EFICÁCIA DA ESTIMULAÇÃO TRANSCRANIANA POR CORRENTE CONTÍNUA EM PACIENTES ADULTOS COM TRANSTORNO DE DÉFICIT DE ATENÇÃO/HIPERATIVIDADE: UMA REVISÃO SISTEMÁTICA

Introduction: Attention-Deficit/Hyperactivity Disorder is one of the mainneurodevelopmental disorders, being increasingly studied and diagnosed. To optimizetreatment, new therapies are emerging, such as Transcranial Direct Current Stimulation, anon-invasive, non-pharmacological intervention that has demonstrated significant clinicalbenefits in reducing symptoms of inattention and hyperactivity/impulsivity in thesepatients. However, its use in adults with ADHD remains underexplored in the literature.Therefore, it is necessary to review the available evidence on the efficacy of tDCS in adultswith ADHD. Methods: A systematic literature review was conducted evaluating the efficacyof tDCS in adult patients with ADHD. PubMed, the Cochrane Central Register of ControlledTrials, and Embase were the platforms used for the systematic search for articlespublished between August 1st and 31st, 2024, using specific descriptors and Booleanoperators. The PICOS strategy guided data collection and analysis, considering thepopulation of adults with ADHD, the Transcranial Direct Current Stimulation intervention,sham control, the outcomes of inattention and hyperactivity/impulsivity, and the studydesign (randomized, double-blind, sham-controlled clinical trials). Study selection wasperformed according to pre-established exclusion and inclusion criteria, and extraction waspresented in tables, given the heterogeneous format of the studies, and was performed byonly one researcher. The risk of bias was assessed using the RoB-2 tool, considering fivemain assessment domains. The primary objective is to evaluate the efficacy of tDCS on thesymptoms of inattention and hyperactivity/impulsivity. Secondary objectives are toevaluate the most effective electrode position on the scalp, assess the number of sessionsthat would be most effective for symptom control, analyze the influence of concomitantuse of neurostimulants, and report the main adverse effects. Results: Five randomizedclinical trials were included in this study, totaling 200 patients. Some evidencedemonstrated the benefits of this intervention both during treatment development and atthe end of treatment, primarily related to improvements in hyperactivity/impulsivity.However, other studies disagree with these findings, not observing significant effects withtDCS. Response to treatment varied according to the number of sessions, electrodelocation, and concomitant use of neurostimulants. Adverse effects, generally mild andtransient, were mainly tingling, itching, headache, and burning. Conclusion: Among adultswith ADHD, it is suggested that tDCS may be associated with a possible reduction insymptoms of inattention and hyperactivity/impulsivity. However, its use remainscontroversial in the literature due to the scarcity of studies that robustly validate itsefficacy.