Does your child have ADHD? Let's learn about a new treatment without medication? (Trigeminal Nerve Stimulation - TNS)

Does your child have trouble staying focused? Is he constantly fidgeting and fidgeting? These could be signs of a condition we call ADHD ( Attention-Deficit/Hyperactivity Disorder ). As a parent of a child like this, one thing you often think about is, "Isn't there a solution to this besides medication?" So today we're going to talk about a new treatment that can help control ADHD symptoms without the use of medication.

What is trigeminal nerve stimulation (TNS)?

Simply put, this is a treatment that improves the functioning of our brain a little. There is a nerve system in our head that is directly connected to the brain. We call this the trigeminal nerve. Scientists believe that by stimulating this nerve, we can increase the function of the parts of the brain that control attention, behavior, and emotions.

This treatment uses a small, battery-operated device called External Trigeminal Nerve Stimulation, or eTNS for short. Similar treatments are also used for other conditions, such as depression and anxiety.

Importantly, in 2019, the US Food and Drug Administration (FDA) approved this treatment for children between the ages of 7 and 12 who are not taking other medications for ADHD. It is also the first non-drug treatment approved for ADHD. However, you cannot buy this device at a pharmacy. To get it, you definitely need a prescription from a doctor. It is usually recommended for children with mild to moderate ADHD symptoms .

How is this treatment done?

This is actually very simple. It's up to the parents or someone who is taking care of the child to do this.

1. Before the child goes to bed at night , a small patch should be placed on the child's forehead, just above the eyebrows. This patch has small electrodes on it.

2. This patch is connected to the eTNS device we mentioned earlier with a wire. This device is about the size of a cell phone.

3. When the device is activated, very low-level electrical pulses pass through the patch placed on the forehead and stimulate the trigeminal nerve.

4. At this time, the baby may feel a slight tingling sensation under the skin. This is normal.

5. This treatment works for the entire 8 hours the child is sleeping .

Typically, after 4 weeks of continued treatment in this way, the doctor will check the child again to see how successful this has been and whether there has been a change in the child's symptoms.

Is this really effective? What evidence is there?

In a study conducted on this topic, 62 children between the ages of 8 and 12 were used. They were divided into two groups.

• The first group: was given the eTNS device that actually worked.
• The second group: They were also given a dummy device that looked the same but did not stimulate anything ( a placebo ). This is called a 'placebo'. This is done to accurately measure the true effect of the treatment.

Over the course of four weeks, parents and researchers monitored the behavior and ADHD symptoms of these children. The results were very interesting.

But there's something important to understand here. It doesn't have immediate results like some stimulant medications for ADHD. Those medications can sometimes start to make a difference in your child within a few hours. It can take up to 4 weeks to see results with eTNS treatment. Also, the improvements may not be as dramatic as those medications. Researchers say the results are similar to those of non-stimulant ADHD medications.

Additionally, brain scans of the children before and after the study showed that the children who received eTNS treatment had increased activity in areas of the brain that are affected by ADHD.

Things to look for further

Although these results are promising, there is still much to be discovered about this treatment. In particular,

• How long does the effect of this treatment last?
• How does this compare to other medications and psychotherapy?
• Is this useful for children under 8 and over 12 years old?
• Does this really improve schoolwork, social relationships, and behavior?
• What are the long-term effects of this?

More extensive research is needed to find answers to these questions.

Can this cause side effects?

Yes, as with any treatment, there are some minor side effects reported. However, these are not as serious as the side effects of some medications for ADHD. You can compare these in the table below.

Is this treatment suitable for my child?

This is the most important question. ADHD treatments don't work the same for every child. Medication works well for some children, and behavioral therapy works better for others. So it's important to find the treatment that works best for your child.

eTNS therapy may be a good option in cases like these:

• If your child is not getting good results from ADHD medication.
• If those medications cause severe side effects .
• If you, as a parent , do not want to give your child medicine.

But this doesn't suit everyone.

Another thing is that this device has only been tested as a single treatment so far. So, if your child is taking medication for other conditions, we don't know how safe it is to use this treatment with those medications. Also, there is no data yet on the effects of using this treatment with medications used for ADHD.

Finally, since this is a new technology, your health insurance may not cover the cost. The cost of this device is around $1,000 (nearly 300,000 Sri Lankan rupees).

ADHD, TNS, eTNS, Trigeminal Nerve Stimulation, ADHD in children, non-drug treatments, nerve stimulation, mental health