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解决经颅电刺激治疗注意缺陷多动障碍疗效异质性问题。

Resolving heterogeneity in transcranial electrical stimulation efficacy for attention deficit hyperactivity disorder.

机构信息

Department of Psychiatry, Charité Universitätsmedizin, Campus Benjamin Franklin, Hindenburgdamm 30, Berlin 12203, Germany.

Department of Experimental Psychology, University of Oxford, Radcliffe Observatory, Anna Watts Building, Woodstock Rd, Oxford OX2 6GG, United Kingdom.

出版信息

Exp Neurol. 2021 Mar;337:113586. doi: 10.1016/j.expneurol.2020.113586. Epub 2020 Dec 28.

Abstract

While the treatment of Attention Deficit Hyperactivity Disorder (ADHD) is dominated by pharmacological agents, transcranial electrical stimulation (tES) is gaining attention as an alternative method for treatment. Most current meta-analyses have suggested that tES can improve cognitive functions that are otherwise impaired in ADHD, such as inhibition and working memory, as well as alleviated clinical symptoms. Here we review some of the promising findings in the field of tES. At the same time, we highlight two factors, which hinder the effective application of tES in treating ADHD: 1) the heterogeneity of tES protocols used in different studies; 2) patient profiles influencing responses to tES. We highlight potential solutions for overcoming such limitations, including the use of active machine learning, and provide simulated data to demonstrate how these solutions could also improve the understanding, diagnosis, and treatment of ADHD.

摘要

虽然注意力缺陷多动障碍(ADHD)的治疗主要以药物为主,但经颅电刺激(tES)作为一种替代治疗方法正受到关注。大多数当前的荟萃分析表明,tES 可以改善 ADHD 患者受损的认知功能,如抑制和工作记忆,以及减轻临床症状。在这里,我们回顾了 tES 领域的一些有希望的发现。同时,我们强调了两个因素,这些因素阻碍了 tES 在治疗 ADHD 中的有效应用:1)不同研究中使用的 tES 方案的异质性;2)影响 tES 反应的患者特征。我们强调了克服这些限制的潜在解决方案,包括使用主动机器学习,并提供模拟数据来说明这些解决方案如何也可以改善 ADHD 的理解、诊断和治疗。

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