Shen Fang, Zhou Hui
Department of Pediatrics, West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education (MOE), Chengdu, China.
Front Psychiatry. 2024 Dec 4;15:1483753. doi: 10.3389/fpsyt.2024.1483753. eCollection 2024.
A growing body of research evidence suggests that many patients with attention deficit hyperactivity disorder (ADHD) have difficulties with emotion regulation. Non-invasive brain stimulation (NIBS), which mainly includes transcranial electrical stimulation (tES) and repetitive transcranial magnetic stimulation (rTMS), has been considered a potential new direction in the treatment of emotion dysregulation in ADHD patients. The key components of tES are transcranial direct current stimulation (tDCS) and transcranial alternating current stimulation (tACS). However, there is no systematic evaluation exploring the effects of non-invasive brain stimulation on emotion regulation in ADHD patients. Therefore, this systematic review aimed to summarize the effects of NIBS on emotion regulation in ADHD patients.
This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched PubMed, Embase, Web of Science, and the Cochrane Library electronic databases up to 1 July 2024. We also hand-searched the reference lists of retrieved articles and reviews. Assessing risk of bias using the Cochrane Assessment Tool.
Through database search, we obtained a total of 1134 studies, of which 5 met the inclusion criteria. Statistically significant improvements in emotion regulation in children with ADHD were observed in 1 study after treatment with tDCS. In the remaining 4 studies (2 with tDCS and 2 with rTMS), there were no statistically significant changes in emotion regulation in ADHD patients after treatment with either tDCS or rTMS.
The data from our preliminary study do not allow us to draw definitive conclusions that non-invasive brain stimulation improves emotion regulation in ADHD patients. This is because there is a paucity of literature on the effects of tES or rTMS on emotion regulation in ADHD patients and a limited number of randomized controlled trials. More high-quality multicenter randomized controlled trials exploring the efficacy of non-invasive brain stimulation on emotion regulation in ADHD patients are needed in the future to provide strong evidence for definitive conclusions before it can be considered as a potential treatment option.
https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42024569041.
越来越多的研究证据表明，许多注意力缺陷多动障碍（ADHD）患者在情绪调节方面存在困难。非侵入性脑刺激（NIBS），主要包括经颅电刺激（tES）和重复经颅磁刺激（rTMS），已被视为治疗ADHD患者情绪调节障碍的一个潜在新方向。tES的关键组成部分是经颅直流电刺激（tDCS）和经颅交流电刺激（tACS）。然而，目前尚无系统评价探讨非侵入性脑刺激对ADHD患者情绪调节的影响。因此，本系统评价旨在总结NIBS对ADHD患者情绪调节的影响。
本系统评价按照系统评价与Meta分析的首选报告项目（PRISMA）指南进行。我们检索了截至2024年7月1日的PubMed、Embase、Web of Science和Cochrane图书馆电子数据库。我们还手工检索了检索到的文章和综述的参考文献列表。使用Cochrane评估工具评估偏倚风险。
通过数据库检索，我们共获得1134项研究，其中5项符合纳入标准。1项研究观察到，ADHD儿童经tDCS治疗后情绪调节有统计学意义的改善。在其余4项研究（2项tDCS研究和2项rTMS研究）中，tDCS或rTMS治疗后ADHD患者的情绪调节无统计学意义的变化。
我们初步研究的数据不允许我们得出非侵入性脑刺激能改善ADHD患者情绪调节的明确结论。这是因为关于tES或rTMS对ADHD患者情绪调节影响的文献较少，且随机对照试验数量有限。未来需要更多高质量的多中心随机对照试验来探索非侵入性脑刺激对ADHD患者情绪调节的疗效，以便在将其视为潜在治疗选择之前提供有力证据得出明确结论。
