  
Samuel J. Westwood ◽  
Joaquim Radua ◽  
Katya Rubia
Keyword(s):  
Systematic Review ◽  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Processing Speed ◽  
Meta Analysis ◽  
Anodal Tdcs ◽  
Cognitive Measures ◽  
Hyperactivity Disorder ◽  
Stimulation Parameters ◽  
Meta Analyses

Background: Repetitive transcranial magnetic stimulation (rTMS) or transcranial direct current stimulation (tDCS) could provide treatment alternatives to stimulant medication for attention-deficit/hyperactivity disorder (ADHD), given some evidence for improvements in cognition and clinical symptoms. However, despite a lack of solid evidence for their use, rTMS and tDCS are already offered clinically and commercially in ADHD. This systematic review and meta-analysis aimed to critically appraise rTMS and tDCS studies in ADHD to inform good research and clinical practice. Methods: A systematic search (up to February 2019) identified 18 studies (rTMS 4, tDCS 14; 311 children and adults with ADHD) stimulating mainly the dorsolateral prefrontal cortex (dlPFC). We included 12 anodal tDCS studies (232 children and adults with ADHD) in 3 random-effects meta-analyses of cognitive measures of attention, inhibition and processing speed. Results: The review of rTMS and tDCS showed positive effects in some functions but not others, and little evidence for clinical improvement. The meta-analyses of 1 to 5 sessions of anodal tDCS over mainly the left or bilateral dlPFC showed trend-level improvements in inhibition and processing speed, but not in attention. Limitations: Heterogeneity in stimulation parameters, patient age and outcome measures limited the interpretation of findings. Conclusion: The review and meta-analysis showed limited evidence that 1 to 5 sessions of rTMS and tDCS, mostly of the dlPFC, improved clinical or cognitive measures of ADHD. These findings did not support using rTMS or tDCS of the dlPFC as an alternative neurotherapy for ADHD as yet. Larger, multi-session stimulation studies identifying more optimal sites and stimulation parameters in combination with cognitive training could achieve larger effects.

scholarly journals Systematic Review and Meta-Analysis: Relationships Between Attention-Deficit/Hyperactivity Disorder and Daytime Urinary Symptoms in Children

2020 ◽  
Author(s):  
Behrang Mahjani ◽  
Lotta Renström Koskela ◽  
Christina Gustavsson Mahjani ◽  
Magdalena Janecka ◽  
Anita Batuure ◽  
...  
Keyword(s):  
Systematic Review ◽  
Attention Deficit Hyperactivity Disorder ◽  
Behavioral Problems ◽  
Attention Deficit ◽  
Meta Analysis ◽  
Random Effect ◽  
Treatment Strategies ◽  
Hyperactivity Disorder ◽  
Standardized Measure ◽  
Meta Analyses

Lower urinary tract symptoms (LUTS), e.g., urinary frequency, pressure, urgency, and overactive bladder syndrome, are commonly reported in children with attention-deficit/hyperactivity disorder (ADHD). Understanding the co-occurrence of these conditions has implications regarding clinical approaches, treatments, and improved quality of life. We conducted a systematic review and meta-analysis to examine the relationships between LUTS and ADHD in children. We searched for articles published between January 1990 and July 2019, in PubMed, CENTRAL, and PsycNet. Two authors independently screened all articles and extracted data. We performed random-effect meta-analyses for ADHD with pooled outcomes for LUTS. We identified 117 relevant articles in the literature and 17 articles fulfilled the inclusion criteria for the systematic review, of which, 5 articles had sufficient data for meta-analysis. Examining ADHD among individuals with LUTS, the odds ratio was 2.99 (95% CI: 1.13,7.88, P < 0.001), compared to controls. In multiple studies, the mean overall score for LUTS, using a standardized measure, was significantly higher in patients with ADHD in comparison to controls, and the severity of ADHD was positively associated with the severity of LUTS. Younger age in children was correlated with a higher LUTS score. Different subtypes of urinary incontinence demonstrated differences in behavioral problems and psychiatric comorbidity. Sex differences in LUTS were not consistent across articles. Our results indicate clinically significant associations between ADHD and LUTS in children. Because LUTS and ADHD are common disorders in children, clinicians should be aware of these associations as they inform optimal assessment and treatment strategies.

Sign in / Sign up

Export Citation Format

Share Document