German Clinical Trials Register

Acronym/abbreviation of the study

No Entry

URL of the study

https://www.attention-projekt.de/

Brief summary in lay language

Attention Deficit Hyperactivity Disorder (ADHD) is characterized by inattention, hyperactivity, and impulsivity and leads to massive consequences. The regular treatment includes a combination of psychopharmacotherapy and psychotherapy whereas psychopharmacotherapy is usually more effective. Unfortunately, pharmacotherapeutic interventions need constant observations by medical doctors and are often followed by unwanted side effects. Additionally, research has shown that around 30% of ADHD patients are nonrespondent to pharmacotherapy. Therefore, alternative treatments for ADHD with better respondence and fewer side effects need to be assessed. Studies comparing the brain activity of ADHD patients (children and adults) with healthy controls identified specific differences in their brain activity. One main difference is reduced alpha-activity which can be a possible cause for attentional deficits. Therefore, we would like to investigate if non-invasive electrostimulation leads to increased alpha-activity as well as improved attention in ADHD patients. ADHD patients will execute an attention task (Continuous Performance Test, CPT) in a virtual reality paradigm while their alpha activity either gets stimulated or sham stimulated. Differences in attention with and without the alpha stimulation will be observed.

Brief summary in scientific language

Attention Deficit Hyperactivity Disorder (ADHD) is a frequent psychiatric disorder that is characterized by inattention, hyperactivity and impulsivity. It often leads to massive psychosocial and health economic consequences (Bachmann, Philipsen, & Hoffmann, 2017; Banaschewski et al., 2017). ADHD is usually treated by a combination of psychopharmacotherapy and psychotherapy, whereas psychopharmacotherapy is generally more effective (AWMF S3-Leitlinien, 2018). Unfortunately, pharmacotherapeutic interventions need constant observations by medical doctors and are often followed by unwanted side effects. Additionally, research has shown that around 30% of ADHD Patients are nonrespondent to pharmacotherapy (Cachoeira et al., 2017; Sotnikova et al., 2017). Therefore, alternative treatments with better compliance need to be assessed. Studies comparing the brain activity of ADHD patients (children and adults) with healthy controls identified specific differences in their brain activity. Main differences include a reduced alpha-activity, which can be a possible cause for attentional deficits (Loo et al., 2009; Woltering et al., 2012; Poil et al.,2014; Liu et al, 2016; Deiber et al., 2020). The alpha rhythm is an oscillating activity in the human brain with a frequency range of 8 to 13 Hz (Niedermeyer & Lopes da Silva, 2005) and is associated with basal cognitive functions and attention processes (Klimesch, 2012). Different studies showed, that an increase in alpha power via neurofeedback improves attention as well as clinical symptoms (Bazanova et al., 2018; Deiber et al., 2020). Therefore, we would like to investigate if non-invasive electrostimulation, more specifically through transcranial alternating current stimulation (tACS), leads to increased alpha-activity as well as improved attention in ADHD patients. TACS is a non-invasive method to stimulate brain activity that can modulate endogenous brain oscillations (Herrmann et al., 2013). Several studies showed that the alpha power increased after stimulating with the individual alpha frequency in healthy control groups (f.ex. Kasten, Dowsett & Herrmann, 2016) and had a positive impact on their performance (Kasten & Herrmann, 2017). The study aims to modulate the activity of alpha with a non-invasive tACS-stimulation in adult ADHD patients. A realistic environment is used to test the attention as ecologically valid as possible. Specifically, we would like to investigate to what extent a tACS-based neuromodulation of attention-associated oscillatory networks (especially alpha rhythm) leads to improvements in attention in ADHD patients. Subjects will do a continuous performance task (CPT) while being in a virtual reality paradigm. At the same time, the frequency of alpha will either be stimulated or sham stimulated. The conditions (stimulation vs. sham-stimulation) are blind to the subjects. Afterwards, performances on the CPT-task with and without the alpha stimulation will be compared to assess the effect of increased alpha activity on attention.