Effects of cathodal transcranial direct current stimulation on inhibitory and attention control in children and adolescents with attention-deficit hyperactivity disorder: A pilot randomized sham-controlled crossover study

Wanalee Klomjai; Vorasith Siripornpanich; Benchaporn Aneksan; Oranich Vimolratana; Kannika Permpoonputtana; Jarugool Tretriluxana; Peeradech Thichanpiang

doi:10.1016/j.jpsychires.2022.02.032

Effects of cathodal transcranial direct current stimulation on inhibitory and attention control in children and adolescents with attention-deficit hyperactivity disorder: A pilot randomized sham-controlled crossover study

J Psychiatr Res. 2022 Jun:150:130-141. doi: 10.1016/j.jpsychires.2022.02.032. Epub 2022 Mar 2.

Authors

Wanalee Klomjai¹, Vorasith Siripornpanich², Benchaporn Aneksan¹, Oranich Vimolratana³, Kannika Permpoonputtana⁴, Jarugool Tretriluxana⁵, Peeradech Thichanpiang⁶

Affiliations

¹ Neuro Electrical Stimulation Laboratory (NeuE), Faculty of Physical Therapy, Mahidol University, Salaya, Nakhon Pathom, 73170, Thailand; Faculty of Physical Therapy Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom, 73170, Thailand.
² Research Center for Neuroscience, Institute of Molecular Biosciences, Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom, 73170, Thailand.
³ Department of Physical Therapy, School of Integrative Medicine, Mae Fah Luang University, Chiang Rai, 57100, Thailand.
⁴ National Institute for Child and Family Development, Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom, 73170, Thailand.
⁵ Faculty of Physical Therapy Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom, 73170, Thailand; Motor Control and Neural Plasticity Laboratory, Faculty of Physical Therapy, Mahidol University, Salaya, Nakhon Pathom, 73170, Thailand.
⁶ Faculty of Physical Therapy Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom, 73170, Thailand; Division of Occupational Therapy, Faculty of Physical Therapy Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom, 73170, Thailand. Electronic address: peeradech.thi@mahidol.edu.

PMID: 35367657
DOI: 10.1016/j.jpsychires.2022.02.032

Abstract

The pathophysiological of attention-deficit hyperactivity disorder (ADHD) includes hypoactivation of the dorso-lateral prefrontal cortex (DLPFC). Most studies have used anodal (excitatory) transcranial direct current stimulation (tDCS) to improve ADHD symptoms, however, a meta-analysis showed limited effect on improving inhibition, and no evidence of attention improvement. We thus present a pilot protocol for investigating the effect of other montage i.e. cathodal (inhibitory) tDCS on neurophysiological and behavioral measures in ADHD. Eleven participants underwent active (1.5 mA, 20 min) and sham cathodal tDCS over the left DLPFC for 5 consecutive days at a 1-month interval. Quantitative electroencephalography was recorded in a resting state with the eyes opened and closed during visual go/no-go and auditory continuous performance tasks at baseline, after five sessions, and at 1-week and 1-month follow-ups. Correct responses and omission errors were recorded. After five active sessions, alpha power increased in the right frontal area when the eyes were opened, and delta power in the left frontal area and omission errors decreased during go/no-go tasks, with no differences at follow-ups. The results revealed improvements in inhibitory control, but not for attention. No aftereffects were observed in either outcomes. However, the changes found in both hemispheres would probably support the hypothesis that cathodal stimulation over the left DLPFC may increase the activity of the right DLPFC via transcallosal inhibition. Results of this pilot trial would help to design and implement a full-scale randomized control trials for further ADHD research. This study was registered on ClinicalTrials.gov (NCT03955692).

Keywords: Adolescents; Attention-deficit hyperactivity disorder; Children; Electroencephalography; Inhibitory control; Transcranial direct current stimulation.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Attention Deficit Disorder with Hyperactivity* / therapy
Child
Cross-Over Studies
Humans
Pilot Projects
Prefrontal Cortex
Randomized Controlled Trials as Topic
Transcranial Direct Current Stimulation* / methods

Associated data

ClinicalTrials.gov/NCT03955692