Some executive functions play more critical roles in the ADHD symptoms and deficits, including cognitive flexibility, inhibitory control, and working memory. According to the first model, the decisive factor in ADHD pathophysiology is impaired executive functions, which are associated with hypoactivation of the dorsolateral prefrontal cortex (dlPFC) and hyperactivation of some subcortical regions. Poor inhibitory control resulting from deficient executive resources (i.e., the inhibition-based model) and impulse control deficits that lead to hyperactivity (i.e., the motivational dysfunction model) are influential theories of ADHD pathophysiology. However, based on neuroimaging and neuropsychological findings, distinct brain regions and networks have been identified to account for the hallmark symptoms and subtypes of ADHD. A precise description of the neuropathology underlying ADHD is difficult due to its neuropsychological heterogeneity and the substantial overlap between children with ADHD and typically developing children. It is characterized by the symptoms of inattention, hyperactivity, impulsivity, and various cognitive dysfunctions. Developmental aspects of tDCS in childhood ADHD should be considered as well.Īttention deficit hyperactivity disorder (ADHD) is one of the most commonly-diagnosed neurodevelopmental disorders. intensity, duration, polarity, and electrode size), and types of symptom/deficit are potential determinants of tDCS efficacy in ADHD. Cortical regions involved in ADHD pathophysiology, stimulation parameters (e.g. However, the clinical utility of tDCS in ADHD cannot yet be concluded and requires further systematic investigation in larger sample sizes. Overall, tDCS seems to be a promising method for improving ADHD deficits. In ADHD children, however, the electrical field induced by 1 mA, which is likely larger than the electrical field induced by 1 mA in adults due to the smaller head size of children, was sufficient to result in significant behavioral change. An intensity of 2 mA induced stronger electrical fields than 1 mA in adults with ADHD and was associated with significant behavioral changes. The left and right dorsolateral prefrontal cortex are the regions most often targeted, and anodal tDCS the protocol most often applied. No serious adverse effects are reported in 747 sessions of tDCS. Partial improving effects of tDCS on cognitive deficits (response inhibition, working memory, attention, and cognitive flexibility) or clinical symptoms (e.g., impulsivity and inattention) are reported in 10 studies. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses approach, a literature search identified 14 empirical experiments investigating tDCS effects in ADHD. In this systematic review, we aimed to (1) explore the effectiveness of tDCS on the clinical symptoms and neuropsychological deficits of ADHD patients, (2) evaluate the safety of tDCS application, especially in children with ADHD, (3) model the electrical field intensity in the target regions based on the commonly-applied and effective versus less-effective protocols, and (4) discuss and propose advanced tDCS parameters. It has been increasingly used in neurodevelopmental disorders, especially attention-deficit hyperactivity disorder (ADHD), but its efficacy (based on effect size calculations), safety, and stimulation parameters have not been systematically examined. Transcranial direct current stimulation (tDCS) is a promising method for altering cortical excitability with clinical implications.

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