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Can Trigeminal Nerve Stimulation (TNS) Help Kids With ADHD?

Medically Reviewed by Dan Brennan, MD on June 24, 2022

Your trigeminal nerve is a set of nerves in your head that connect directly to your brain. Research has shown that using an appliance that stimulates this nerve, called an external trigeminal nerve stimulation (eTNS) device, could improve ADHD symptoms in children.

While the eTNS device doesn’t work as well as stimulant medication, it offers a non-drug option for treating school-aged kids with ADHD.

What Is Trigeminal Nerve Stimulation?

The pulse from the battery-powered eTNS device stimulates nerves in the brain stem. In turn, scientists believe, this increases activity in parts of the brain that play a role in attention, behavior, and emotions.

Similar treatments are used to treat other conditions, including depression and anxiety.

In 2019, the FDA approved the eTNS device for children ages 7-12 who have ADHD but are not taking ADHD medication. (It’s the first non-drug treatment for ADHD to be approved by the FDA.)

You need a doctor’s prescription to get the device. It’s recommended for children with mild to moderate ADHD symptoms.

How Does eTNS Work?

Parents or caregivers place a patch with electrodes on the child’s forehead, just above the eyebrows, at night. The patch is connected via a wire to a cell-phone sized device that delivers the stimulation.

The treatment uses magnetic waves to send very low-level pulses of electricity into the trigeminal nerve. The child may feel a slight tingling on their skin.

The brain stimulation treatment continues for 8 hours while the child sleeps. After your child uses the device for 4 weeks, a doctor should see them to assess how well it’s working.

How Well Does eTNS Work?

During a four-week study of 62 children ages 8 to 12, researchers and parents monitored and rated the children’s symptoms. The study included two groups – one that used the TNS device and another that used a placebo (dummy) device.

Every week, the researchers tracked the children using a parent questionnaire about behavior and a clinical scale that measures ADHD symptoms.

Many symptoms improved for the children using the eTNS. Their scores on the symptom scale dropped by an average of 31%, compared to 18% for kids who used the dummy device.

But it took longer to see results with this device than with ADHD stimulant medication – up to 4 weeks. These medications can sometimes produce signs of improvement within hours. The improvements also were not as drastic as they often are with stimulants. Researchers said the benefits were similar to those of nonstimulant ADHD medications.

The children also had brain scans both before and after the study. Those who got eTNS showed increased activity in areas of the brain affected by ADHD.

While these results seem promising, experts say we need more, larger studies to see:

  • How long the effects of eTNS treatment might last
  • How it compares with medications and psychotherapy
  • If it might benefit those under age 8 or over 12
  • Whether it leads to improvements in school, social life, and behavior
  • What the long-term effects of eTNS are

What Are the Possible Side Effects?

Some children involved in studies of eTNS reported minor side effects, including:

  • Drowsiness
  • Headache
  • Fatigue
  • Trouble sleeping
  • Teeth clenching
  • Increased appetite

Some also gained weight and had a faster pulse.

These side effects are no more serious than those some kids have when taking ADHD medication. Side effects of stimulant ADHD drugs can include:

  • Loss of appetite
  • Trouble sleeping
  • Irritability
  • Weight loss

Among the side effects of nonstimulant ADHD medications are:

  • Stomach problems including nausea
  • Headache
  • Drowsiness
  • Insomnia

Is eTNS Right for My Child?

ADHD treatments – including medications, behavioral therapy, and complementary regimens like biofeedback – work differently for each child. None is 100% effective. It’s important to find the right treatment or combination of treatments for your child.

If ADHD drugs don’t work well for your child or have too many side effects, eTNS might be a good choice. They’re also an alternative if you don’t want your child to use ADHD medications.

eTNS is not right for everyone, though. Children with pacemakers, insulin pumps, and other medical devices shouldn’t use one of these devices. Never use it near a cell phone since the phone’s signals may interfere with the treatment.

Because the device was only tested as a single treatment, we don’t know if it’s safe to use along with treatments for other medical conditions your child may have. And we don’t know whether it could work along with ADHD medications.

As with many new medical devices, your health insurance may not cover the eTMS device. It costs about $1,000.

Show Sources

SOURCES:

Journal of the American Academy of Child and Adolescent Psychiatry: “Double-Blind, Sham-Controlled, Pilot Study of Trigeminal Nerve Stimulation for Attention-Deficit/Hyperactivity Disorder.”

American Psychological Association: “A new device for treating ADHD in children.”

CHADD: “New Device May Decrease Symptoms.”

Cleveland Clinic: “Could a New Device Be the Right ADHD Treatment for your Child?”

FDA: “FDA permits marketing of first medical device for treatment of ADHD.”

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