tDCS Device for ADHD: A Promising Non-Invasive Treatment for Attention Disorders

Introduction to tDCS Device for ADHD

ADHD is a prevalent neurodevelopmental disorder affecting millions globally, characterized by symptoms like inattention, hyperactivity, and impulsivity that affect both children[around 5-7% globally] and many continue to have symptoms into adulthood. 

It is characterised by symptoms of inattention, hyperactivity, and impulsivity. These symptoms can vary in severity and can significantly impact daily functioning, academic performance, and social interactions.

The common Symptoms of ADHD are:

1. Inattention:
   1. Difficulty sustaining attention in tasks or play activities
   2. Often does not follow through on instructions and fails to finish tasks
   3. Easily distracted by extraneous stimuli
2. Hyperactivity:
   1. Fidgets with hands or feet or squirms in seat
   2. Often runs about or climbs in situations where it is inappropriate
   3. Talks excessively
3. Impulsivity:
   1. Blurts out answers before questions have been completed
   2. Has difficulty waiting for their turn
   3. Interrupts or intrudes on others

Transcranial Direct Current Stimulation (tDCS) is a non-invasive brain stimulation (NIBS) technique that is being researched as a potential treatment for ADHD. Other NIBS techniques include Deep-Brain Stimulation (DBS). NIBS techniques serve as alternate mental health treatments.  tDCS involves applying a low electrical current to specific areas of the brain through electrodes placed on the scalp. This current is believed to modulate neuronal activity and potentially improve symptoms of ADHD.

It is important to note that tDCS is still under research and is not yet a mainstream treatment for ADHD. The effectiveness and safety of tDCS for ADHD are still being studied, and it is not widely available as a clinical treatment option. However, early research has shown promise, suggesting that tDCS could become a valuable tool in managing ADHD symptoms in the future.

This article focuses on the potential of tDCS devices in treating ADHD symptoms, providing an overview of how these devices work, the current research findings, and what the future may hold for this innovative treatment approach.

How Does tDCS Work for ADHD? Can It Improve Attention and Impulse Control?

tDCS devices are composed of a few key components that work together to deliver a gentle electrical current to the brain. Typically, a tDCS device uses two electrodes: an anode (positive electrode) and a cathode (negative electrode).

These electrodes are placed on the scalp, usually over specific brain regions that are targeted for stimulation. The placement of the electrodes depends on the area of the brain being treated and the symptoms being addressed.

The current generator, the core component of the tDCS device, produces a low and steady electrical current—typically between 1 and 2 milliamps—targeted at specific brain areas. This current is then delivered through the electrodes to the brain.

The basic operating principles of a tDCS device involve the application of a mild electrical current to modulate neuronal activity in the brain. The electrodes are carefully positioned on the scalp, ensuring they are over the target brain areas. For instance, in the case of ADHD, the electrodes might be placed over regions associated with attention and impulse control.

The current generator sends a low electrical current through the electrodes. This current flows from the anode to the cathode, passing through the scalp and the brain. The electrical current can either increase (anodal stimulation) or decrease (cathodal stimulation) the excitability of neurons in the targeted brain area. This modulation is believed to help normalise brain activity and improve symptoms associated with ADHD.

A typical tDCS session lasts about 20 to 30 minutes. The frequency and number of sessions can vary depending on the treatment protocol and individual response. By understanding the components and basic operating principles of tDCS devices, we can appreciate how this non-invasive technique has the potential to modulate brain activity and offer new hope for managing ADHD symptoms.

A more detailed explanation of the workings of tDCS can be found in our article here.

How does a tDCS Device Work for ADHD?

One of the primary theories behind its potential effectiveness is the idea that tDCS can increase neural activity in specific regions of the brain. ADHD is often associated with low activity in areas such as the prefrontal cortex, which is involved in attention, impulse control, and executive function.

By applying a low electrical current to these areas, tDCS is believed to enhance neuronal excitability, thereby improving cognitive functions and reducing ADHD symptoms (Rubia et al., 2014).

Another theory is related to neuroplasticity, the brain's ability to reorganise itself by forming new neural connections. tDCS may allow neuroplastic changes in the brain, helping to strengthen neural pathways that are underactive in individuals with ADHD. This process could lead to long-term improvements in attention and behaviour. Studies have suggested that repeated sessions of tDCS can induce lasting changes in brain function, supporting the idea of enhanced neuroplasticity.

It is important to note that research is still being conducted into how tDCS exactly affects ADHD. Given the evolving nature of this research, it is crucial for individuals considering tDCS for ADHD to consult a healthcare professional before starting treatment.

A doctor can provide personalised advice, assess the potential benefits and risks, and ensure that tDCS is used safely and appropriately. As with any emerging treatment, it is crucial to rely on the latest scientific evidence and professional guidance to make informed decisions.

Research on tDCS Devices for ADHD: Effectiveness and Success Rates

A study conducted in 2014 study by Rubia et al. explored the effects of tDCS on children with ADHD, showing a 15% improvement in attention. However, more extensive trials are needed to confirm its efficacy.

This double-blind, placebo-controlled trial involved 30 children aged 8 to 12 years. The results showed that children who received tDCS exhibited a 15% improvement in attention and a 20% reduction in hyperactivity and impulsivity compared to the control group. This study suggests that tDCS can have a significant positive impact on core ADHD symptoms.

In another study conducted in 2018, 52 participants with ADHD underwent five sessions of tDCS. A 2018 study demonstrated a 25% reduction in ADHD symptoms after five tDCS sessions, with effects lasting up to three months. These findings support the potential of tDCS as a long-term intervention for ADHD.

Ongoing clinical trials are further exploring the potential of tDCS for ADHD. In India, researchers are conducting trials to assess the effectiveness of tDCS in managing ADHD symptoms.

One such trial at the National Institute of Mental Health and Neurosciences (NIMHANS) in Bangalore aims to evaluate the impact of tDCS on cognitive functions and behavioural symptoms in children with ADHD. These trials are expected to provide more comprehensive data on the utility of tDCS in diverse populations.

Benefits of Using a tDCS Device for ADHD

Using a transcranial direct current stimulation device for ADHD offers several potential advantages over traditional treatments. Here are some key benefits:

1. Non-invasive: tDCS is a non-invasive technique, meaning it does not require surgery or penetration of the skin. This reduces the risk of infections and other complications associated with invasive procedures.
2. Potentially Fewer Side Effects: Traditional ADHD medications, such as stimulants, can cause side effects like insomnia, appetite loss, and increased heart rate. tDCS, on the other hand, has been shown to have minimal side effects, typically limited to mild skin irritation or tingling at the electrode site.
3. Possible At-Home Use: tDCS devices are portable, and under proper medical supervision, can be used at home, offering convenience for long-term ADHD management, making them suitable for at-home use under medical supervision. This can provide greater convenience and flexibility for individuals with ADHD and their caregivers.
4. Alternative for Non-Responders: Some individuals with ADHD do not respond well to traditional treatments, such as medications or behavioural therapy. tDCS may offer a valuable alternative for these individuals, providing another option for managing their symptoms.

The non-invasive nature, minimal side effects, potential for at-home use, and suitability for individuals who have not responded well to other treatments make tDCS a promising tool in the management of ADHD.

Safety Considerations: Side Effects, Risks, and Regulations in India

Using a tDCS device is generally considered safe, but it can still cause some side effects. Here are the common side effects associated with tDCS:

1. Tingling: A mild tingling sensation on the scalp where the electrodes are placed is one of the most frequently reported side effects.
2. Itching: Some users may experience itching at the electrode sites during or after the session.
3. Mild Discomfort:

Mild discomfort or a slight burning sensation at the electrode site can occur but usually subsides quickly.

4. Skin Redness: Temporary redness or irritation on the skin under the electrodes may appear, but typically resolves on its own.

You can read more about the side effects of neurostimulation devices.

Before using a tDCS device, it is crucial to consult with a healthcare professional. Here is why:

1. Personalised Advice: A healthcare professional can provide personalised advice based on the individual’s specific medical condition and history.
2. Assessment of Risks and Benefits: They can assess the potential risks and benefits of using tDCS for ADHD and determine if it is a suitable treatment option.
3. Proper Use and Supervision: Professional guidance ensures the device is used correctly and safely, reducing the risk of adverse effects and maximising the potential benefits.

4. Monitoring and Follow-Up: Ongoing monitoring and follow-up by a healthcare provider can help track progress and make necessary adjustments to the treatment plan.

More reasons to talk to a mental health professional can be found here.

By understanding the potential side effects and consulting with a healthcare professional, individuals can make informed decisions about using tDCS devices for ADHD. To prepare for a session with a psychologist, here are some questions you can read to have a better and more productive time.

There are a few common questions that you can ask your psychologist. These questions will help your mental health professional get a better understanding of your issue and be able to help you more effectively.

Who is a Candidate for Using a tDCS Device for ADHD?

Is tDCS the Right Treatment for ADHD? Who Can Benefit Most?

tDCS can be a good option for people with ADHD, especially those who are considered good candidates for this treatment. One key group includes individuals with treatment-resistant ADHD. These are people who have not responded well to traditional treatments, such as stimulant medications or behavioural therapies.

Research shows that a significant number of patients, up to 30% to 40%, may not get enough relief from their symptoms despite trying multiple treatments. For these individuals, tDCS may offer a promising alternative.

tDCS may also be suitable for those who have side effects from common ADHD medications. Many patients find it challenging to handle the side effects of stimulant drugs, such as trouble sleeping, anxiety, or loss of appetite. For these individuals, tDCS presents a non-invasive option that typically has fewer side effects, making it an appealing alternative.

However, it is crucial to talk to a healthcare professional to determine if tDCS is suitable for ADHD. A doctor can assess the individual's specific medical history, symptoms, and previous treatment responses. This personalised evaluation helps ensure that tDCS is a good option and that any potential risks are carefully considered.

While tDCS offers promising benefits for some individuals with ADHD, proper medical supervision is essential to make sure the treatment is effective and safe. By working closely with a healthcare provider, patients can make informed decisions about their treatment options and pursue the best strategies for managing their ADHD symptoms.

The tDCS Treatment Process for ADHD

Clinical tDCS Treatment

1. Preparation: Before a tDCS session, there are several steps involved to ensure the treatment is suitable and safe. First, an initial consultation with a healthcare professional is necessary to determine if tDCS is an appropriate treatment option. During this consultation, the doctor will discuss the patient's medical history, current symptoms, and previous treatments. This is followed by a screening process to check for any contraindications or medical conditions that might make tDCS unsuitable. Once the patient is deemed a good candidate for tDCS, the doctor will determine the optimal electrode placement based on the areas of the brain targeted for ADHD treatment.
2. Procedure: During a tDCS session, the procedure involves numerous key steps. Electrodes are placed on specific areas of the scalp, typically targeting the prefrontal cortex. A low electrical current, usually between 1-2 milliamps, is applied through these electrodes. Each session typically lasts 20–30 minutes. During the session, patients may experience mild sensations such as tingling, itching, or a slight burning sensation at the electrode sites.
3. Treatment Course: The number and frequency of tDCS sessions can vary, but treatment typically involves multiple sessions. Sessions may be scheduled daily or several times a week, with a typical course lasting 2–4 weeks. The exact treatment course will be determined by the healthcare professional based on the patient's response to the therapy and specific needs.

Using a tDCS Device at Home

1. Considerations: Using a tDCS device at home requires careful consideration of numerous important factors. First, it is essential to ensure that regulatory authorities approve the device for home use, which is allowed in India. Patients should be aware of the potential risks and limitations compared to receiving treatment in a clinical setting. Home use may offer a different level of precision and monitoring than clinical treatments, which can impact the effectiveness and safety of the therapy.
2. Instructions: When using a tDCS device at home, following the manufacturer's instructions is crucial. This includes ensuring proper electrode placement and adhering to the recommended current intensity and session duration. Patients should only use the device as frequently as recommended. Taking these safety precautions helps to minimise the risk of adverse effects and maximise the potential benefits of the treatment.

Disclaimer

The information provided about using a tDCS device for ADHD is for educational purposes only. It is essential to always consult with a healthcare professional before using a tDCS device at home. Professional guidance ensures that the treatment is used safely and effectively, tailored to the individual's specific medical condition and needs.

Cost of tDCS Treatment for ADHD in India

Clinical tDCS Treatment Costs

In India, clinical tDCS treatment for ADHD is conducted by healthcare professionals in specialised clinics. The cost per tDCS session generally ranges from ₹2,000 to ₹5,000 or more, depending on the location and the clinic's facilities.

Using a tDCS Device at Home

tDCS devices are legally available for home use in India. The price of these devices varies depending on the type and brand. Typically, home-use tDCS devices range from ₹50,000 to ₹80,000 or more, based on their features and quality. An affordable alternative is the 'ARC' device from Mave Health, which is designed to help individuals manage symptoms of mental health disorders such as depression without causing any side effects.

Alternatives and Comparisons

Several treatment options are available for ADHD, including:

1. Medications: Commonly prescribed medications include stimulants (such as methylphenidate and amphetamines) and non-stimulants (such as atomoxetine and guanfacine). These medications help manage symptoms by increasing attention and reducing hyperactivity and impulsivity. Know more about how to treat without medication for ADHD.
2. Behavioural Therapy: This type of therapy focuses on modifying negative behaviours and reinforcing positive behaviours through structured interventions. It often involves parents, teachers, and therapists working together to support the child.
3. Cognitive Behavioural Therapy (CBT): CBT is a form of psychotherapy that helps individuals identify and change negative thought patterns and behaviours. It is particularly effective for older children, adolescents, and adults with ADHD.

Comparing tDCS with Other Treatments

In summary, while traditional treatments like medications, behavioural therapy, and CBT are well-established and effective for many individuals with ADHD, tDCS offers a promising alternative, particularly for those who do not respond well to other treatments. Each treatment option has its own set of advantages and limitations, and the choice of treatment should be tailored to the individual's specific needs and circumstances.

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FAQ

What is ADHD?

ADHD, or Attention Deficit Hyperactivity Disorder, is a common neurodevelopmental disorder characterised by symptoms such as inattention, hyperactivity, and impulsivity.

What is tDCS, and how does it work for ADHD?

tDCS (transcranial direct current stimulation) is a non-invasive treatment that uses a low electrical current to stimulate specific areas of the brain. It aims to increase neural activity and promote neuroplasticity, potentially improving ADHD symptoms.

Who is a candidate for using a tDCS device for ADHD?

Suitable candidates include individuals with treatment-resistant ADHD or those who experience adverse side effects from traditional medications. Consulting with a healthcare professional is crucial to determine suitability.

What are the benefits of using a tDCS device for ADHD?

1. Non-invasive: tDCS is a non-invasive treatment.
2. Fewer Side Effects: Generally has fewer side effects compared to medications.
3. At-Home Use: This can be used at home with proper guidance.

What are the potential side effects and risks of tDCS?

Common side effects include tingling, itching, and mild discomfort at the electrode sites. These are usually temporary and resolve quickly.

What should I do before considering tDCS treatment for ADHD?

Consult with a healthcare professional to ensure tDCS is a suitable and safe treatment option for you. They can provide personalised guidance based on your medical history and symptoms.

Conclusion and Call to Action

Transcranial direct current stimulation (tDCS) presents a promising option for managing ADHD, particularly for those who have not responded well to traditional treatments like medications, behavioural therapy, and cognitive behavioural therapy (CBT). tDCS is generally well-tolerated, with mild side effects such as tingling or slight discomfort at the electrode sites. The non-invasive nature of tDCS and its potential for at-home use make it an appealing alternative. However, it is essential to approach tDCS with caution and seek professional medical advice to ensure its suitability and safe application. Before considering tDCS as a treatment for ADHD, it is crucial to consult with a healthcare professional. They can provide personalised guidance based on your specific medical history and symptoms, ensuring that tDCS is used safely and effectively. We encourage readers to share their own experiences with ADHD treatments or ask questions about tDCS. Your stories and inquiries can help others in similar situations and contribute to a broader understanding of ADHD management options. Stay informed and proactive in managing ADHD, and always seek the guidance of healthcare professionals to ensure the best possible outcomes.

References

• Wikipedia contributors. (2024, July 9). Transcranial direct-current stimulation. Wikipedia. https://en.wikipedia.org/wiki/Transcranial_direct-current_stimulation
• Mauche, N., Ulke, C., Huang, J., Franke, A., Bogatsch, H., Ethofer, T., Grimm, O., Frodl, T., Hoffmann, K., Juckel, G., Kittel-Schneider, S., Mehren, A., Philipsen, A., Plewnia, C., Reif, A., Ziegler, G. C., & Strauß, M. (2023b). Treatment of adult attention-deficit hyperactivity disorder (ADHD) with transcranial direct current stimulation (tDCS): study protocol for a parallel, randomized, double-blinded, sham-controlled, multicenter trial (Stim-ADHD). European Archives of Psychiatry and Clinical Neuroscience. https://doi.org/10.1007/s00406-023-01652-4
• Kneisel, K. (2022, August 3). In adult ADHD, Home-Based brain stimulation improved attention. MedPage Today. https://www.medpagetoday.com/psychiatry/adhd-add/100046
• Leffa, D. T., Grevet, E. H., Bau, C. H. D., Schneider, M., Ferrazza, C. P., Da Silva, R. F., Miranda, M. S., Picon, F., Teche, S. P., Sanches, P., Pereira, D., Rubia, K., Brunoni, A. R., Camprodon, J. A., Caumo, W., & Rohde, L. A. (2022). Transcranial Direct Current Stimulation vs Sham for the Treatment of Inattention in Adults With Attention-Deficit/Hyperactivity Disorder. JAMA Psychiatry, 79(9), 847. https://doi.org/10.1001/jamapsychiatry.2022.2055
• Salehinejad, M. A., Wischnewski, M., Nejati, V., Vicario, C. M., & Nitsche, M. A. (2019). Transcranial direct current stimulation in attention-deficit hyperactivity disorder: A meta-analysis of neuropsychological deficits. PloS One, 14(4), e0215095. https://doi.org/10.1371/journal.pone.0215095
• Home-Based tDCS Brain Stimulation Treatments Reduced Inattention in Adults with ADHD. (2023, August 11). Home-Based tDCS Brain Stimulation Treatments Reduced Inattention in Adults With ADHD | Brain & Behavior Research Foundation. https://bbrfoundation.org/content/home-based-tdcs-brain-stimulation-treatments-reduced-inattention-adults-adhd
• Salehinejad, M. A., Nejati, V., Mosayebi-Samani, M., Mohammadi, A., Wischnewski, M., Kuo, M., Avenanti, A., Vicario, C. M., & Nitsche, M. A. (2020b). Transcranial Direct Current Stimulation in ADHD: A systematic review of efficacy, safety, and protocol-induced electrical field modeling results. Neuroscience Bulletin/Neuroscience Bulletin, 36(10), 1191–1212. https://doi.org/10.1007/s12264-020-00501-x
• Shmerling, R. H., MD. (2023, March 3). Can electrical brain stimulation boost attention, memory, and more? Harvard Health. https://www.health.harvard.edu/blog/can-electrical-brain-stimulation-boost-attention-memory-and-more-202303032898
• Caputron. (2023, July 21). Findings on TDCS montages and ADHD. Caputron. https://caputron.com/blogs/news/findings-on-tdcs-montages-and-adhd
• Purpura, D. P., & McMurtry, J. G. (1965). Intracellular activities and evoked potential changes during polarization of motor cortex.Journal of neurophysiology, 28, 166–185. https://doi.org/10.1152/jn.1965.28.1.166
• Rubia, K., Alegria, A., & Brinson, H. (2014). Imaging the ADHD brain: disorder-specificity, medication effects and clinical translation. Expert review of neurotherapeutics, 14(5), 519–538. https://doi.org/10.1586/14737175.2014.907526
• Allenby, C., Falcone, M., Bernardo, L., Wileyto, E. P., Rostain, A., Ramsay, J. R., Lerman, C., & Loughead, J. (2018). Transcranial direct current brain stimulation decreases impulsivity in ADHD. Brain stimulation, 11(5), 974–981. https://doi.org/10.1016/j.brs.2018.04.016
• Vicario, C. M., & Nitsche, M. A. (2013). Non-invasive brain stimulation for the treatment of brain diseases in childhood and adolescence: state of the art, current limits and future challenges. Frontiers in Systems Neuroscience, 7. https://doi.org/10.3389/fnsys.2013.00094
• Faraone, S. V., & Wilens, T. E. (2007). Effect of stimulant medications for attention-deficit/hyperactivity disorder on later substance use and the potential for stimulant misuse, abuse, and diversion. The Journal of clinical psychiatry, 68 Suppl 11, 15–22.