RESUMEN
Introduction: Abnormal brain structure and function have been reported in individuals with attention deficit hyperactivity disorder (ADHD). This study investigated the parietal lobe structure and function alteration in individuals with ADHD. Methods: In this systematic review, we searched English papers in accordance with the PRISMA (the preferred reporting items for systematic reviews and meta-analyses) approach. Studies were published between January 2010 and May 2021. Our search was conducted in two parts. Our first search was in July 2020, and our final search was in June 2021. A literature search identified 20 empirical experiments. Results: Functional magnetic resonance imaging (MRI) studies generally reported low activity and poor connectivity; structural MRI studies reported less gray matter in this lobe, and an echo study reported atrophy. In addition, electroencephalographic studies reported less connectivity of the parietal lobes in ADHD. Furthermore, the transcranial direct current stimulation intervention has shown that activation of this lobe improves attention and executive functions in children with ADHD. Finally, a deep transcranial magnetic stimulation study has demonstrated that activation of this lobe improves working memory. Conclusion: Functional and structural alteration of the parietal cortex has been reported in ADHD, which has a causal relationship with cognitive impairments. In sum, all included studies reported abnormal structure, function, or connectivity of the parietal lobe or improvement of cognitive functions with parietal lobe stimulation.
RESUMEN
Transcranial direct current stimulation (tDCS) has been increasingly used in attention-deficit hyperactivity disorder (ADHD) with mixed results. Previous tDCS studies merely targeted the dorsolateral prefrontal cortex and right inferior frontal gyrus with partial or no improving effects on cognitive deficits respectively. Posterior parietal cortex is another region involved in attentional functioning of ADHD, however, its contribution to ADHD attention functions has not been explored in tDCS studies. Moreover, attention networks are not investigated in the previous tDCS studies in ADHD neither. Here, we explored the effects of anodal tDCS over the right posterior parietal cortex (r-PPC) on attentional functioning (i.e., attention networks, selective attention, shifting attention) and response inhibition in ADHD children. 19 children with ADHD were recruited and underwent anodal/sham r-PPC tDCS (1â¯mA, 20â¯min) during task performance in a randomized cross-over design. Our results show an improving effect of anodal r-PPC tDCS specifically on the orienting but alerting or executive networks, in line with findings of healthy populations. Furthermore, activation of the r-PPC had a deteriorating effect on the top-down attentional control required for selective attention measured by the Stroop test. Modeling of the current flow showed a stronger electrical field induced in the inferior PPC (BA 39,40) which mediates bottom-up attentional control. No significant effect on shifting attention and response inhibition was found. Our findings indicate a domain-specific involvement of the r-PPC in attention orienting network of ADHD children. Activation of the r-PPC improves bottom-up but hinders top-down attentional control suggesting a critical role of the r-PPC in ADHD bottom-up attentional control.