Dakwar-Kawar Ornella, Berger Itai, Barzilay Snir, Grossman Ephraim S, Cohen Kadosh Roi, Nahum Mor
School of Occupational Therapy, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel.
Pediatric Neurology, Assuta-Ashdod University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel.
Front Hum Neurosci. 2022 Jul 27;16:791478. doi: 10.3389/fnhum.2022.791478. eCollection 2022.
Processing Speed (PS), the ability to perceive and react fast to stimuli in the environment, has been shown to be impaired in children with attention deficit hyperactivity disorder (ADHD). However, it is unclear whether PS can be improved following targeted treatments for ADHD. Here we examined potential changes in PS following application of transcranial electric stimulation (tES) combined with cognitive training (CT) in children with ADHD. Specifically, we examined changes in PS in the presence of different conditions of mental fatigue.
We used a randomized double-blind active-controlled crossover study of 19 unmedicated children with ADHD. Participants received either anodal transcranial direct current stimulation (tDCS) over the left dorsolateral prefrontal cortex (dlPFC) or transcranial random noise stimulation (tRNS), while completing CT, and the administration order was counterbalanced. PS was assessed before and after treatment using the MOXO-CPT, which measures PS in the presence of various conditions of mental fatigue and cognitive load.
tRNS combined with CT yielded larger improvements in PS compared to tDCS combined with CT, mainly under condition of increased mental fatigue. Further improvements in PS were also seen in a 1-week follow up testing.
This study provides initial support for the efficacy of tRNS combined with CT in improving PS in the presence of mental fatigue in pediatric ADHD.
处理速度（PS），即对环境中的刺激进行快速感知和反应的能力，已被证明在注意力缺陷多动障碍（ADHD）儿童中受损。然而，尚不清楚针对ADHD的靶向治疗后PS是否能得到改善。在此，我们研究了经颅电刺激（tES）联合认知训练（CT）应用于ADHD儿童后PS的潜在变化。具体而言，我们研究了在不同精神疲劳状态下PS的变化。
我们对19名未接受药物治疗的ADHD儿童进行了一项随机双盲主动对照交叉研究。参与者在完成CT时，接受左侧背外侧前额叶皮质（dlPFC）的阳极经颅直流电刺激（tDCS）或经颅随机噪声刺激（tRNS），给药顺序相互平衡。使用MOXO-CPT在治疗前后评估PS，该测试在各种精神疲劳和认知负荷状态下测量PS。
与tDCS联合CT相比，tRNS联合CT在PS改善方面效果更显著，主要是在精神疲劳增加的情况下。在1周后的随访测试中，PS也有进一步改善。
本研究为tRNS联合CT在改善小儿ADHD精神疲劳状态下的PS疗效提供了初步支持。
