Transcranial Direct Current Stimulation in Child and Adolescent Psychiatric Disorders

Lee, Jonathan C.; Kenney‐Jung, Daniel L.; Blacker, Caren J.; Camsari, Deniz Doruk; Lewis, Charles P.

doi:10.1016/j.chc.2018.07.009

Cited by 19 publications

(16 citation statements)

References 33 publications

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“…Rivera-Urbina et al [17] highlighted evidence for pediatric tDCS in epilepsy, autism, dyslexia, ADHD, and other psychiatric disorders such as depression and schizophrenia. This is further supported by the review from Lee et al [18] which presented evidence for overall interest and efficacy of tDCS in child and adolescent psychiatric disorders. Despite the growing evidence, there is still a degree of uncertainty regarding tDCS use in children.…”

Section: Introductionmentioning

confidence: 61%

“…Of the 12 articles included, there were: 7 randomized controlled trials, 156 children, and 864 active tDCS sessions (0.5-2 mA) totalling 303 h of stimulation in boys and girls typically aged 6 to 17 (mean 10.75) ( Table 2). It is important to remind that these numbers represent only a fraction of all the published pediatric tDCS literature [17][18][19]34], but an important fraction which specifically investigated objective measures of safety and tolerability (an extended version of Table 2, with 19 total articles, is included in the supplementary materials; Table S1). In other words, there were more than 1000 sessions with rigorous safety testing.…”

Section: Safety and Tolerability Literature Characteristicsmentioning

confidence: 99%

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Systematic Review on the Safety and Tolerability of Transcranial Direct Current Stimulation in Children and Adolescents

et al. 2021

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Background: Transcranial direct current stimulation (tDCS) is a safe, tolerable, and acceptable technique in adults. However, there is limited evidence for its safety in youth. Although limited, there are a handful of important empirical articles that have evaluated safety and tolerability outcomes in youth. However, a synthesis of pediatric safety studies is not currently available. Objective: To synthesize objective evidence regarding the safety and tolerability of pediatric tDCS based on the current state of the literature. Methods: Our search and report used PRISMA guidelines. Our method systematically examined investigations purposefully designed to evaluate the safety, tolerability, and acceptability of tDCS in healthy and atypical youth that were submitted to three databases, from the beginning of the database to November 2019. Safety considerations were evaluated by studies utilizing neuroimaging, physiological changes, performance on tasks, and by analyzing reported and objective side effects; tolerability via rate of adverse events; and acceptability via rate of dropouts. Results: We report on 203 sham sessions, 864 active sessions up to 2 mA, and 303 active hours of stimulation in 156 children. A total of 4.4% of the active sessions were in neurotypical controls, with the other 95.6% in clinical subjects. Conclusion: In spite of the fact that the current evidence is sporadic and scarce, the presently reviewed literature provides support for the safety, tolerability, and acceptability, of tDCS in youth for 1–20 sessions of 20 min up to 2 mA. Future pediatric tDCS research is encouraged.

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Section: Introductionmentioning

confidence: 61%

Section: Safety and Tolerability Literature Characteristicsmentioning

confidence: 99%

Systematic Review on the Safety and Tolerability of Transcranial Direct Current Stimulation in Children and Adolescents

et al. 2021

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“…Therefore, these approaches may also be promising in terms of improving clinical and cognitive ADHD symptoms such as inattention and impulsiveness. 258 260 261 262 Based on a meta-analysis, Westwood et al 263 suggested that left and/or right prefrontal stimulation may improve performance in attention, inhibition and/or working memory tasks. However, these approaches are not yet recommended by therapy guidelines.…”

Section: Treatmentmentioning

confidence: 99%

ADHD: Current Concepts and Treatments in Children and Adolescents

et al. 2020

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Attention deficit hyperactivity disorder (ADHD) is among the most frequent disorders within child and adolescent psychiatry, with a prevalence of over 5%. Nosological systems, such as the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) and the International Classification of Diseases, editions 10 and 11 (ICD-10/11) continue to define ADHD according to behavioral criteria, based on observation and on informant reports. Despite an overwhelming body of research on ADHD over the last 10 to 20 years, valid neurobiological markers or other objective criteria that may lead to unequivocal diagnostic classification are still lacking. On the contrary, the concept of ADHD seems to have become broader and more heterogeneous. Thus, the diagnosis and treatment of ADHD are still challenging for clinicians, necessitating increased reliance on their expertise and experience. The first part of this review presents an overview of the current definitions of the disorder (DSM-5, ICD-10/11). Furthermore, it discusses more controversial aspects of the construct of ADHD, including the dimensional versus categorical approach, alternative ADHD constructs, and aspects pertaining to epidemiology and prevalence. The second part focuses on comorbidities, on the difficulty of distinguishing between “primary” and “secondary” ADHD for purposes of differential diagnosis, and on clinical diagnostic procedures. In the third and most prominent part, an overview of current neurobiological concepts of ADHD is given, including neuropsychological and neurophysiological researches and summaries of current neuroimaging and genetic studies. Finally, treatment options are reviewed, including a discussion of multimodal, pharmacological, and nonpharmacological interventions and their evidence base.

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“…Hence, the same tDCS parameters could have a larger impact in children and adolescents (46). This could lead to unexpected or even dangerous results if it misdirects plasticity or increases the likelihood of brain tissue lesions due to a thinner skull, resulting in higher peak current density in the child’s brain (47, 48).…”

Section: Safetymentioning

confidence: 99%

Unmet Needs in Children With Attention Deficit Hyperactivity Disorder—Can Transcranial Direct Current Stimulation Fill the Gap? Promises and Ethical Challenges

et al. 2019

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Attention deficit hyperactivity disorder (ADHD) is a disorder most frequently diagnosed in children and adolescents. Although ADHD can be effectively treated with psychostimulants, a significant proportion of patients discontinue treatment because of adverse events or insufficient improvement of symptoms. In addition, cognitive abilities that are frequently impaired in ADHD are not directly targeted by medication. Therefore, additional treatment options, especially to improve cognitive abilities, are needed. Because of its relatively easy application, well-established safety, and low cost, transcranial direct current stimulation (tDCS) is a promising additional treatment option. Further research is needed to establish efficacy and to integrate this treatment into the clinical routine. In particular, limited evidence regarding the use of tDCS in children, lack of clear translational guidelines, and general challenges in conducting research with vulnerable populations pose a number of practical and ethical challenges to tDCS intervention studies. In this paper, we identify and discuss ethical issues related to research on tDCS and its potential therapeutic use for ADHD in children and adolescents. Relevant ethical issues in the tDCS research for pediatric ADHD center on safety, risk/benefit ratio, information and consent, labeling problems, and nonmedical use. Following an analysis of these issues, we developed a list of recommendations that can guide clinicians and researchers in conducting ethically sound research on tDCS in pediatric ADHD.

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Transcranial Direct Current Stimulation in Child and Adolescent Psychiatric Disorders

Cited by 19 publications

References 33 publications

Systematic Review on the Safety and Tolerability of Transcranial Direct Current Stimulation in Children and Adolescents

Systematic Review on the Safety and Tolerability of Transcranial Direct Current Stimulation in Children and Adolescents

ADHD: Current Concepts and Treatments in Children and Adolescents

Unmet Needs in Children With Attention Deficit Hyperactivity Disorder—Can Transcranial Direct Current Stimulation Fill the Gap? Promises and Ethical Challenges

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