WP4: Phase-IIa randomized, double-blind, sham-controlled, parallel group trials on anodal tDCS over the prefrontal cortex on neuropsychological functions and clinical course in patients with ADHD
Work package 4 is led by PD Dr. Kerstin Krauel leader of the ADHD research group at the Department of Child and Adolescent Psychiatry and Psychotherapy of the OvGU.
The objectives of this work package are as follows:
- The overarching goal is to investigate whether tDCS is a safe, effective, and well tolerable tool that can be applied in children and adolescents suffering from ADHD.
- In two clinical studies, we will aim to identify the stimulation site of brain that is best suited to improve cognitive functions affected in ADHD.
- Moreover, we aim to determine individual factors that can predict the success of tDCS by using modern structural and functional imaging methods.
- Finally, we aim to apply tDCS in the home environment in children and adolescents with ADHD to develop recommendations for a tDCS home-treatment.
TDCS is already used in many different neurological and psychiatric conditions to treat associated cognitive deficits. Within work package 4, we will apply tDCS to children and adolescents suffering from ADHD. The success of tDCS in the treatment of psychiatric conditions depends on many factors such as the optimal electrode montage in regard to the targeted cognitive function or the number of sessions. In the first two clinical studies, we will use repeated stimulation over 10 sessions targeting two prominent cognitive deficits in ADHD, namely inhibitory control and working memory. In the first study, the left dorsolateral prefrontal cortex (dlPFC) will be stimulated to improve working memory performance (lead: PD Dr. Alexander Prehn-Kristensen, Zentrum für Integrative Psychiatry, Kiel Germany). The second study focusses on the right inferior frontal gyrus (rIFG) to enhance interference control (lead: PD Dr. Kerstin Krauel, Otto-von-Guericke-University Magdeburg, Germany). Safety aspects and tolerability will be monitored during all sessions as well as after four weeks. We aim to include 100 children and adolescents with ADHD within each study. Participants will be recruited at Coimbra (Portugal), Frankfurt (Germany), Kiel (Germany), and Magdeburg (Germany).
Current research suggests that not all individuals benefit equally from tDCS. In collaboration with other work packages, we aim to determine individual factors that can predict the success of tDCS. For this purpose, characteristics of the participants´ brain will be recorded using functional and structural imaging as well as neurophysiological methods. In cooperation with our STIPED partners, we will combine behavioural and imaging data to optimise the stimulation protocol.
Finally, we aim to develop a tDCS home-treatment approach to allow easier access to this treatment for families. Via a home-treatment device developed in work package 8, patients themselves and/or their parents will apply tDCS at home and will be supported by telemental methods. This study will help us to develop future-directed recommendations for a tDCS home-treatment as a new alternative treatment in ADHD (lead: Prof. Dr. Michael Siniatchkin, Christian-Albrechts-Universität zu Kiel; and Evangelisches Klinikum Bethel (EvKB), Bielefeld, Germany).