Randomised sham-controlled study of high-frequency bilateral deep transcranial magnetic stimulation (dTMS) to treat adult attention hyperactive disorder (ADHD): Negative results

Abstract

Objectives: Recent studies support the possible effectiveness of repetitive transcranial magnetic stimulation (rTMS) as a treatment for attention deficit hyperactivity disorder (ADHD). The objective of this study was to evaluate the safety and possible efficacy of bilateral prefrontal deep rTMS for the treatment of adult ADHD.

Methods: Twenty-six adult ADHD patients were randomised blindly to sham or actual deep TMS (dTMS). Twenty daily sessions were conducted using the bilateral H5 dTMS coil (Brainsway, IL) in order to stimulate the prefrontal cortex at 120% of the motor threshold at high frequency. For assessment, Conners' Adult ADHD Rating Scale questionnaire and a computerised continuous performance test, Test of Variables of Attention, were used.

Results: No differences in clinical outcomes were detected between the actual dTMS and sham groups.

Conclusions: The presented evidence does not support the utility of bilateral prefrontal stimulation to treat adult ADHD. Due to the small sample size, caution must be exercised in interpreting our preliminary findings.

Keywords:

• deep TMS
• ADHD
• transcranial magnetic stimulation
• bilateral stimulation
• adult attention deficit hyperactive disorder

Acknowledgements

The authors wish to acknowledge Brainsway, producer of the dTMS HBLPADD coil systems, who provided financial support for this study; Errikos-Chaim Ventouras for support in the planning of this study; Ms Eve Horowitz Leibowitz and Ms Judy Hann for their editorial assistance; Dr Friedwald for the clinical aspect of this study which was derived from her Child and Adolescent psychiatry thesis; and Mr Paz for the cognitive part of this study which was derived from his MA thesis in psychology at Tel Aviv University.

Disclosure statement

This study was supported by Brainsway (which produces the dTMS HBLPADD coil systems) who supplied the coil and supported its maintenance and the salary of the TMS technician. Professor Levkovitz and Professor Zangen have had financial interests in Brainsway, Inc.

Mr Paz, Dr Friedwald, Dr Alyagon, Dr Maoz, Dr Segev, Dr Nitzan, Ms Koubi and Dr Bloch do not have any conflicts of interest in the conduct or reporting of this research.

Additional information

Funding

This study was supported by Brainsway, which produces the dTMS HBLPADD coil systems.