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Modulating Cognition Using Transcranial Direct Current Stimulation of the Cerebellum
Published on: February 15, 2015
Transcranial Direct Current Stimulation to the Left Dorsolateral Prefrontal Cortex Improves Cognitive Control in
Laura Dubreuil-Vall1, Federico Gomez-Bernal2, Ana C Villegas2
1Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Department of Psychiatry and Clinical Psychobiology, Universitat de Barcelona, Barcelona, Spain; Neuroelectrics Corporation, Barcelona, Spain.
Insights
Transcranial direct current stimulation (tDCS) improved cognitive control in adults with ADHD by modulating brain activity. This study highlights tDCS as a potential biomarker for ADHD executive function and individualized treatment.
Area of Science:
- Neuroscience
- Psychiatry
- Cognitive Science
Background:
- Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder with significant morbidity.
- Existing ADHD therapies do not fully address critical dysexecutive deficits.
- There is a need for novel diagnostic and treatment biomarkers for ADHD.
Purpose of the Study:
- To investigate the cognitive and physiological effects of transcranial direct current stimulation (tDCS) in adult ADHD patients.
- To identify potential diagnostic and treatment biomarkers for ADHD using tDCS.
- To explore the mechanistic underpinnings of tDCS effects on cognitive control and impulsivity.
Main Methods:
- A randomized, sham-controlled, double-blind, crossover study involving 40 adult ADHD patients.
- Participants received 30 minutes of anodal tDCS targeting the left or right dorsolateral prefrontal cortex, or sham stimulation.
- Cognitive performance and neurophysiology (event-related potentials) were assessed using the Eriksen flanker task and the stop signal task.
Main Results:
- Anodal tDCS to the left dorsolateral prefrontal cortex significantly modulated cognitive (reaction time) and physiological (P300 amplitude) measures in the Eriksen flanker task.
- These effects were observed in a state-dependent manner, indicating a link between tDCS application and cognitive changes.
- No significant effects of tDCS were found on the stop signal reaction time, suggesting distinct neural substrates for different impulsivity constructs.
Conclusions:
- tDCS demonstrates procognitive effects in ADHD by modulating event-related potential signatures of cognitive control.
- Event-related potentials serve as valuable cross-sectional biomarkers for executive performance in ADHD.
- Findings support the state-dependent nature of tDCS and have implications for developing individualized ADHD therapeutics targeting specific cognitive deficits.
Background:
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder associated with significant morbidity and mortality that may affect over 5% of children and approximately 2.8% of adults worldwide. Pharmacological and behavioral therapies for ADHD exist, but critical symptoms such as dysexecutive deficits remain unaffected. In a randomized, sham-controlled, double-blind, crossover mechanistic study, we assessed the cognitive and physiological effects of transcranial direct current stimulation (tDCS) in 40 adult patients with ADHD in order to identify diagnostic (cross-sectional) and treatment biomarkers (targets).
Methods:
Patients performed three experimental sessions in which they received 30 minutes of 2 mA anodal tDCS targeting the left dorsolateral prefrontal cortex, 30 minutes of 2 mA anodal tDCS targeting the right dorsolateral prefrontal cortex, and 30 minutes of sham. Before and after each session, half the patients completed the Eriksen flanker task and the other half completed the stop signal task while we assessed behavior (reaction time, accuracy) and neurophysiology (event-related potentials).
Results:
Anodal tDCS to the left dorsolateral prefrontal cortex modulated cognitive (reaction time) and physiological (P300 amplitude) measures in the Eriksen flanker task in a state-dependent manner, but no effects were found in the stop signal reaction time of the stop signal task.
Conclusions:
These findings show procognitive effects in ADHD associated with the modulation of event-related potential signatures of cognitive control, linking target engagement with cognitive benefit, proving the value of event-related potentials as cross-sectional biomarkers of executive performance, and mechanistically supporting the state-dependent nature of tDCS. We interpret these results as an improvement in cognitive control but not action cancellation, supporting the existence of different impulsivity constructs with overlapping but distinct anatomical substrates, and highlighting the implications for the development of individualized therapeutics.
