FDA Approves First Non-Pharmaceutical Treatment For AD/HD: External Trigeminal Nerve Stimulation (Etns)


By: John Conde DC, DACNB Special to the Boca and Delray newspapers

Attention Deficit Hyperactivity Disorder (AD/HD) is a brain-based disorder characterized by inattention, hyperactivity, and impulsivity. In essence the individual exhibits difficulty with concentration, difficulty with organization, difficulty with focus, they move constantly, they excessively fidget, and they makes hasty actions. These behavioral tendencies lend to problems making friends and excelling in academics. There are 3 million U.S. cases per year, an epidemic.

Traditionally, the U.S. Food and Drug Administration (FDA) have only approved pharmaceutical agents for the treatment of AD/HD. The class of medications typically approved has been stimulants. Stimulants are known to increase alertness, attention, and energy by raising the levels of key chemicals in the brain, namely dopamine. However, stimulants are known to have significant long and short term side effects such as sleep problems, decreased appetite, weight loss, increased blood pressure, increased heart rate, dizziness, headaches, stomach aches, hallucinations, panic, and psychosis to name a few. Growing research over the last decade has focused on how to functionally change the status of the nervous system naturally using environmental stimuli to increase the firing capability of brain without medication. These concepts are heavily rooted in another breakthrough in neuroscience in the 21st century termed plasticity. Plasticity is the neuroscientific principle that states that the brain can be changed or molded or re-mapped according to the environmental stimuli it is exposed to at the time.

For the first time in the history of the FDA, a non-pharmaceutical treatment is being approved to help children suffering with AD/HD. External trigeminal nerve stimulation (eTNS) is a form of neuromodulation, better known as nerve stimulation, in which a slight electrical pulse to the trigeminal nerve in the brain is administered. This electrical pulse is conducted via bi-polar probes or electrodes that are placed on different regions of the face where the branches of the trigeminal nerve are most superficial. The trigeminal nerve is mainly responsible for sensation from the face. The main branches that are utilized are the supraorbital nerve (SO), supratrochlear nerve (ST), and the zygomaticotemporal nerve (ZTN). From a neuroscience perspective, when the trigeminal nerve is activated the pulse travels through the nerve and helps convey “therapeutic signals” to the parts of the brain thought to be involved in AD/HD. These signals that are being propagated will help stabilize the unstable neurological activity seen in the brain of those suffering from AD/ HD.

eTNS coupled with functional neurological rehabilitation truly produces the most potent outcomes in these children suffering with AD/HD. Functional neurological rehabilitation uses environmental stimuli like light, sound, smell, and touch as well as other sensory aspects to enhance areas of deficient function in the nervous system. Utilizing the understanding of plasticity, brain activity is enhanced and stabilized and true long-term change can be made.  These children can be successful in school and sports and become amazingly organized adults.

Dr. John Conde is a Board Certified Chiropractic Neurologist, one of only one thousand in the country. He holds diplomate status through the American Chiropractic Neurology Board. He provides specialized care for difficult cases of back neck pain, numbness-tingling, vertigo-dizziness balance disorders, fibromyalgia, migraines, AD/HD, autism, and dyslexia. His office is located at the Atlantic Grove in Delray Beach, FL and can be reached at 561-330-6096, drconde@thecondecenter.com, and at www.thecondecenter.com