Efficacy of Non-Invasive Brain Stimulation in Improving Working Memory in Children and Adolescents with Attention-Deficit/Hyperactivity Disorder: A Systematic Review.

Overview

1. Facultad de Ciencias Sociales y de la Salud, Universidad Estatal Península de Santa Elena, La Libertad 240250, Ecuador; (J.L.A.P.); (W.G.B.B.); (H.M.C.d.V.); (R.A.B.Q.)

Abstract

Highlights: What are the main findings?

High-frequency rTMS (10 Hz) and anodal tDCS over the left dorsolateral prefrontal cortex (l-DLPFC) significantly improve executive working memory in pediatric ADHD.

Clinical efficacy is more consistent in central executive components (N-back and backward digit span) than in simple phonological or visuospatial storage tasks.

What are the implications of the main findings?

NIBS acts as a “neuroplasticity primer” that can partially correct functional recruitment deficits in the frontoparietal network of children and adolescents.

Both tDCS and rTMS demonstrate a superior safety-to-efficacy ratio compared to pharmacological side effects, supporting their role as viable complementary pediatric therapies.

Abstract: Background/Objectives: Attention-Deficit/Hyperactivity Disorder (ADHD) is associated with working memory deficits linked to frontoparietal alterations. Non-invasive brain stimulation (NIBS) is a potential intervention to modulate neuroplasticity and improve this executive function. In this study, we aimed to evaluate the clinical efficacy of non-invasive brain stimulation techniques (tDCS/rTMS) for strengthening working memory in children and adolescents with ADHD. Methods: This systematic review adhered to the PRISMA 2020 guidelines, with a search of Scopus and Web of Science conducted to identify relevant studies published between 2011 and 2026. Eligibility criteria, defined a priori, included original empirical studies (RCTs and quasi-experimental designs) focusing on pediatric populations (≤18 years) diagnosed with ADHD. Eligible interventions involved tDCS or rTMS with explicit working memory outcomes. Only peer-reviewed articles published in English or Spanish were included. Reviews, case reports, and studies exclusive to adults were excluded. Data on application parameters, durability, and safety were extracted for narrative synthesis. Results: Six studies met the criteria. Both tDCS and rTMS targeting the left dorsolateral prefrontal cortex showed improvements in working memory, particularly in executive components measured using digit span backward and N-back tasks. High-frequency rTMS (10 Hz) with repeated sessions showed more consistent effects, while tDCS showed modest and variable improvements. Evidence regarding long-term effects was limited. Both techniques were well-tolerated, with mild and transient adverse events. Conclusions: NIBS shows promise as a complementary intervention to improve working memory in pediatric ADHD; however, current evidence is limited. Larger, standardized, longitudinal trials are required to confirm its efficacy and clinical utility.

Reproduced under the paper's license (CC BY), from the paper cited above.

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Data

Datasets cited

• osf:g8ztp, at OSF; found in “Data Availability Statement”

Data Availability Statement

The data supporting the findings of this systematic review, including the study protocol, search strategies, and the data extraction matrix, are openly available in the Open Science Framework (OSF) at https://doi.org/10.17605/OSF.IO/G8ZTP.

Reproduced under the paper's license (CC BY), from the paper cited above.

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Version 1, 30 September 2026: the first record

Recorded: type, language, journal, volume, issue, pages, dates, 5 authors, 6 keywords, 62 references.

Cite

This paper

Zambrano Vélez, W. A., Alcívar Ponce, J. L., Bailón Bailón, W. G., Castillo del Valle, H. M., & Baquerizo Quirumbay, R. A. (2026). Efficacy of Non-Invasive Brain Stimulation in Improving Working Memory in Children and Adolescents with Attention-Deficit/Hyperactivity Disorder: A Systematic Review. Brain sciences, 16(5), 480. https://doi.org/10.3390/brainsci16050480

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