McGough James J, Loo Sandra K, Sturm Alexandra, Cowen Jennifer, Leuchter Andrew F, Cook Ian A
Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, USA.
Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, USA.
Brain Stimul. 2015 Mar-Apr;8(2):299-304. doi: 10.1016/j.brs.2014.11.013. Epub 2014 Nov 28.
This study examined the potential feasibility and utility of trigeminal nerve stimulation (TNS) for attention-deficit/hyperactivity disorder (ADHD) in youth.
Twenty-four participants ages 7-14 with ADHD enrolled in an 8-week open trial of TNS administered nightly during sleep, and were assessed weekly with parent- and physician-completed measures of ADHD symptoms and executive functioning as well as measures of treatment compliance, adverse events, and side effects. Computerized tests of cognitive functioning were administered at baseline and weeks 4 and 8.
Significant improvements were seen on the ADHD-IV Rating Scale (P < .0001) and parent-completed Conners Global Index (P < .0001), as well as the majority of scales on the parent-completed Behavior Rating Inventory of Executive Functioning (BRIEF). Improvements were also noted on the computerized Attention Network Task (ANT) Incongruent Reaction Time (P = .006), suggesting that TNS has positive effects on response inhibition.
TNS therapy for youth with ADHD appears to be both feasible and without significant risk. Subjective improvements on rating scales and laboratory measures of cognition suggest a potential role for TNS in treating ADHD that merits further investigation. Future research in anticipation of designing definitive controlled efficacy trials should evaluate time to onset of TNS response and durability of treatment effects following TNS discontinuation, as well as validate an effective active sham comparator suitable for blinded studies.
本研究探讨了三叉神经刺激(TNS)治疗青少年注意力缺陷多动障碍(ADHD)的潜在可行性和效用。
24名7至14岁的ADHD患者参加了一项为期8周的开放试验,在睡眠期间每晚进行TNS治疗,并每周使用家长和医生完成的ADHD症状及执行功能测量量表,以及治疗依从性、不良事件和副作用测量量表进行评估。在基线以及第4周和第8周进行认知功能的计算机化测试。
在ADHD-IV评定量表(P <.0001)、家长完成的康纳斯综合指数(P <.0001)以及家长完成的执行功能行为评定量表(BRIEF)的大多数分量表上均有显著改善。在计算机化注意力网络任务(ANT)的不一致反应时间方面也有改善(P =.006),表明TNS对反应抑制有积极作用。
TNS治疗青少年ADHD似乎既可行又无显著风险。评定量表和认知实验室测量的主观改善表明TNS在治疗ADHD方面具有潜在作用,值得进一步研究。在预期设计确定性对照疗效试验的未来研究中,应评估TNS反应的起效时间以及TNS停药后治疗效果的持久性,并验证适用于盲法研究的有效活性安慰剂对照。