TMS治療のうつ病以外の疾患への有効性と安全性についての論文がいくつかでてきています。

今回はADHDに対する有効性と安全性についての論文の紹介です。


「Noninvasive cerebral stimulation for treatment of ADHD: A review of the literature」

Brandejsky L, Micoulaud Franchi JA, Lopez R, Bioulac S, Da Fonseca D, Daudet C, Boyer L, Richieri R, Lançon C.
Encephale. 2016 Oct 10. pii: S0013-7006(16)30201-9. doi: 10.1016/j.encep.2016.08.011.
OBJECTIVES:

The aim of this review is to summarize the available data in the literature about the therapeutic applications of transcranial magnetic stimulation and transcranial direct current stimulation in attention-deficit hyperactivity disorder (ADHD).
METHOD:

The scientific literature search of international articles was performed in February 2016 using the PubMed electronic database. The following MeSH terms were employed: "attention-deficit disorder with hyperactivity" AND "transcranial magnetic stimulation", "attention-deficit disorder with hyperactivity" AND "transcranial direct current stimulation".
RESULTS:

Five studies were retained by the literature search and were included in the review about rTMS and ADHD. Except for one study, they all showed significant positive effects of rTMS on ADHD. Four studies were retained by the literature search and were included in the review about tDCS and ADHD. Three of them showed significant positive effects of tDCS on ADHD. Two of them used tDCS during sleep at a frequency<1Hz. Only low-level evidences are available to support treatment with rTMS or tDCS in patients with ADHD. Indeed, randomized controlled trials are rare in this field of research.
CONCLUSION:

Additional studies are needed to confirm the efficacy of rTMS and tDCS in ADHD. rTMS could be used as an alternative therapy when methylphenidate is not well tolerated or shows an insufficient efficacy. Nevertheless, the optimal target, frequency and duration remain to be determined. tDCS can modulate attention in healthy subjects but data are insufficient in ADHD to conclude. It could be interesting to study its use in association with cognitive remediation to enhance its cognitive efficacy.


これはレビューですので、元文献はまださらっとしか見ていませんが、ADHDに対しての有効性について報告されています。まだTMS治療のやり方はそれぞれ同一ではありませんが、治療選択肢としての可能性はあると思います。薬物療法に対して部分効果しかでない、もしくは効果はでたが副作用が強い、まったく効果がない、という方にとっては意味のあるテーマです。

記事作成：加藤　晃司（医療法人永朋会）