University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Cologne, Germany.
Section of Medical Psychology, Department of Psychiatry and Psychotherapy, Faculty of Medicine, University of Bonn, Bonn, Germany.
Brain Stimul. 2024 Jul-Aug;17(4):899-906. doi: 10.1016/j.brs.2024.07.018. Epub 2024 Jul 30.
Youth with attention-deficit/hyperactivity disorder (ADHD) exhibit increased effort aversion, likely due to deficits in anticipatory dopamine firing. Previous research has shown that transcranial direct current stimulation (tDCS) targeting the right prefrontal cortex can enhance activity in dopaminergic meso-striatal regions. However, the extent to which this specific tDCS configuration effectively modulates effort behavior in anticipation of rewards in ADHD remains uncertain.
We expected an increase of effort maintenance and invigoration during and following our tDCS set-up compared to sham in subjects with ADHD.
Twenty-four children and adolescents with ADHD (mean age: 11.6 years; 95 % CI [10.7, 12.4]) received 2 mA and sham tDCS for 20 min each. The anode was positioned over the ventromedial prefrontal cortex (PFC), while the cathode was placed over the right dorsolateral PFC, generating an electrical field with maximal strength in the right PFC. During and after the tDCS sessions, participants performed a button-pressing task aimed at earning delayed monetary rewards. Primary outcomes were effort maintenance (frequency of button presses) and invigoration (slopes of button presses), measuring motor task performance.
We observed a significant increase in effort maintenance both during (b = 2.66; p < 0.001) and after tDCS (b = 2.04; p= .007) compared to sham. No significant difference was found for invigoration during stimulation, while after bonferroni correction (p = 0.025) a non-significant decrease was found after tDCS compared to sham (b = -5.18; p = 0.041).
tDCS targeting the ventromedial PFC (anodal) and right dorsolateral PFC (cathodal) increases effort maintenance in children and adolescents with ADHD.
患有注意力缺陷/多动障碍 (ADHD) 的年轻人表现出更高的努力回避倾向，这可能是由于预期多巴胺发射的缺陷所致。先前的研究表明，针对前额叶皮层的经颅直流电刺激 (tDCS) 可以增强多巴胺能中脑-纹状体区域的活动。然而，这种特定的 tDCS 配置在多大程度上有效地调节 ADHD 患者对奖励的预期中的努力行为仍不确定。
我们预计与假刺激相比，ADHD 患者在 tDCS 设置期间和之后的努力维持和激发会增加。
24 名患有 ADHD 的儿童和青少年（平均年龄：11.6 岁；95%置信区间 [10.7, 12.4]）接受了 2 mA 和假 tDCS，每次 20 分钟。阳极置于腹侧前额叶皮层 (PFC)，阴极置于右侧背外侧 PFC，在右侧 PFC 产生最大强度的电场。在 tDCS 期间和之后，参与者执行了一项按钮按压任务，旨在赚取延迟的金钱奖励。主要结果是努力维持（按钮按压的频率）和激发（按钮按压的斜率），测量运动任务表现。
与假刺激相比，我们观察到在 tDCS 期间（b=2.66；p<0.001）和之后（b=2.04；p=0.007）努力维持显著增加。在刺激期间未发现激发的显著差异，而在 Bonferroni 校正后（p=0.025），与假刺激相比，tDCS 后发现激发显著降低（b=-5.18；p=0.041）。
针对腹侧前额叶皮层（阳极）和右侧背外侧前额叶皮层（阴极）的 tDCS 增加了 ADHD 儿童和青少年的努力维持。
