A functional magnetic resonance imaging investigation of prefrontal cortex deep transcranial magnetic stimulation efficacy in adults with attention deficit/hyperactive disorder: A double blind, randomized clinical trial

Bleich-Cohen, Maya; Gurevitch, Guy; Carmi, Noa; Medvedovsky, Mordekhay; Bregman, Noa; Nevler, Naomi; Elman, Karin; Ginou, Amit; Zangen, Abraham; Ash, Elissa

doi:10.1016/j.nicl.2021.102670

Cited by 14 publications

(30 citation statements)

References 54 publications

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“…The study found that increased rDLPFC activation was associated with more symptom improvement in the right stimulation group. This study concluded that dTMS is an effective and feasible technique that may improve attention symptoms in adults with ADHD [27].…”

Section: Discussionmentioning

confidence: 73%

The therapeutic role of repetitive transcranial magnetic stimulation in children with attention deficit/hyperactivity disorder in Egypt a randomized sham controlled clinical trial

Nagy

Amin

Khalil

et al. 2022

Middle East Curr Psychiatry

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Background Repetitive transcranial magnetic stimulation showed some evidence for improving symptoms of ADHD along with its relative safety, thus could serve as a treatment strategy or an alternative to stimulant medication. Accordingly, 60 children with ADHD were assessed, and 30 participants were allocated to the rTMS group and received 15 sessions of rTMS over the right dorsolateral prefrontal cortex combined with Atomoxetine 1.2 mg/kg/day. The other 30 participants were allocated to the Sham group and received 15 sessions of sham rTMS and atomoxetine 1.2 mg/kg/day. Clinical assessments of ADHD symptoms and severity were done and compared at 3 points, before treatment, after receiving 15 sessions of rTMS and follow-up 1 month after the last rTMS session, using Conner’s Parent Rating Scale-Revised-Long form, Children’s Global Assessment Scale, and Clinical Global Impression. Results The two groups show significant improvement in the T scores of all CPRS subscales, CGI and CGAS. However, the rTMS group had a significantly more improvement than the sham group in inattention, total ADHD severity, CGI, and CGAS after rTMS and continued to the follow-up after 1 month. Conclusions rTMS is an efficacious intervention for treating ADHD, and combined rTMS and atomoxetine is superior to atomoxetine alone in improving attention deficit symptoms and total ADHD symptoms severity. Trial registration PACTR, PACTR202110558451583. Registered 25 June 2021. Approved 29 October 2021- Retrospectively registered, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=15968.

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Section: Discussionmentioning

confidence: 73%

The therapeutic role of repetitive transcranial magnetic stimulation in children with attention deficit/hyperactivity disorder in Egypt a randomized sham controlled clinical trial

Nagy

Amin

Khalil

et al. 2022

Middle East Curr Psychiatry

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“…In ADHD, weaker function and structure in PFC circuits were previously reported 26 . MRI studies indicate that volumetric variance in prefrontal/striatal systems and caudate nucleus predicts the severity of parent-reported ADHD diagnostic behaviors 27 .…”

Section: Introductionmentioning

confidence: 68%

Functional changes in prefrontal cortex following frequency-specific training

Bach-Morrow

Boccalatte

DeRosa

et al. 2022

Sci Rep

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Numerous studies indicate a significant role of pre-frontal circuits (PFC) connectivity involving attentional and reward neural networks within attention deficit hyperactivity disorder (ADHD) pathophysiology. To date, the neural mechanisms underlying the utility of non-invasive frequency-specific training systems in ADHD remediation remain underexplored. To address this issue, we created a portable electroencephalography (EEG)-based wireless system consisting of a novel headset, electrodes, and neuro program, named frequency specific cognitive training (FSCT). In a double-blind, randomized, controlled study we investigated the training effects in N = 46 school-age children ages 6–18 years with ADHD. 23 children in experimental group who underwent FCST training showed an increase in scholastic performance and meliorated their performance on neuropsychological tests associated with executive functions and memory. Their results were compared to 23 age-matched participants who underwent training with placebo (pFSCT). Electroencephalogram (EEG) data collected from participants trained with FSCT showed a significant increase in 14–18 Hz EEG frequencies in PFC brain regions, activities that indicated brain activation in frontal brain regions, the caudate nucleus, and putamen. These results demonstrate that FSCT targets specific prefrontal and striatal areas in children with ADHD, suggesting a beneficial modality for non-invasive modulation of brain areas implicated in attention and executive functions.

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“…One study included a CT-only control condition (Charvet et al, 2018), and two studies used both control conditions (Dousset et al, 2021; Gonzalez et al, 2021). Thirteen studies (Au et al, 2016; Bleich-Cohen et al, 2021; Brambilla et al, 2021; Dousset et al, 2021; Ehrhardt et al, 2021; Filmer, Lyons, et al, 2017; Gonzalez et al, 2021; Horne et al, 2021; Jones et al, 2015; Krebs et al, 2021; Ruf et al, 2017; Sommer & Plewnia, 2021; Weller et al, 2020) included more than one control or experimental group of interest for this meta-analysis (see , for more information on the experimental and control conditions).…”

Section: Resultsmentioning

confidence: 99%

“…No outlying effect size estimates were identified. Excluding one study (Bleich-Cohen et al, 2021) decreased the total heterogeneity to 0.21 and increased the mean effect size to g = 0.23 (95% CI [0.07, 0.40], p = .006).…”

Section: Perceptual Motor Processingmentioning

confidence: 99%

The efficacy of combining cognitive training and noninvasive brain stimulation: A transdiagnostic systematic review and meta-analysis.

Poppe,

Ritter,

Bais

et al. 2024

Psychological Bulletin

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Over the past decade, an increasing number of studies investigated the innovative approach of supplementing cognitive training (CT) with noninvasive brain stimulation (NIBS) to increase the effects on outcomes. In this review, we aim to summarize the evidence for this treatment combination. We identified 72 published and unpublished studies (reporting 773 effect sizes), including 2,518 participants from healthy and clinical populations indexed in PubMed, MEDLINE, APA PsycInfo, ProQuest, Web of Science, and https://ClinicalTrials.gov (last search: August 9, 2022) that compared the effects of NIBS combined with CT on cognitive, symptoms, and everyday functioning to CT alone at postintervention and/or follow-up. We performed random-effects meta-analyses with robust variance estimation and assessed risk of bias with the Cochrane ROB tool. Only four studies had low risk of bias in all domains, and many studies lacked standard controls such as keeping the outcome assessor and trainer unaware of the treatment condition. Following sensitivity analyses, only learning/memory robustly improved significantly more when CT was combined with NIBS compared to CT only (g = 0.18, 95% CI [0.07, 0.29]) at postintervention, but not in the long term. The effect was small and limited by substantial heterogeneity. The other seven cognitive outcome domains, symptoms, and everyday functioning did not benefit from adding NIBS to CT. Given the methodological limitation of prior studies, more high-quality trials that focus on the potential of combining NIBS and CT to enhance benefits in everyday functioning in the short and long term are needed to evaluate whether combining NIBS and CT is relevant for clinical practice.

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A functional magnetic resonance imaging investigation of prefrontal cortex deep transcranial magnetic stimulation efficacy in adults with attention deficit/hyperactive disorder: A double blind, randomized clinical trial

Cited by 14 publications

References 54 publications

The therapeutic role of repetitive transcranial magnetic stimulation in children with attention deficit/hyperactivity disorder in Egypt a randomized sham controlled clinical trial

The therapeutic role of repetitive transcranial magnetic stimulation in children with attention deficit/hyperactivity disorder in Egypt a randomized sham controlled clinical trial

Functional changes in prefrontal cortex following frequency-specific training

The efficacy of combining cognitive training and noninvasive brain stimulation: A transdiagnostic systematic review and meta-analysis.

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