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The Effects of Methylphenidate and Non-invasive Brain Stimulation on Inhibitory Control in Children With ADHD

Not Applicable
Completed
Conditions
Attention Deficit Hyperactivity Disorder
Interventions
Device: anodal tDCS
Device: sham tDCS
Registration Number
NCT04964427
Lead Sponsor
Bambino Gesù Hospital and Research Institute
Brief Summary

The aim of this study is comparing the effects of non-pharmacological intervention (transcranial Direct Current Stimulation, tDCS) with those of drug (methylphenidate, MPH) administration in children and adolescents with ADHD.

The investigators hypothesized that tDCS would improve inhibitory control and visuo-spatial working memory as well as MPH.

Detailed Description

A sham controlled within-subjects study design will be conducted. Clinical eligibility screening will be completed at baseline. All participants will undergo an extensive neuropsychiatric evaluation in which developmental neuropsychiatrists and psychologists will evaluate the cognitive and the adaptive level, the severity of ADHD symptoms, and the presence of comorbid psychiatric disorders. After completing baseline assessment (T0), participants will be exposure to 3 conditions with an intersession-interval of 24h (T1, T2, T3): A) a single administration of 1 milliampere (mA) anodal tDCS session over the dorsolateral prefrontal cortex (DLPFC); B) a single administration of 1 mA sham tDCS session over the DLPFC; C) a single administration of immediate release MPH (Ritalin®), in accordance with the National Institute for Clinical Excellence (NICE) guidelines for ADHD (NICE, 2000). The order of the conditions will be counterbalanced across participants. After recruitment, the participants will be assigned to one of the 6 possible combinations of conditions (ABC, ACB, BAC, BCA, CBA, or CAB). The assignment will be according to a randomization order generated by a computer. The randomization information will be maintained by an independent researcher until data collection is completed. Participants will be tested on inhibitory control, by the Stop Signal Task (SST) and on working memory, by the N-Back Task, at baseline (T0), during tDCS administration (after 10 minutes of anodal and sham conditions) and after 1 hour of MPH administration. To verify that carry-over effects will not occur, the SST and the N-Back Task will be performed before each session (T1, T2, T3) and results will be compared with those obtained at baseline (T0). If the participant will not return to baseline level, another evaluation will be administered at least after two hours and, again, until participant's performance will return to baseline. Participants and parents will be blinded to tDCS conditions allocation. The tDCS will be carried out with a BrainStim stimulator.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
26
Inclusion Criteria
  • Patients must receive a Diagnostic and Statistical Manual of Mental Disorders (DSM-5) oriented diagnosis of ADHD and need drug treatment for the severity of symptoms;
  • Intelligent Quotient (IQ) > 85;
Exclusion Criteria
  • Presence of Autism Spectrum Disorders;
  • Presence of Mood Disorders;
  • Previous/current diagnosis of neurological conditions (i.e. epilepsy, neurodegenerative diseases);
  • Presence of Genetic Syndromes;
  • Presence of basal medical conditions (i.e. heart, kidney or liver diseases) which may exclude the possibility to administer MPH.

Study & Design

Study Type
INTERVENTIONAL
Study Design
CROSSOVER
Arm && Interventions
GroupInterventionDescription
anodal tDCS- sham tDCS- MPHanodal tDCS(A) anodal tDCS at t1 (B) sham tDCS at t2 (C) MPH at t3
anodal tDCS- sham tDCS- MPHsham tDCS(A) anodal tDCS at t1 (B) sham tDCS at t2 (C) MPH at t3
anodal tDCS- MPH- sham tDCSanodal tDCS(A) anodal tDCS at t1 (C) MPH at t2 (B) sham tDCS at t3
anodal tDCS- MPH- sham tDCSsham tDCS(A) anodal tDCS at t1 (C) MPH at t2 (B) sham tDCS at t3
sham tDCS- MPH- anodal tDCSsham tDCS(B) sham tDCS at t1 (C) MPH at t2 (A) anodal tDCS at t3
sham tDCS- anodal tDCS- MPHanodal tDCS(B) sham tDCS at t1 (A) anodal tDCS at t2 (C) MPH at t3
sham tDCS- anodal tDCS- MPHsham tDCS(B) sham tDCS at t1 (A) anodal tDCS at t2 (C) MPH at t3
sham tDCS- MPH- anodal tDCSanodal tDCS(B) sham tDCS at t1 (C) MPH at t2 (A) anodal tDCS at t3
MPH- anodal tDCS- sham tDCSanodal tDCS(C) MPH at t1 (A) anodal tDCS at t2 (B) sham tDCS at t3
MPH- anodal tDCS- sham tDCSsham tDCS(C) MPH at t1 (A) anodal tDCS at t2 (B) sham tDCS at t3
MPH- sham tDCS- anodal tDCSanodal tDCS(C) MPH at t1 (B) sham tDCS at t2 (A) anodal tDCS at t3
MPH- sham tDCS- anodal tDCSsham tDCS(C) MPH at t1 (B) sham tDCS at t2 (A) anodal tDCS at t3
anodal tDCS- sham tDCS- MPHMethylphenidate(A) anodal tDCS at t1 (B) sham tDCS at t2 (C) MPH at t3
anodal tDCS- MPH- sham tDCSMethylphenidate(A) anodal tDCS at t1 (C) MPH at t2 (B) sham tDCS at t3
MPH- sham tDCS- anodal tDCSMethylphenidate(C) MPH at t1 (B) sham tDCS at t2 (A) anodal tDCS at t3
sham tDCS- anodal tDCS- MPHMethylphenidate(B) sham tDCS at t1 (A) anodal tDCS at t2 (C) MPH at t3
sham tDCS- MPH- anodal tDCSMethylphenidate(B) sham tDCS at t1 (C) MPH at t2 (A) anodal tDCS at t3
MPH- anodal tDCS- sham tDCSMethylphenidate(C) MPH at t1 (A) anodal tDCS at t2 (B) sham tDCS at t3
Primary Outcome Measures
NameTimeMethod
evaluate the change in response inhibition measuresimmediately after the interventions

Compare Stop Signal Reaction Times in patients with ADHD following the administration of a single anodal tDCS session, a single sham tDCS session and a single dose of MPH

Secondary Outcome Measures
NameTimeMethod
evaluate the change in visuo-spatial working memory measureimmediately after the interventions

Compare N-Back Correct Scores of visuo-spatial working memory task in patients with ADHD following the administration of a single anodal tDCS session, a single sham tDCS session and a single dose of MPH

evaluate the change in other response inhibition measuresimmediately after the interventions

Reaction Times and Variability of Reaction Times of SST in patients with ADHD following the administration of a single anodal tDCS session, a single sham tDCS session and a single dose of MPH

Trial Locations

Locations (1)

Bambino Gesù Hospital and Research Institute

🇮🇹

Roma, Italy

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