Editorial: Precision Medicine in Neurotherapeutics for Attention-Deficit/Hyperactivity Disorder

Noninvasive brain stimulation is a novel treatment avenue for attention-deficit/hyperactivity disorder (ADHD). The advantages over pharmacological treatment are relatively minimal and transient side-effects, which make it a treatment preferred by patients and parents. Neurostimulation can furthermore target key neurobiological abnormalities established over decades of neuroimaging research. Trigeminal nerve stimulation (TNS) is the only neuromodulation and device-based nonpharmacological treatment recently licensed for children with ADHD by the US Food and Drug Administration. This was based on a double-blind sham-controlled proof-of-concept trial of 4 weeks of TNS in 62 children, who showed a reduction of ADHD symptoms with an effect size of 0.5, similar to the results with second-line nonstimulant pharmacological treatment.¹ Precision medicine approaches, such as establishing predictors of treatment response using relatively cost-effective cognitive and electrophysiological measures would be clinically very useful to screen children with ADHD for whom TNS is likely to be effective.