Transcranial Direct Current Stimulation to the Left Dorsolateral Prefrontal Cortex Improves Cognitive Control in Patients With Attention-Deficit/Hyperactivity Disorder: A Randomized Behavioral and Neurophysiological Study.
Transcranial Direct Current Stimulation to the Left Dorsolateral Prefrontal Cortex Improves Cognitive Control in Patients With Attention-Deficit/Hyperactivity Disorder: A Randomized Behavioral and Neurophysiological Study.
复制标题
经颅直流电刺激左背外侧前额叶皮质改善注意缺陷多动障碍患者的认知控制：一项随机行为和神经生理学研究。
DOI：
10.1016/j.bpsc.2020.11.006
复制
发表时间：
2021-04
期刊：
影响因子：
--
通讯作者：
Camprodon JA
中科院分区：
文献类型：
--
作者：
Dubreuil-Vall L;Gomez-Bernal F;Villegas AC;Cirillo P;Surman C;Ruffini G;Widge AS;Camprodon JA
注意力缺陷/多动障碍 (ADHD) 是一种与显着发病率和死亡率相关的神经发育障碍，可能影响全球超过 5% 的儿童和约 2.8% 的成人。针对多动症的药物和行为疗法是存在的，但执行障碍等关键症状仍然不受影响。在一项随机、假对照、双盲、交叉机制研究中，我们评估了 40 名成年 ADHD 患者经颅直流电刺激 (tDCS) 的认知和生理效应，以确定诊断（横断面）和治疗生物标志物（目标）。患者进行了三个实验，其中接受针对左背外侧前额叶皮层的 30 分钟 2 mA 阳极 tDCS、针对右背外侧前额叶皮层的 30 分钟 2 mA 阳极 tDCS 以及 30 分钟的假手术。每次治疗前后，一半患者完成埃里克森侧翼任务，另一半完成停止信号任务，同时我们评估行为（反应时间、准确性）和神经生理学（事件相关电位）。左背外侧前额叶皮层的阳极 tDCS 以状态依赖的方式调节 Eriksen 侧翼任务中的认知（反应时间）和生理（P300 幅度）测量，但在停止信号任务的停止信号反应时间中没有发现影响。这些发现表明，ADHD 中的前认知效应与认知控制的事件相关电位信号的调节相关，将目标参与与认知益处联系起来，证明了事件相关电位作为执行绩效的横截面生物标志物的价值，并从机制上支持 tDCS 的状态依赖性质。我们将这些结果解释为认知控制的改善，而不是行动的取消，支持具有重叠但不同的解剖学基础的不同冲动结构的存在，并强调了对个体化治疗的发展的影响。
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder associated with significant morbidity and mortality that may affect over 5% of children and approximately 2.8% of adults worldwide. Pharmacological and behavioral therapies for ADHD exist, but critical symptoms such as dysexecutive deficits remain unaffected. In a randomized, sham-controlled, double-blind, crossover mechanistic study, we assessed the cognitive and physiological effects of transcranial direct current stimulation (tDCS) in 40 adult patients with ADHD in order to identify diagnostic (cross-sectional) and treatment biomarkers (targets). Patients performed three experimental sessions in which they received 30 minutes of 2 mA anodal tDCS targeting the left dorsolateral prefrontal cortex, 30 minutes of 2 mA anodal tDCS targeting the right dorsolateral prefrontal cortex, and 30 minutes of sham. Before and after each session, half the patients completed the Eriksen flanker task and the other half completed the stop signal task while we assessed behavior (reaction time, accuracy) and neurophysiology (event-related potentials). Anodal tDCS to the left dorsolateral prefrontal cortex modulated cognitive (reaction time) and physiological (P300 amplitude) measures in the Eriksen flanker task in a state-dependent manner, but no effects were found in the stop signal reaction time of the stop signal task. These findings show procognitive effects in ADHD associated with the modulation of event-related potential signatures of cognitive control, linking target engagement with cognitive benefit, proving the value of event-related potentials as cross-sectional biomarkers of executive performance, and mechanistically supporting the state-dependent nature of tDCS. We interpret these results as an improvement in cognitive control but not action cancellation, supporting the existence of different impulsivity constructs with overlapping but distinct anatomical substrates, and highlighting the implications for the development of individualized therapeutics.
登录
查看更多内容
影响因子：
7.7
作者：
Brunoni, Andre Russowsky;Nitsche, Michael A.;Bolognini, Nadia;Bikson, Marom;Wagner, Tim;Merabet, Lotfi;Edwards, Dylan J.;Valero-Cabre, Antoni;Rotenberg, Alexander;Pascual-Leone, Alvaro;Ferrucci, Roberta;Priori, Alberto;Boggio, Paulo Sergio;Fregni, Felipe
通讯作者：
Fregni, Felipe
影响因子：
3.7
作者：
Danielmeier, Claudia;Wessel, Jan R.;Ullsperger, Markus
通讯作者：
Ullsperger, Markus
影响因子：
3.7
作者：
Cunillera T;Fuentemilla L;Brignani D;Cucurell D;Miniussi C
通讯作者：
Miniussi C
影响因子：
5.6
作者：
Biederman, Joseph;Mick, Eric;Faraone, Stephen V.
通讯作者：
Faraone, Stephen V.
影响因子：
17.7
作者：
Biederman, Joseph;Petty, Carter;Faraone, Stephen V.
通讯作者：
Faraone, Stephen V.