Deep Transcranial Magnetic Stimulation over the right prefrontal cortex improves ADHD symptoms: A combined TMS-EEG study

Background:

ADHD is a mental health disorder characterized by various symptoms including cognitive impairments, inattention, impulsivity and in some cases, hyperactivity. Despite its high prevalence, the only empirically validated treatment for ADHD ischronic administration of psychostimulants which is not tolerable by all patients. Deep TMS is a promising technique used for treatment of otherwise treatment-resistant neuropsychiatric patients. Notably, this tool can induce long-term alterations in neuralcognitive networks and thus may provide means for cognitive and executive restoration.

Objective:

This study wasdesigned to investigate the therapeutic effect of dTMSon attention measures of ADHD patients and to map the resulting short and long-term changes within the brain.

Methods:

In this double-blind randomized controlled study, patients diagnosed as having adult ADHD receive 15 sessions ofhigh-frequency repetitive TMS using either deep,figure-8 or shamcoils over the right prefrontal cortex. Assessments of the anticipated change include behavioral measures and questionnaires, aswell as resting and evoked EEG responses including use of a stopsignal task for comparison of activity between the treatmentgroups.

Results:

Thepreliminary results indicate that the deep TMStreatment (n=10) induced an improvement in attention measures(p=0.007, CAARS) and response inhibition (p=0.014, SSRT) relativeto the sham (n=5) andfigure-8 (n=5) groups.

Conclusions:

This study’sinitial outcomes suggest that stimulation ofdeep areas in the right PFC has therapeutic potential for ADHDsymptoms through alteration of cognitive related brain circuits.The extent and potential mechanisms of these findings are currentlyinvestigated.

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