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

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

doi:10.1016/j.jpsychires.2022.08.022

Cited by 5 publications

(12 citation statements)

References 54 publications

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“…This study found no difference between the tDCS and sham groups in any of the measures used to assess subjects pre-intervention. This was the case after six sessions, 12 sessions, and 1 month after completing the sessions ( 46 ).…”

Section: Discussionmentioning

confidence: 94%

Efficacy and safety of transcranial direct current stimulation over the left dorsolateral prefrontal cortex in children and adolescents with attention-deficit/hyperactivity disorder: a randomized, triple-blinded, sham-controlled, crossover trial

Guimarães,

Bandeira,

Barretto

et al. 2024

Front. Psychiatry

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IntroductionAlthough pharmacological treatment for Attention-Deficit/Hyperactivity Disorder (ADHD) has demonstrated efficacy, several individuals persist in experiencing social and academic impairment. Additionally, the occurrence of significant side effects may render the use of psychotropic medications untenable. However, Transcranial Direct Current Stimulation (tDCS), a non-invasive brain stimulation technique, shows promising results in treating ADHD.ObjectivesTo investigate the efficacy and safety of tDCS on the performance of children and adolescents with ADHD in neuropsychological tests involving visual attention, visual and verbal working memory, and inhibitory control.MethodologyThis study was a triple-blind, randomized, sham-controlled, crossover clinical trial. The intervention consisted of a daily session of tDCS (2 mA) or sham targeting the left dorsolateral prefrontal cortex (L-DLPFC), for 30 min, on five consecutive days. The primary outcome was change in the Visual Attention Test, Fourth Edition (TAVIS-4) before and after each intervention. Subjects were also evaluated pre and post-tDCS using the Digit Span subtest of the Wechsler Intelligence Scale for Children, Fifth Edition (WISC-V), the Developmental Neuropsychological Assessment, Second Edition (NEPSY-II) Inhibiting Response (IR) subtest, and the Corsi Block-Tapping Task.ResultsFifteen individuals were included, and no statistically significant difference was observed when comparing the results of the TAVIS-4, the IR of NEPSY-II, and the intragroup Digit Span subtest of WISC-V undertaken before and after the procedure. Adverse events were mainly self-limiting and transient. The participants did not perceive any benefit from tDCS when measured on the Patient Global Impression of Improvement (PGI-I) Scale.ConclusionThis study did not meet its primary endpoint and found no performance enhancement in any investigated neuropsychological outcomes relating to the intervention group.

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Section: Discussionmentioning

confidence: 94%

Efficacy and safety of transcranial direct current stimulation over the left dorsolateral prefrontal cortex in children and adolescents with attention-deficit/hyperactivity disorder: a randomized, triple-blinded, sham-controlled, crossover trial

Guimarães,

Bandeira,

Barretto

et al. 2024

Front. Psychiatry

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“…We identified 33 eligible studies (total N = 517; age range 2-25 years, M = 15.53, SD = 6.44; 82.2% male), composed of eight double-blind RCTs [37-40, 43, 44, 46, 48], four double-blind, crossover RCTs [35,43,45,47], one doubleblind, sham-controlled trial [67], two single-blind RCTs [41,63], one single-blind controlled clinical trial [65], four openlabel studies [36,38,44,62], and 14 case series/studies [42, 51-61, 64, 66] (see Table 1 and 2). Seven studies were in ASD [35][36][37][38][39][40][41][42][43], seven in ADHD [44][45][46][47][48][49][50], four in schizophrenia [51][52][53][54], two in OCD [55,56], Tourette's syndrome [57,58], depression [59,60], anxiety [61,62], or substance abuse disorder [63,64], and one each in eating disorders…”

Section: Resultsmentioning

confidence: 99%

“…Four RCTs were prospectively registered [40,45,48,50], and three were retrospectively registered [43,47,63]. Among these seven protocols or trial registries, we found inconsistent and/or selective reporting in four studies.…”

Section: Quality Assessmentmentioning

confidence: 99%

Effects of transcranial direct current stimulation in children and young people with psychiatric disorders: a systematic review

Gallop

Westwood

Lewis

et al. 2023

Eur Child Adolesc Psychiatry

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Transcranial direct current stimulation (tDCS) has demonstrated benefits in adults with various psychiatric disorders, but its clinical utility in children and young people (CYP) remains unclear. This PRISMA systematic review used published and ongoing studies to examine the effects of tDCS on disorder-specific symptoms, mood and neurocognition in CYP with psychiatric disorders. We searched Medline via PubMed, Embase, PsychINFO via OVID, and Clinicaltrials.gov up to December 2022. Eligible studies involved multiple session (i.e., treatment) tDCS in CYP (≤ 25 years old) with psychiatric disorders. Two independent raters assessed the eligibility of studies and extracted data using a custom-built form. Of 33 eligible studies (participant N = 517), the majority (n = 27) reported an improvement in at least one outcome measure of disorder-specific symptoms. Few studies (n = 13) examined tDCS effects on mood and/or neurocognition, but findings were mainly positive. Overall, tDCS was well tolerated with minimal side effects. Of 11 eligible ongoing studies, many are sham-controlled RCTs (n = 9) with better blinding techniques and a larger estimated participant enrolment (M = 79.7; range 15–172) than published studies. Although encouraging, the evidence to date is insufficient to firmly conclude that tDCS can improve clinical symptoms, mood, or cognition in CYP with psychiatric disorders. Ongoing studies appear of improved methodological quality; however, future studies should broaden outcome measures to more comprehensively assess the effects of tDCS and develop dosage guidance (i.e., treatment regimens).

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“…Our findings are in line with the results from our recent qualitative study that showed how tDCS is raising hope for parents of children with ADHD dealing with pharmacological treatment: These parents made it clear that understanding the safety, tolerability, and side effects of tDCS was imperative for accepting the treatment, provided that it is effective, relatively inexpensive, practical, and accessible [ 9 , 31 ]. Thankfully, the call for tDCS as a treatment option for ADHD may soon be answered as promising results from a number of clinical trials are starting to be published in adults [ 55 ] and in children [ 48 , 56 , 57 ].…”

Section: Discussionmentioning

confidence: 99%

Safety and Tolerability of tDCS across Different Ages, Sexes, Diagnoses, and Amperages: A Randomized Double-Blind Controlled Study

Buchanan

Amare

Gaumond

et al. 2023

JCM

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Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique with substantial evidence for its safety and tolerability in adults. However, less than 5% of published tDCS research is in pediatrics. Our primary objective was to investigate tDCS safety, tolerability, and acceptability in a sample of children and adults. We hypothesized that children and adults would be equal with regard to tDCS safety, tolerability, and acceptability. We tested this hypothesis using a Bayesian approach. Sixty participants aged 6–45 (balanced for sex) participated in a randomized double-blind controlled trial. They were randomly assigned to two ten-minute tDCS sessions with varying amperages and electrode locations. The primary outcome measure of this study was the intensity of 13 potential side effects evaluated at six different time points spanning two weeks. Independent sample Bayes factor tests were conducted between children/adults, males/females, clinical/healthy, and low/high amperage groups. As predicted, there was moderate support for the null hypothesis in all between-group analyses. There were no serious adverse events or dropouts, and the number needed to treat for an additional harmful outcome was 23. This study provided evidence supporting the overall short-term safety, tolerability, and acceptability of tDCS including amperages up to 2 mA and different electrode placements.

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

Cited by 5 publications

References 54 publications

Efficacy and safety of transcranial direct current stimulation over the left dorsolateral prefrontal cortex in children and adolescents with attention-deficit/hyperactivity disorder: a randomized, triple-blinded, sham-controlled, crossover trial

Efficacy and safety of transcranial direct current stimulation over the left dorsolateral prefrontal cortex in children and adolescents with attention-deficit/hyperactivity disorder: a randomized, triple-blinded, sham-controlled, crossover trial

Effects of transcranial direct current stimulation in children and young people with psychiatric disorders: a systematic review

Safety and Tolerability of tDCS across Different Ages, Sexes, Diagnoses, and Amperages: A Randomized Double-Blind Controlled Study

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