Evidence map›Paper›PMID 33009906›Full record

SynthesisJournal of psychiatry & neuroscience : JPN2021

Noninvasive brain stimulation in children and adults with attention-deficit/hyperactivity disorder: a systematic review and meta-analysis.

Samuel J Westwood, Joaquim Radua, Katya Rubia

Open access · diamondAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of psychiatry & neuroscience : JPN, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 57 papers, 14 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
57citing papers in PubMed, 14 pooled it
7.6field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

57 citing papers in PubMed, 14 syntheses or guidelines pooled it, 110 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors at 3 institutions in 4 countries.

Samuel J WestwoodFrom the Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom (Westwood, Rubia); the Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain (Radua); the Mental Health Research Networking Centre (CIBERSAM), Madrid, Spain (Radua); the Department of Clinical Neuroscience, Centre for Psychiatric Research and Education, Karolinska Institutet, Tomtebodavägen 18A, Stockholm, Sweden (Radua); and the Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, United Kingdom (Radua).
Joaquim RaduaFrom the Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom (Westwood, Rubia); the Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain (Radua); the Mental Health Research Networking Centre (CIBERSAM), Madrid, Spain (Radua); the Department of Clinical Neuroscience, Centre for Psychiatric Research and Education, Karolinska Institutet, Tomtebodavägen 18A, Stockholm, Sweden (Radua); and the Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, United Kingdom (Radua).
Katya RubiaFrom the Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom (Westwood, Rubia); the Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain (Radua); the Mental Health Research Networking Centre (CIBERSAM), Madrid, Spain (Radua); the Department of Clinical Neuroscience, Centre for Psychiatric Research and Education, Karolinska Institutet, Tomtebodavägen 18A, Stockholm, Sweden (Radua); and the Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, United Kingdom (Radua).
Consorci Institut D'Investigacions Biomediques August Pi I Sunyer · ESKarolinska Institutet · SEKing's College London · GB

Funding

Medical Research Council MR/P012647/1
6 · The paper itself

Abstract

backgroundRepetitive transcranial magnetic stimulation (rTMS) or transcranial direct current stimulation (tDCS) could provide treatment alternatives to stimulant medication for attention-deficit/hyperactivity disorder (ADHD), given some evidence for improvements in cognition and clinical symptoms. However, despite a lack of solid evidence for their use, rTMS and tDCS are already offered clinically and commercially in ADHD. This systematic review and meta-analysis aimed to critically appraise rTMS and tDCS studies in ADHD to inform good research and clinical practice.

methodsA systematic search (up to February 2019) identified 18 studies (rTMS 4, tDCS 14; 311 children and adults with ADHD) stimulating mainly the dorsolateral prefrontal cortex (dlPFC). We included 12 anodal tDCS studies (232 children and adults with ADHD) in 3 random-effects meta-analyses of cognitive measures of attention, inhibition and processing speed.

resultsThe review of rTMS and tDCS showed positive effects in some functions but not others, and little evidence for clinical improvement. The meta-analyses of 1 to 5 sessions of anodal tDCS over mainly the left or bilateral dlPFC showed trend-level improvements in inhibition and processing speed, but not in attention. LIMITATIONS: Heterogeneity in stimulation parameters, patient age and outcome measures limited the interpretation of findings.

conclusionThe review and meta-analysis showed limited evidence that 1 to 5 sessions of rTMS and tDCS, mostly of the dlPFC, improved clinical or cognitive measures of ADHD. These findings did not support using rTMS or tDCS of the dlPFC as an alternative neurotherapy for ADHD as yet. Larger, multi-session stimulation studies identifying more optimal sites and stimulation parameters in combination with cognitive training could achieve larger effects.

Indexed as

Outcome Assessment, Health CarePrefrontal CortexTranscranial Direct Current StimulationTranscranial Magnetic StimulationAdolescentAdultAttention Deficit Disorder with HyperactivityChildHumansYoung Adult

Identifiers

PMID33009906
PMCPMC7955851
OpenAlexW3091733004

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.