Baseline brain volume predicts home-based transcranial direct current stimulation effects on inattention in adults with attention-deficit/ hyperactivity disorder

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da Silva, Pedro Henrique Rodrigues ; Leffa, Douglas T. ; Luethi, Matthias S. ; Silva, Roberta F. ; Ferrazza, Carolina Prietto ; Picon, Felipe Almeida ; Grevet, Eugenio Horacio ; Bau, Claiton Henrique Dotto ; Rovaris, Diego Luiz ; Razza, Lais B. ; Caumo, Wolnei ; Camprodon, Joan A. ; Rohde, Luis Augusto Paim ; Brunoni, Andre R.

• Document type: Journal article
• Source: JOURNAL OF PSYCHIATRIC RESEARCH; v. 177, p. 9-pg., 2024-07-31.

Abstract

Background: Home-based transcranial direct current stimulation (Hb-tDCS) is a non-invasive brain stimulation technique that utilizes low-intensity electric currents delivered via scalp electrodes to modulate brain activity. It holds significant promise for addressing inattention in adults with attention-deficit/hyperactivity disorder (ADHD). However, its effectiveness varies among individuals, and predicting outcomes remains uncertain, partially due to the influence of individual differences in ADHD-related brain anatomy. Methods: We analyzed data from a subsample, composed by twenty-nine adult patients with ADHD, of the Treatment of Inattention Symptoms in Adult Patients with ADHD (TUNED) trial. Fourteen patients underwent active anodal right cathodal left dorsolateral prefrontal cortex (DLPFC) Hb-tDCS for 4 weeks and fifteen received sham-related tDCS intervention. Inattention outcome was evaluated at both baseline and endpoint (4th week). Baseline structural measures of the DLPFC, anterior cingulate cortex (ACC) and subcortical structures, previously associated with ADHD, were quantified. Several linear mixed models, with a three-way interaction between the fixed predictors brain volume or thickness, time, and treatment were calculated. Multiple comparison corrections were applied using the Benjamini-Hochberg method. Results: Baseline volume of the left DLPFC regions middle frontal gyrus (t (25) = 3.33, p-adjusted = 0.045, Cohen's d = 1.33, 95% CI = [0.45, 2.19]), inferior frontal gyrus (orbital part) (t (25) = 3.10, p-adjusted = 0.045, Cohen's d = 1.24, 95% CI = [0.37, 2.08]), and of the left ACC supragenual (t (25) = 3.15, p-adjusted = 0.045, Cohen's d = 1.26, 95% CI = [0.39, 2.11]) presented significant association with the inattentive score improvement only in the active tDCS group. More specifically, the smaller these regions were, the more the symptoms improved following anodal right cathodal left DLPFC Hb-tDCS. Conclusion: Hb-tDCS was associated with greater improvement in brain areas related to attention regulation. Brain MRI can be potentially used to predict clinical response to tDCS in ADHD adults. (AU)

• FAPESP's process: 21/10574-0 - Prognostic enhancement in depressed patients on different non-implantable neuromodulation interventions
• Grantee: Matthias Stephan Luthi
• Support Opportunities: Scholarships in Brazil - Post-Doctoral
• FAPESP's process: 19/06009-6 - Non-implantable neuromodulation therapies: a perspective for the depressed brain
• Grantee: Geraldo Busatto Filho
• Support Opportunities: Research Projects - Thematic Grants
• FAPESP's process: 22/03266-0 - Investigation of neuroimaging assessments and current flow modeling as target engagement and predictor biomarkers of convulsive therapies
• Grantee: Pedro Henrique Rodrigues da Silva
• Support Opportunities: Scholarships in Brazil - Post-Doctoral
• FAPESP's process: 18/10861-7 - A Phase-I bilateral project using a sham-controlled, factorial design of transcranial direct current stimulation and theta-burst stimulation to investigate the effects on multimodal assessments of prefrontal cortex functioning
• Grantee: Andre Russowsky Brunoni
• Support Opportunities: Regular Research Grants