Brain Stimulation for Working Memory Deficits in Adolescents With ADHD

Summary

Working memory (WM) is the foundational cognitive control process of holding information 'in mind' to execute goal-directed behaviors. WM deficits are an established component of ADHD. Despite being one of the strongest predictors of poor clinical and functional outcomes in pediatric mental health, there remains a dearth of available treatments for WM deficits.

Non-invasive brain stimulation hold tremendous promise in transforming psychiatry, as it takes a "brain-first" approach to treatment. The dorsolateral prefrontal cortex (DLPFC) is the known structural foundation of WM, and the interaction between slow and fast brain waves (i.e., "theta-gamma coupling \[TGC\]") is a neural, functional foundation of WM. Thus, the DLPFC and TGC are potential brain-based targets for the modulation of WM with brain stimulation. Intermittent theta burst stimulation (iTBS) is a novel paradigm that applies a three-minute dose of stimulation to the DLPFC at an intensity that directly mimics TGC dynamics.

The objective of this study is to test whether iTBS can enhance dysfunctional brain activity that causes working memory deficits. iTBS will be tested compared to standard or traditional transcranial magnetic stimulation (TMS), called 10 Hz TMS. It will also be compared to sham or fake TMS. Each participant receives a single session of each of these types of TMS. EEG will record neural activity during a working memory test immediately before and after each TMS session. If this study shows TMS can enhance dysfunctional brain activity, the next step will be to conduct a clinical trial to test if TMS can lead to a sustained, positive effect on working memory deficits.

Conditions

• ADHD With Working Memory Deficits

Interventions

DEVICE

Magstim Super Rapid2 stimulator, 10 Hz condition

10 Hz (2,000 pulses) at left DLPFC

DEVICE

Magstim Super Rapid2 stimulator, Sham condition

sham

DEVICE

Magstim Super Rapid2 stimulator, iTBS condition

50 Hz, iTBS (600 pulses) at left DLPFC

Sponsors & Collaborators

• Thrasher Research Fund

  collaborator OTHER

• Rhode Island Foundation

  collaborator OTHER

• Bradley Hospital

  lead OTHER

Principal Investigators

• Brian Kavanaugh, PsyD · E. P. Bradley Hospital/Alpert Medical School of Brown University

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Model

CROSSOVER

Eligibility

Min Age

13 Years

Max Age

17 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2019-11-01

Primary Completion

2023-03-30

Completion

2023-03-30

FDA Device

Yes

Countries

• United States

Study Locations