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What did the project achieve?
“The results of this project are likely to have immediate impact in the clinic treating children with ADHD. We showed that transcranial direct current stimulation (tDCS) of the right frontal part of the brain combined with a video game did not improve symptoms or thinking skills in children with ADHD,” says Professor Katya Rubia of King’s College London.
“These findings are important as tDCS is already offered as a treatment for ADHD in some clinics, despite the current lack of convincing evidence of its benefits. But these results mean that children with ADHD will not need to undergo this type of brain stimulation treatment, because there is no convincing evidence so far that it can improve the condition.”
Children with ADHD have a poor attention span, difficulties concentrating, restlessness and impulsive behaviour – symptoms that can seriously affect their lives at home and school. Although treatment with medication can be highly effective, it doesn’t work for everyone and can cause unwanted side effects.
The researchers recruited 50 children with ADHD onto a clinical trial to research the safety and effectiveness of tDCS of the right frontal part of the brain against a dummy form of electrical brain stimulation – while playing a specially designed video game. Each stimulation session lasted 20 minutes and was given 15 times over a three-week period. They then assessed the children’s ADHD symptoms and their performance on computer tests of self-control, attention and memory abilities immediately after completing the treatment and six months later.
“We found that both the children receiving tDCS and those receiving the dummy electrical brain stimulation showed improvements in their ADHD symptoms and performance on the computer tests,” says Professor Rubia. “But there were no differences between the two groups – except for a reduced improvement in the attention span of children who received tDCS, which did not persist six months later.”
The researchers also used a test called electroencephalography (EEG) to look for changes in the electrical brain activity during rest and during a thinking task in 26 study participants, finding no differences between the two groups.
“Our clinical trial is the largest ever study of tDCS in children with ADHD,” says Professor Rubia. “The implications from this research are that tDCS, in its current form, should not be recommended as a novel treatment for children with this condition.”
This research was completed on
Estimates suggest around one in 40 children in the UK has attention deficit hyperactivity disorder (ADHD).1 Children with ADHD tend to be hyperactive and impulsive, and have a short attention span, meaning they’re easily distracted. They can’t control this behaviour very well, which can seriously impact life at home and at school. Professor Katya Rubia, of King’s College London, is investigating the potential of a new, drug-free approach to treatment, which combines a specially designed video game with electrical brain stimulation. The need for a new treatment that offers long-term benefits for children with ADHD without causing side effects is high.
This project is funded by a generous donation from the Garfield Weston Foundation.
How are children’s lives affected now?
“Having ADHD can have serious consequences in life, affecting children’s concentration in the classroom, their academic performance and their relationships with parents, teachers and peers,” says Professor Rubia. Children with ADHD are prone to other problems too, including depression, anxiety and difficulties sleeping at night.
There's no cure for ADHD, but children can benefit from talking therapies and social skills training, along with educational support for their parents. If this doesn’t work well enough, or if children’s symptoms are severe, they are offered medication.
“Although medication is often highly effective in the short term, there is little evidence that it helps in the longer term and benefits are immediately lost if children stop taking their medication,” says Professor Rubia. “What’s more, medication can have side effects, it doesn’t work for everyone, it is disliked by many teenagers and the long-term effects on the developing brain are unknown. Safer and more effective drug-free treatments would be highly desirable.”
How could this research help?
The researchers are investigating whether a possible new, drug-free approach to treatment might benefit children with ADHD.
The treatment involves playing a specially designed video game while receiving what’s called transcranial direct current stimulation (tDCS). The video game is designed to help children to become less impulsive and more able to pay attention without being distracted. tDCS involves stimulating underactive areas of the brain with weak electric currents – using electrodes placed on the scalp – and the researchers are investigating whether it enhances the effects of the video game with a group of boys with ADHD.
“If our new approach to treatment, of combining video games and stimulation of the brain, shows promise, we will set up a larger clinical trial with more children, with the ultimate goal of giving children with ADHD a new drug-free treatment option,” adds Professor Rubia.
References
1. National Institute for Health and Care Excellence (NICE) Clinical Knowledge Summary. Attention deficit hyperactivity disorder. http://cks.nice.org.uk/attention-deficit-hyperactivity-disorder#!backgroundsub Website accessed 25 October 2015.
| Project Leader | Professor Katya E Rubia PhD |
| Project Team | Professor Anthony David MB ChB MSC MD MRCP MRCPsychProfessor Philip Asherson MBBS MRCPsych PhDProfessor Roi Cohen Kadosh PhD |
| Project Location | Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London |
| Project Location Other | Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College LondonSocial Genetic and Developmental Psychiatry MRC Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College LondonDepartment of Experimental Psychology, University of Oxford |
| Project duration | 3 years |
| Date awarded | 3 October 2016 |
| Project start date | 20 November 2017 |
| Project end date | 31 March 2021 |
| Grant amount | £199,999 |
| Grant code | GN2426 |
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