Trigeminal Nerve Stimulation for Attention-Deficit/Hyperactivity Disorder: Cognitive and Electroencephalographic Predictors of Treatment Response.
Trigeminal Nerve Stimulation for Attention-Deficit/Hyperactivity Disorder: Cognitive and Electroencephalographic Predictors of Treatment Response.
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三叉神经刺激治疗注意缺陷多动障碍：治疗反应的认知和脑电图预测因素。
DOI：
10.1016/j.jaac.2020.09.021
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发表时间：
2021-07
影响因子：
13.3
通讯作者：
McGough, James J.
中科院分区：
文献类型：
--
作者：
Loo, Sandra K.;Salgari, Giulia C.;Ellis, Alissa;Cowen, Jennifer;Dillon, Andrea;McGough, James J.
The current study applies a precision medicine approach to Trigeminal Nerve Simulation (TNS), an FDA approved, neuromodulation treatment for attention-deficit/hyperactivity disorder (ADHD) by testing secondary outcomes of cognitive and electrophysiological (EEG) predictors of treatment response among subjects from the original randomized controlled trial. Children aged 8–12 years with ADHD, were randomized to four weeks of active or sham TNS treatment; after which, the sham group crossed over into four weeks of open-label treatment. TNS treatment responders (RESP) had an ADHD Rating Scale (ADHD-RS) Total score reduction of ≥25%, while non-responders (NR) had <25% reduction post-treatment. Assessments included weekly behavioral ratings and pre-/post-treatment cognitive and EEG measures. The final sample was 25 RESP and 26 NR (34 male children, mean age 10.3 (1.4) years). Baseline measures that significantly differentiated RESP from NR include: lower working memory, lower spelling and math achievement, deficits on behavioral ratings of executive function (BRIEF), and lower resting state EEG power in the right frontal (F4) region (all p’s <.05). Compared to NRs, responders showed significantly increased right frontal EEG power with TNS treatment, which was predictive of improved executive functions and ADHD symptomatology (β=.65, p<.001). When EEG and behavior were modeled together, the area under the curve (AUC) for BRIEF Working Memory scale was .83 (p=.003), indicating moderate prediction of treatment response. Children with ADHD who have executive dysfunction are more likely to be TNS responders and show modulation of right frontal brain activity, improved/normalized executive functions, and ADHD symptom reduction.
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