A novel neurotherapy of transcranial direct current stimulation (tDCS) combined with cognitive training in ADHD children

Introduction: The frontline treatment for ADHD is psycho-stimulants, but these are not effective in ∼30% of patients, have side effects and limited long-term efficacy. An alternative treatment might be transcranial direct current stimulation (tDCS), which can lead to long-lasting gains in the function of targeted brain regions by potentiating neural plasticity; underpinned by dopamine and noradrenaline release, which is dysfunctional in ADHD. In ADHD, several small studies showed improved clinical and/or cognitive measures of inattention and inhibition with anodal-tDCS. However, these mainly targeted the dorsolateral prefrontal regions with single session stimulation. The right inferior frontal cortex (rIFC) might be a more optimal target since it is a hub for self-control and attention that is consistently underactive in ADHD and upregulated with psycho-stimulants. Further, multiple sessions paired with cognitive training can prolong tDCS effects for up to 12 months in healthy controls. We conducted the first study targeting the rIFC with multi-session tDCS combined with cognitive training in ADHD children.