Behavioral outcomes after tDCS treatment during immediate post-intervention and follow-up periods in children and adolescents diagnosed with attention-deficit/hyperactivity disorder: a systematic review and meta-analysis on randomized sham-controlled trials
- Forfatter(e)
- Tung, C. B., Liang, S. C., Sun, C. K., Cheng, Y. S., Hung, K. C.
- År
- 2025
- Tidsskrift
- Journal of Psychiatric Research
- Volum
- 191
- Sider
- 8-14
- Kategori(er)
- ADHDAtferdsproblemer, antisosial atferd og atferdsforstyrrelser
- Tiltakstype(r)
- Abstract
This meta-analysis aimed at elucidating the effectiveness of transcranial direct current stimulation (tDCS) in improving behavioral symptoms of attention deficit/hyperactivity disorder (ADHD) in children/adolescents during the immediate post-intervention/follow-up periods and identifying potential confounders. Randomized placebo-controlled trials (RCTs) were retrieved from major databases using the main keywords "tDCS" and "ADHD". The outcomes of interest were quantified using effect size expressed as standardized mean difference (SMD) for continuous variables with 95 % confidence interval (CI). Meta-analysis of five RCTs (158 participants, mean age = 13) revealed greater improvement in impulsivity symptoms during follow-ups (SMD = -0.48, 95 % CI: -0.88 to -0.09, p = 0.02) but not immediately after treatment (p = 0.61) in the tDCS group than in sham-controls without significant improvements in the total and behavioral symptoms of inattention/hyperactivity both immediately post-treatment (p = 0.61, p = 0.81, and p = 0.81, respectively) and during follow-ups (p = 0.28, p = 0.24, and p = 0.14, respectively). Subgroup comparison between trials locating the anode over the left prefrontal cortex (PFC) and those on the right PFC showed therapeutic effect of the former on impulsivity symptoms during follow-ups (SMD = -0.76 vs. -0.06, p = 0.04). In summary, our results did not support effectiveness of tDCS in alleviating symptoms of inattention and hyperactivity/impulsivity immediately after treatment and during follow-ups. Our study only showed tDCS-associated impulsivity improvement in children/adolescents with ADHD during follow-ups and anode placement on the left PFC. Nevertheless, the relatively short treatment periods may obscure the therapeutic benefit immediately after tDCS. Despite implications for designing optimal treatment protocols, our findings based on a limited number of available trials warrant further verification from large-scale clinical investigations.