Deep Transcranial Magnetic Stimulation Over the Right Prefrontal Cortex Improves ADHD Symptoms: A Combined TMS-EEG Study

Journal: Brain Stimulation 7:17-26 (2014)

Authors: H Shahar, U Alyagon, H Shalev, A Zangen

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 was designed 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 of high-frequency repetitive TMS using either deep,figure-8 or sham coils over the right prefrontal cortex. Assessments of the anticipated change include behavioral measures and questionnaires, as well as resting and evoked EEG responses including use of a stop signal task for comparison of activity between the treatment groups.

Results:

The preliminary results indicate that the deep TMS treatment (n=10) induced an improvement in attention measures(p=0.007, CAARS) and response inhibition (p=0.014, SSRT) relative to the sham (n=5) and figure-8 (n=5) groups.

Conclusions:

This study’s initial outcomes suggest that stimulation of deep areas in the right PFC has therapeutic potential for ADHD symptoms through alteration of cognitive related brain circuits.The extent and potential mechanisms of these findings are currently investigated.

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