The study discusses advances in understanding the mechanism of ADHD and available therapeutic treatments, including pharmacotherapy, cognitive behavioral therapy (CBT), and brain-computer interfaces (BCI). Although pharmacotherapy is the most widely used approach due to its immediate efficacy, it presents challenges such as side effects and resistance to central agonists in certain patients. The research explores the benefits and limitations of each therapeutic approach, emphasizing the need for advances to overcome existing limitations.
ADHD Mechanism:
ADHD is attributed to neuroanatomical, neurophysiological and neurobiochemical abnormalities. Alterations in the frontal lobe and in the connections between the frontal cortex, striatum and cerebellum stand out in the pathophysiology. At the neurophysiological level, disturbances in neurotransmitters such as dopamine, norepinephrine and serotonin contribute to the symptoms, with D1/D5 and α2A receptors being fundamental in the functioning of the prefrontal cortex.
Pharmacotherapy:
Pharmacotherapy is the main intervention, with methylphenidate (MPH) being the most commonly used stimulant. It works by blocking dopamine and norepinephrine transporters, increasing their synaptic concentration. However, approximately 30%–50% of adults with ADHD are resistant to treatment. Nonstimulant alternatives, such as selective norepinephrine reuptake inhibitors (SNRIs) and alpha-2 agonists (e.g., guanfacine), offer options for patients intolerant to stimulants, although they have reduced efficacy and milder adverse effects.
Cognitive Behavioral Therapy (CBT):
CBT is a behavioral approach that aims to modify dysfunctional thoughts and behaviors. Studies show significant efficacy in reducing symptoms, but the time required for therapy and the need for qualified professionals are barriers to its widespread implementation.
Brain-Computer Interface (BCI):
BCI is emerging as a promising technology, using electroencephalographic signals to quantify and train attention in patients with ADHD. BCI-based games have shown lasting improvements in attention levels, but high costs and the need for robust validation limit their current applicability.
Conclusion:
Despite advances, each approach has inherent limitations. Future research should focus on improving treatments, including optimizing pharmacological composition, personalizing CBT programs, and developing accessible BCI technologies. Full elucidation of the mechanism of ADHD is essential for more effective therapies.
Reference :
Jiang, P. (2024). Advanced progress in Pharmacotherapy Research for ADHD. Proceedings of the 4th International Conference on Biological Engineering and Medical Science, 85-90. DOI: 10.54254/2753-8818/66/2024.18040.
