TeachableMedicalNews article 09162020

Teachable moment in classrooms:

  1. nervous system chapter – Na channel opening during nerve impulse
  2. nervous system chapter – neurotransmitters pass excitation from one neuron to another
  3. brain chapter – cranial nerves and their functions

The news item:  Recently a news article described a medical device to treat ADHD in children:

FDA signs off on first medical device for treating ADHD in children

As diagnosis rates of ADHD among children skyrocket, a new medical device for the treatment of ADHD could soon hit the market.

The article states that the device called Monarch eTNS is placed on the forehead to send electrical impulses to the brain through the trigeminal nerve.

So, Why Do I Care??  Over 7 million children and 8 million adults have ADHD (attention deficit hyperactivity disorder).  ADHD can severely disrupt learning, school activities, social interactions, and job performance, among others. While there are existing treatment options for people with ADHD, any new treatment with fewer side effects is welcome news.

Plain English, Please!!!  First, let’s talk about ADHD.  Attention deficit hyperactivity disorder is a disorder of the nervous system.  Normally, small group of neurons in the brain actively keep behaviors like attention span, interactions with others, and executive function going.  When those groups of neurons have a lower than normal activity level, the consequence is the undesirable behavioral changes we see in ADHD.

Second, let’s talk about the trigeminal nerve. There are twelve nerves that connect the brain to various areas of the head and neck. The trigeminal nerve, among other roles, bring nerve impulses representing touch, warm, cold, and pain sensations from the face, forehead and jaw area to the brain. The nerve impulse is a signal that moves along the axons that make up the nerve. The signal itself starts with a flow of Na ions into the neuron, and Na ions can move into the neuron only if Na channel proteins open up along the membrane of the axon. Imagine the axon as a long school hallway, and fresh air (Na ions) can get into the hallway only if the doors (Na channels) are open. During a natural nerve impulse the doors are opened by doorknobs on the inside.

Third, let’s talk about how electrical stimulation of the skin can affect brain activity. The trigeminal nerve makes connections with several groups of neurons, in the brain, including the groups that have low activity in ADHD.  The Monarch eTNS stimulator device generates electrical impulses in the skin of the forehead, and those minor electrical waves open Na channels in the trigeminal nerve; the doors in that long school hallway are now opened by doorknobs on the outside.  When Na ions flow though those newly opened Na channels, an artificial nerve impulse will move along the trigeminal nerve.  Those nerve impulses reach the critical groups of neurons in the brain.  The trigeminal nerve releases neurotransmitter chemicals, and they will activate the groups of neurons involved in ADHD, so ADHD symptoms will be moderated.