Zhi Jincao, Zhang Shiwen, Huang Meiling, Qin Huan, Xu He, Chang Qing, Wang Yan
Graduate School of Heilongjiang University of Chinese Medicine, Harbin, China.
Clinical Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Traditional Chinese Medicine, Guangzhou, China.
Front Neurosci. 2024 Dec 4;18:1494272. doi: 10.3389/fnins.2024.1494272. eCollection 2024.
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by developmental impairments, inattention, motor hyperactivity, and impulsivity. Currently, there is no effective intervention that can completely cure it. One of the pathogenic mechanisms of ADHD involves abnormalities in the norepinephrine (NE) pathway within the prefrontal cortex (PFC). In recent years, transcutaneous auricular vagus nerve stimulation (taVNS), a non-invasive neuromodulation technique, has demonstrated promising potential in the treatment of neurological and psychiatric disorders. However, its application in the management of ADHD remains relatively unexplored. Previous studies have shown that taVNS exerts therapeutic effects on attention, cognition, arousal, perception, and behavioral regulation primarily through activating the vagus nerve conduction pathway, specifically targeting the nucleus tractus solitarius - locus coeruleus - NE pathway. These findings have led to the hypothesis that taVNS may be an effective intervention for ADHD, with NE and its pathway playing a pivotal role in this context. Therefore, this review comprehensively examines the correlation between NE pathway alterations in the PFC and ADHD, the mechanism of action of taVNS, and the potential role of the NE pathway in treating ADHD with taVNS, aiming to provide a theoretical foundation for clinical applications.
注意缺陷多动障碍(ADHD)是一种神经发育障碍,其特征为发育受损、注意力不集中、多动及冲动。目前,尚无能够完全治愈该病的有效干预措施。ADHD的致病机制之一涉及前额叶皮质(PFC)内去甲肾上腺素(NE)通路的异常。近年来,经皮耳迷走神经刺激(taVNS)作为一种非侵入性神经调节技术,已在神经和精神疾病的治疗中显示出有前景的潜力。然而,其在ADHD管理中的应用仍相对未被充分探索。先前的研究表明,taVNS主要通过激活迷走神经传导通路,特别是靶向孤束核 - 蓝斑 - NE通路,对注意力、认知、觉醒、感知和行为调节发挥治疗作用。这些发现引发了这样的假说,即taVNS可能是ADHD的一种有效干预措施,在此背景下NE及其通路起着关键作用。因此,本综述全面探讨了PFC中NE通路改变与ADHD之间的相关性、taVNS的作用机制以及NE通路在taVNS治疗ADHD中的潜在作用,旨在为临床应用提供理论基础。
JAMA. 2024-3-12
Hum Brain Mapp. 2024-2-15