Transcutaneous electrical stimulation of the trigeminal nerve for ADHD

2.1 Attention deficit hyperactivity disorder (ADHD) is a heterogeneous disorder characterised by the core symptoms of hyperactivity, impulsivity and inattention, which are judged excessive for the person's age or level of overall development. Symptoms are usually evident in childhood and may persist into adulthood.

2.2 Treatment for ADHD may be non-pharmacological, pharmacological or a combination of both. Non-pharmacological treatment includes cognitive behavioural therapy and parent‑training programmes (for parents of children and young people with ADHD). Pharmacological treatment includes central nervous system stimulants such as methylphenidate and amphetamines, and non-stimulants such as atomoxetine.

2.3 In this procedure, an external trigeminal nerve stimulation device is worn on the clothes and attached by wires to a single-use adhesive patch which is worn overnight. The patch contains 2 electrodes placed over the left and right V1 branches of the trigeminal nerve on the forehead. The stimulator bilaterally stimulates the trigeminal nerve for approximately 8 hours. For children, parents or carers attach the device. In a typical treatment course, stimulation is given nightly for approximately 4 weeks. Treatment duration may vary; a clinical response may take longer, and continued therapy may be needed.

2.4 The mechanism of action is not completely understood. The trigeminal nerve connects to regions of the brain that may be associated with selective maintenance of attention and arousal, and it is thought that its stimulation improves the symptoms of ADHD.