Transcranial 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).

Fifty 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.

ADHD-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.

This 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.

经颅直流电刺激 (tDCS) 可能是注意力缺陷/多动障碍 (ADHD) 中精神兴奋剂的无副作用替代品。尽管关于临床和认知影响的证据有限，但大多数研究都是小型的、单次的并且刺激左背外侧前额叶皮层 (dlPFC)。没有假对照研究刺激右下额叶皮层 (rIFC)，这是 ADHD 中最持续功能不足的区域，多次阳极-tDCS 会议与认知训练 (CT) 相结合以增强效果。因此，我们在双盲、随机、假对照试验 (RCT, ISRCTN48265228) 中研究了多次阳极 tDCS 相对于 rIFC 联合 CT 的临床和认知效果。

50 名患有 ADHD 的男孩（10-18 岁）通过 rIFC 联合 CT（20 分钟，1 毫安）接受了 15 个工作日的阳极或假 tDCS 疗程。ANCOVA 根据基线测量值、年龄和用药状况进行调整，测试了治疗后和 6 个月后临床和 ADHD 相关执行功能的组间差异。

与阳极 tDCS 相比，假手术后 ADHD 评定量表、Conners ADHD 指数和不良反应显着降低。没有其他影响是显着的。

这项针对 ADHD 青春期男孩的 tDCS 的严格且最大的 RCT 发现，与 rIFC 联合 CT 相比，多次阳极 tDCS 后没有证据表明 ADHD 症状或认知能力有所改善。这些发现扩展了 1-5 次 tDCS 治疗主要针对左侧 dlPFC 后 ADHD 认知和临床影响的有限荟萃分析证据。鉴于 tDCS 在商业和临床上可用，这些发现很重要，因为它们表明 rIFC 刺激可能不适用于 ADHD 的认知或临床补救的神经疗法。