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Researchers at Bradley Hospital are recruiting adolescents who have previously been diagnosed with Attention Deficit Hyperactivity Disorder, or better known as ADHD, to determine whether magnetic brain stimulation can alter dysfunctional brain dynamics and by subsequently improve clinical symptoms of ADHD in adolescents.
ADHD is one of the most common neurodevelopmental disorders in children, which can also last into adulthood, according to the Centers for Disease Control and Prevention. People diagnosed with the disorder have trouble concentrating, sometimes have impulsive controlling behaviors, and may be overly active.
And it affects millions of children every year.
Pediatric neuropsychologist Dr Brian Kavanaugh, who is the study’s lead investigator, said he hopes it may help develop a brain-based treatment for ADHD.
âWe have treatments for ADHD and they work great for a lot of people, but they don’t work for everyone,â Kavanaugh said in a recent interview. âOne trend we’re seeing in psychiatry is moving away from our current treatments that focus on symptoms. Now we are moving towards developing brain-based approaches that instead focus on the origin or cause. “
Q: What are you testing in this study?
Kavanaugh: We are testing whether a new type of brain stimulation can alter dysfunctional brain circuitry and whether it can actually improve ADHD symptoms in children. This is one of many attempts to develop the treatment that actually focuses on changing brain dynamics to improve symptom presentation and response.
Q: How does this brain-based treatment work?
Kavanaugh: TMS, or transcranial magnetic stimulation, has been around since the mid-1980s. It is a clinical treatment for depression in adults. [since 2008] and it became approved for adult OCD in 2018 and became approved for smoking in adults since 2020. It is non-invasive and the coil is the size of a manual, which sits on the part of the head where you will stimulate . It’s basically hooked up to a big computer. There are two magnets that spin back and forth and create an electric current, which can travel through the skull a few inches to the upper layers of the cortex and depolarize or activate the brain that is active there.
When children get their dose, it sends a pulse to the brain for about three minutes while they are seated in a Lazy-Boy style chair. Everyone has an MRI first and we can target specific sections of the brain.
Q: How long does it take to see improvement?
Kavanaugh: We do not know yet. In depression, they discovered that brain changes can occur after a few weeks of daily stimulation. So a single session will not really cause a lasting effect. But for this study, we’re doing two weeks of daily stimulation. Every day they come in and get their three minutes. In some studies, it has been shown to have a therapeutic effect on people. But we’re still exploring, and we’ll be measuring brain activity intermittently afterwards from time to time so that we can track and chart the improvement in brain activity. We want to know if there is an optimal dose or if it is linear (the more doses you get, the more you get better).
Q: How many teens are you recruiting and who is eligible?
Kavanaugh: We stop at about 25 adolescents with ADHD who continue to be affected by their symptoms. It’s a small cohort, and they’re 13 to 17 years old.
Q: Why only 25 teens, and those 25 teens can still follow their usual treatments for ADHD?
Kavanaugh: This is partial funding, but its participation is quite intensive and requires 24 visits. It will also be a randomized treatment, so for half the time they will have the treatment and for the second half they will not. But all participants will receive the treatment at some point.
And yes, we are just asking patients to maintain stability in their treatments and to check with their psychiatrist to make sure that we can keep that same dose and the same drugs that they are taking for a few weeks.
Q: Are there any risks?
Kavanaugh: What we do know is that TMS is more advanced for adolescent depression than for adolescent ADHD. Hundreds of children have been in clinical trials to use it to help depression in adolescents and we know it’s safe. And preliminary research in teens with ADHD shows it’s safe for them, too.