Transcranial random noise stimulation combined with cognitive training for treating ADHD: a randomized, sham-controlled clinical trial

Abstract

Non-invasive brain stimulation has been suggested as a potential treatment for improving symptomology and cognitive deficits in Attention-Deficit/Hyperactivity Disorder (ADHD), the most common childhood neurodevelopmental disorder. Here, we examined whether a novel form of stimulation, high-frequency transcranial random noise stimulation (tRNS), applied with cognitive training (CT), may impact symptoms and neural oscillations in children with ADHD. We conducted a randomized, double-blind, sham-controlled trial in 23 unmedicated children with ADHD, who received either tRNS over the right inferior frontal gyrus (rIFG) and left dorsolateral prefrontal cortex (lDLPFC) or sham stimulation for 2 weeks, combined with CT. tRNS + CT yielded significant clinical improvements (reduced parent-reported ADHD rating-scale scores) following treatment, compared to the control intervention. These improvements did not change significantly at a 3-week follow-up. Moreover, resting state (RS)-EEG periodic beta bandwidth of the extracted peaks was reduced in the experimental compared to control group immediately following treatment, with further reduction at follow-up. A lower aperiodic exponent, which reflects a higher cortical excitation/inhibition (E/I) balance and has been related to cognitive improvement, was seen in the experimental compared to control group. This replicates previous tRNS findings in adults without ADHD but was significant only when using a directional hypothesis. The experimental group further exhibited longer sleep onset latencies and more wake-up times following treatment compared to the control group. No significant group differences were seen in executive functions, nor in reported adverse events. We conclude that tRNS + CT has a lasting clinical effect on ADHD symptoms and on beta activity. These results provide a preliminary direction towards a novel intervention in pediatric ADHD.

Efficacy and safety of transcranial pulse stimulation in young adolescents with attention-deficit/hyperactivity disorder: a pilot, randomized, double-blind, sham-controlled trial

“…Notably, we found that TPS improved ADHD core symptoms, and the effects were sustained at the 1- and 3-month follow-ups. Our results are supported by a recent double-blind, sham-controlled trial administering transcranial random noise stimulation (tRNS) ( 60 ) to 23 children aged 6 to 12 years. Subjects received 10 sessions of tRNS over the inferior frontal gyrus (rIFG) and left dorsolateral prefrontal cortex (lDLPFC) plus cognitive training (CT) over 2 weeks.…”

Transcranial random noise stimulation (tRNS) improves hot and cold executive functions in children with attention deficit-hyperactivity disorder (ADHD)

“…The stimulation was applied through a pair of sponge electrodes, each measuring 5 × 5 cm, soaked in saline solution for optimal conductivity. This frequency and intensity have been previously employed in studies involving children with ADHD 34 , 45 . The electrodes were placed over the left dlPFC and the right vmPFC, and electrode placement was based on the 10–20 EEG international system (electrode positions with the center over F3, and FP2).…”