Evidence map›Paper›PMID 34225830›Full record

Trial reportPsychological medicine2023

Transcranial direct current stimulation (tDCS) combined with cognitive training in adolescent boys with ADHD: a double-blind, randomised, sham-controlled trial.

Samuel J Westwood, Marion Criaud, Sheut-Ling Lam, Steve Lukito, Sophie Wallace-Hanlon, Olivia S Kowalczyk, Afroditi Kostara, Joseph Mathew, Deborah Agbedjro, Bruce E Wexler and 3 more

Registry-linked trialOpen access · hybridAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Psychological medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01876524 (Transcranial Random Noise Stimulation in Anterior Cingulate Cortex Reduces Craving Over Dual Pathology Patients), which is not on this map. Cited by 33 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
33citing papers in PubMed, 7 pooled it
5.3field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01876524 nacompletednot on this map

Transcranial Random Noise Stimulation in Anterior Cingulate Cortex Reduces Craving Over Dual Pathology Patients

TypeinterventionalSponsorSpanish Foundation for Neurometrics DevelopmentRan2013 to 2014Enrolled225ConditionsSubstance Use Disorder, Attention Deficit Disorder With Hyperactivity, Bipolar Disorder, SchizophreniaArmsTranscranial Random Noise Stimulation
3 · Its place in the literature

Who cites it

33 citing papers in PubMed, 7 syntheses or guidelines pooled it, 45 citations in OpenAlex.

  1. Pooled it
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  8. Trial
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  13. Review
  14. Article
  15. Research progress of tDCS in the treatment of ADHD.Journal of neural transmission (Vienna, Austria : 1996) · 2025
    Review
  16. Neuromodulation as a Potential Intervention for Children With Attention-Deficit/Hyperactivity Disorder.Journal of the Korean Academy of Child and Adolescent Psychiatry · 2025
    Article
  17. Article
  18. Article
  19. Attention-deficit/hyperactivity disorder.Nature reviews. Disease primers · 2024
    Review
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 4 institutions in 2 countries.

Samuel J WestwoodDepartment of Child & Adolescent Psychiatry, King's College London, London, UK.ORCID 0000-0002-0107-6651
Marion CriaudDepartment of Child & Adolescent Psychiatry, King's College London, London, UK.ORCID 0000-0002-9713-3568
Sheut-Ling LamDepartment of Child & Adolescent Psychiatry, King's College London, London, UK.ORCID 0000-0003-1065-561X
Steve LukitoDepartment of Child & Adolescent Psychiatry, King's College London, London, UK.ORCID 0000-0002-0616-5055
Sophie Wallace-HanlonSchool of Psychology, University of Surrey, Guildford, UK.ORCID 0000-0002-2920-2912
Olivia S KowalczykDepartment of Child & Adolescent Psychiatry, King's College London, London, UK.ORCID 0000-0002-6543-290X
Afroditi KostaraDepartment of Child & Adolescent Psychiatry, King's College London, London, UK.
Joseph MathewDepartment of Child & Adolescent Psychiatry, King's College London, London, UK.
Deborah AgbedjroDepartment of Biostatistics, King's College London, London, UK.ORCID 0000-0003-2240-253X
Bruce E WexlerDepartment of Psychiatry, Yale School of Medicine, New Haven, CT, USA.ORCID 0000-0002-9266-9099
Roi Cohen KadoshDepartment of Experimental Psychology, University of Oxford, Oxford, UK.ORCID 0000-0002-5564-5469
Philip AshersonSocial Genetic & Developmental Psychiatry, King's College London, London, UK.ORCID 0000-0003-2667-2254
Katya RubiaDepartment of Child & Adolescent Psychiatry, King's College London, London, UK.ORCID 0000-0002-1410-7701
King's College London · GBUniversity of Oxford · GBUniversity of Surrey · GBYale University · US

Funding

Department of HealthMedical Research Council MR/P012647/1
6 · The paper itself

Abstract

backgroundTranscranial direct current stimulation (tDCS) could be a side-effect-free alternative to psychostimulants in attention-deficit/hyperactivity disorder (ADHD). Although there is limited evidence for clinical and cognitive effects, most studies were small, single-session and stimulated left dorsolateral prefrontal cortex (dlPFC). No sham-controlled study has stimulated the right inferior frontal cortex (rIFC), which is the most consistently under-functioning region in ADHD, with multiple anodal-tDCS sessions combined with cognitive training (CT) to enhance effects. Thus, we investigated the clinical and cognitive effects of multi-session anodal-tDCS over rIFC combined with CT in double-blind, randomised, sham-controlled trial (RCT, ISRCTN48265228).

methodsFifty boys with ADHD (10-18 years) received 15 weekday sessions of anodal- or sham-tDCS over rIFC combined with CT (20 min, 1 mA). ANCOVA, adjusting for baseline measures, age and medication status, tested group differences in clinical and ADHD-relevant executive functions at posttreatment and after 6 months.

resultsADHD-Rating Scale, Conners ADHD Index and adverse effects were significantly lower at post-treatment after sham relative to anodal tDCS. No other effects were significant.

conclusionsThis rigorous and largest RCT of tDCS in adolescent boys with ADHD found no evidence of improved ADHD symptoms or cognitive performance following multi-session anodal tDCS over rIFC combined with CT. These findings extend limited meta-analytic evidence of cognitive and clinical effects in ADHD after 1-5 tDCS sessions over mainly left dlPFC. Given that tDCS is commercially and clinically available, the findings are important as they suggest that rIFC stimulation may not be indicated as a neurotherapy for cognitive or clinical remediation for ADHD.

Indexed as

Attention Deficit Disorder with HyperactivityTranscranial Direct Current StimulationAdolescentCognitive TrainingFrontal LobeHumansMalePrefrontal CortexADHDrandomised controlled trialtDCStreatment

Identifiers

PMID34225830
PMCPMC9899574
OpenAlexW3179286058

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.