Transcranial Direct Current Stimulation (tDCS) in children with ADHD: A randomized, sham-controlled pilot study

Mitchell Schertz; Yael Karni-Visel; Jacob Genizi; Hofit Manishevitch; Menachem Lam; Ashraf Akawi; Michal Dudai; André A. Fenton; Marom Bikson

doi:10.1016/j.jpsychires.2022.08.022

Transcranial Direct Current Stimulation (tDCS) in children with ADHD: A randomized, sham-controlled pilot study

Mitchell Schertz, Yael Karni-Visel, Jacob Genizi, Hofit Manishevitch, Menachem Lam, Ashraf Akawi, Michal Dudai, André A. Fenton, Marom Bikson

School of Social Work

Research output: Contribution to journal › Article › peer-review

5 Scopus citations

Abstract

Background: ADHD is a common neurodevelopmental disorder with a pediatric prevalence of 5.2%.While medication treatment for ADHD is effective, it does not address all symptoms and a small but notable subgroup does not respond to medications. Adverse effects limit its use and some parents and participants resist use of medication. Thus, limitations of medication treatment for ADHD motivate searching for other therapeutic options. Transcranial Direct Current Stimulation (tDCS) has been suggested as a treatment for children with ADHD, with mixed results to date. Protocol variables employed, including combined use of cognitive training (CT) and scheduling of sessions, may explain diverse findings to date. The aim of this study was to examine safety, feasibility and efficacy of tDCS combined with CT provided three-times-per week for one-month to treat children with ADHD. Methods: In a double blind, randomized, sham-controlled pilot study, 25 children with ADHD were randomized to receive 12 sessions of either anodal tDCS or sham-tDCS for 20 min combined with CT three-times-per-week for four weeks. The tDCS anode was over left dorsolateral prefrontal cortex (DLPFC) and cathode over vertex. Assessments were obtained prior to, after 6 sessions, 12 sessions and one-month after intervention. Results: No significant post-intervention differences were found between those receiving tDCS or sham-tDCS. Both groups demonstrated significant improvement on questionnaire measures of ADHD and executive function with mixed results seen on computerized performance measures. Overall, adverse effects were mild with no significant difference between groups. However, three children, all from the tDCS group, experienced headaches with two requiring temporary cessation and one requiring removal from the study. Conclusions: Anodal tDCS to the DLPFC using the above protocol in children with ADHD did not demonstrate additional treatment benefits beyond that of CT.

Original language	English
Pages (from-to)	302-312
Number of pages	11
Journal	Journal of Psychiatric Research
Volume	155
DOIs	https://doi.org/10.1016/j.jpsychires.2022.08.022
State	Published - Nov 2022

Bibliographical note

Publisher Copyright:
© 2022 Elsevier Ltd

Funding

Marom Bikson is supported by grants from the National Institutes of Health: R01NS101362, R01NS095123, R01NS112996, R01MH111896, R01MH109289, UG3DA048502. The City University of New York (CUNY) has IPs on neuro-stimulation systems and methods with authors MB as inventor. MB has equity in Soterix Medical. MB served on the advisory boards, received grants, and/or consulted for Boston Scientific, Mecta, Halo Neuroscience, Google, Apple, and GlaxoSmithKline Inc. This work was supported by a grant from Meuhedet.

Funders	Funder number
Halo Neuroscience
National Institutes of Health	R01MH109289, R01MH111896, R01NS112996, R01NS095123, R01NS101362
National Institute on Drug Abuse	UG3DA048502
North Carolina GlaxoSmithKline Foundation
City University of New York
Google

Keywords

Attention deficit hyperactivity disorder (ADHD)
Cognitive training
Dorsolateral prefrontal cortex (DLPFC)
Randomized controlled trial
Transcranial direct current stimulation (tDCS)

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.jpsychires.2022.08.022

Cite this

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title = "Transcranial Direct Current Stimulation (tDCS) in children with ADHD: A randomized, sham-controlled pilot study",

abstract = "Background: ADHD is a common neurodevelopmental disorder with a pediatric prevalence of 5.2%.While medication treatment for ADHD is effective, it does not address all symptoms and a small but notable subgroup does not respond to medications. Adverse effects limit its use and some parents and participants resist use of medication. Thus, limitations of medication treatment for ADHD motivate searching for other therapeutic options. Transcranial Direct Current Stimulation (tDCS) has been suggested as a treatment for children with ADHD, with mixed results to date. Protocol variables employed, including combined use of cognitive training (CT) and scheduling of sessions, may explain diverse findings to date. The aim of this study was to examine safety, feasibility and efficacy of tDCS combined with CT provided three-times-per week for one-month to treat children with ADHD. Methods: In a double blind, randomized, sham-controlled pilot study, 25 children with ADHD were randomized to receive 12 sessions of either anodal tDCS or sham-tDCS for 20 min combined with CT three-times-per-week for four weeks. The tDCS anode was over left dorsolateral prefrontal cortex (DLPFC) and cathode over vertex. Assessments were obtained prior to, after 6 sessions, 12 sessions and one-month after intervention. Results: No significant post-intervention differences were found between those receiving tDCS or sham-tDCS. Both groups demonstrated significant improvement on questionnaire measures of ADHD and executive function with mixed results seen on computerized performance measures. Overall, adverse effects were mild with no significant difference between groups. However, three children, all from the tDCS group, experienced headaches with two requiring temporary cessation and one requiring removal from the study. Conclusions: Anodal tDCS to the DLPFC using the above protocol in children with ADHD did not demonstrate additional treatment benefits beyond that of CT.",

keywords = "Attention deficit hyperactivity disorder (ADHD), Cognitive training, Dorsolateral prefrontal cortex (DLPFC), Randomized controlled trial, Transcranial direct current stimulation (tDCS)",

author = "Mitchell Schertz and Yael Karni-Visel and Jacob Genizi and Hofit Manishevitch and Menachem Lam and Ashraf Akawi and Michal Dudai and Fenton, {Andr{\'e} A.} and Marom Bikson",

note = "Publisher Copyright: {\textcopyright} 2022 Elsevier Ltd",

year = "2022",

month = nov,

doi = "10.1016/j.jpsychires.2022.08.022",

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T1 - Transcranial Direct Current Stimulation (tDCS) in children with ADHD

T2 - A randomized, sham-controlled pilot study

AU - Schertz, Mitchell

AU - Karni-Visel, Yael

AU - Genizi, Jacob

AU - Manishevitch, Hofit

AU - Lam, Menachem

AU - Akawi, Ashraf

AU - Dudai, Michal

AU - Fenton, André A.

AU - Bikson, Marom

PY - 2022/11

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N2 - Background: ADHD is a common neurodevelopmental disorder with a pediatric prevalence of 5.2%.While medication treatment for ADHD is effective, it does not address all symptoms and a small but notable subgroup does not respond to medications. Adverse effects limit its use and some parents and participants resist use of medication. Thus, limitations of medication treatment for ADHD motivate searching for other therapeutic options. Transcranial Direct Current Stimulation (tDCS) has been suggested as a treatment for children with ADHD, with mixed results to date. Protocol variables employed, including combined use of cognitive training (CT) and scheduling of sessions, may explain diverse findings to date. The aim of this study was to examine safety, feasibility and efficacy of tDCS combined with CT provided three-times-per week for one-month to treat children with ADHD. Methods: In a double blind, randomized, sham-controlled pilot study, 25 children with ADHD were randomized to receive 12 sessions of either anodal tDCS or sham-tDCS for 20 min combined with CT three-times-per-week for four weeks. The tDCS anode was over left dorsolateral prefrontal cortex (DLPFC) and cathode over vertex. Assessments were obtained prior to, after 6 sessions, 12 sessions and one-month after intervention. Results: No significant post-intervention differences were found between those receiving tDCS or sham-tDCS. Both groups demonstrated significant improvement on questionnaire measures of ADHD and executive function with mixed results seen on computerized performance measures. Overall, adverse effects were mild with no significant difference between groups. However, three children, all from the tDCS group, experienced headaches with two requiring temporary cessation and one requiring removal from the study. Conclusions: Anodal tDCS to the DLPFC using the above protocol in children with ADHD did not demonstrate additional treatment benefits beyond that of CT.

AB - Background: ADHD is a common neurodevelopmental disorder with a pediatric prevalence of 5.2%.While medication treatment for ADHD is effective, it does not address all symptoms and a small but notable subgroup does not respond to medications. Adverse effects limit its use and some parents and participants resist use of medication. Thus, limitations of medication treatment for ADHD motivate searching for other therapeutic options. Transcranial Direct Current Stimulation (tDCS) has been suggested as a treatment for children with ADHD, with mixed results to date. Protocol variables employed, including combined use of cognitive training (CT) and scheduling of sessions, may explain diverse findings to date. The aim of this study was to examine safety, feasibility and efficacy of tDCS combined with CT provided three-times-per week for one-month to treat children with ADHD. Methods: In a double blind, randomized, sham-controlled pilot study, 25 children with ADHD were randomized to receive 12 sessions of either anodal tDCS or sham-tDCS for 20 min combined with CT three-times-per-week for four weeks. The tDCS anode was over left dorsolateral prefrontal cortex (DLPFC) and cathode over vertex. Assessments were obtained prior to, after 6 sessions, 12 sessions and one-month after intervention. Results: No significant post-intervention differences were found between those receiving tDCS or sham-tDCS. Both groups demonstrated significant improvement on questionnaire measures of ADHD and executive function with mixed results seen on computerized performance measures. Overall, adverse effects were mild with no significant difference between groups. However, three children, all from the tDCS group, experienced headaches with two requiring temporary cessation and one requiring removal from the study. Conclusions: Anodal tDCS to the DLPFC using the above protocol in children with ADHD did not demonstrate additional treatment benefits beyond that of CT.

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KW - Randomized controlled trial

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Transcranial Direct Current Stimulation (tDCS) in children with ADHD: A randomized, sham-controlled pilot study

Abstract

Bibliographical note

Funding

Keywords

UN SDGs

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