Comparison between conventional and HD-tDCS of the right inferior frontal gyrus in children and adolescents with ADHD

Carolin Breitling, Tino Zaehle, Moritz Dannhauer, Jana Tegelbeckers, Hans-Henning Flechtner, Kerstin Krauel, Carolin Breitling, Tino Zaehle, Moritz Dannhauer, Jana Tegelbeckers, Hans-Henning Flechtner, Kerstin Krauel

Abstract

Objective: To investigate whether the effects of HD-tDCS and conventional tDCS of the right IFG are superior to the effects of sham stimulation for the improvement of working memory performance in ADHD.

Methods: 15 ADHD patients between 10 and 16 years underwent three tDCS sessions in which conventional, HD and sham tDCS of the right IFG were applied. In all sessions a 2-back working memory task was solved and EEG was recorded. Baseline data were assessed from 15 age matched healthy controls.

Results: In ADHD patients, increased positive values of P300 and N200 mean amplitudes were found after conventional and HD-tDCS. Thus, both components were more in resemblance to ERPs in healthy controls. Behavioral performance was not generally influenced by tDCS but effects of HD-tDCS depended on individual hyperactive/impulsive symptom load. The rate of responders for HD-tDCS was equivalent to the responder rate for conventional tDCS.

Conclusions: ERP data indicate that HD-tDCS is equally suitable as conventional tDCS for the recruitment of the right IFG in the context of working memory processing.

Significance: HD-tDCS of the right IFG is a promising approach for neuromodulation in ADHD but further research is necessary to develop adaptations that produce reliable behavioral benefits.

Keywords: Attention deficit hyperactivity disorder (ADHD); High definition transcranial direct current stimulation (HD-tDCS); Right inferior frontal gyrus (IFG); Transcranial direct current stimulation (tDCS); Working memory; n-back task.

Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Copyright © 2020 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

Figures

Fig. 1.
Fig. 1.
Methods. (A) Schematic illustration of the modifiedn-back task, (B) Simulations of current flow for conventional and HD-tDCS.
Fig. 2.
Fig. 2.
Topographic distribution of ERP components. Topographic plots show a right lateralization of N200 (at 220 ms) and P300 (at 320 ms) components in ADHD patients (sham session) and controls during n-back target trials.
Fig. 3.
Fig. 3.
Interindividual variability. (A) Individual changes of working memory performance (WM) in response to conventional and HD-tDCS, positive values represent performance increase in tDCS conditions, numbers over the bars indicate if the verum tDCS condition was first or second to sham condition, numbers under the bars indicate individual patients with * specifying patients stimulated with reduced current intensities, (B) Number of patients that responded to stimulation for different montages, (C) Association between number of hyperactive ADHD symptoms and HD-tDCS induced working memory improvement.
Fig. 4.
Fig. 4.
ERP results. (A) Grand average ERPs at a right parietal ROI (P4, P8) for conventional, HD and sham tDCS in ADHD patients and healthy controls duringn-back target trials (B) with their 95% confidence intervals, (C) ERPs of individual ADHD patients for different experimental conditions.

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