Investigating the Effectiveness of Direct Anodal Electrical Stimulation in the Dorsolateral Prefrontal Cortex on the Cognitive Emotion Regulation in Adolescents with Attention-Deficit/Hyperactivity Disorder

Attention–deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by inappropriate levels of impulsive behavior, hyperactivity, and inattention. Cognitive regulation of emotion refers to regulation strategies and using cognitive strategies to manage emotional experiences, the ability to re–evaluate, and cognitive effort. Disturbance in emotion regulation continues for many people with ADHD until adulthood and can lead to the development of other psychiatric disorders. The treatments that have been used to manage emotion regulation problems in adolescents with ADHD have not been able to solve the problem of these people. The noninvasive technique of direct transcranial electrical stimulation (tDCS) of the brain has been studied very little for problems with cognitive regulation of emotion, and there are also few studies in adolescents with ADHD. Therefore, the effectiveness of direct electrical stimulation of the anode in the dorsolateral prefrontal cortex on the cognitive emotion regulation of adolescents with ADHD was investigated in this study.

This study was quasi–experimental with a pretest–posttest design with a control group. Among adolescents aged 14 to 18 years with symptoms of ADHD referred to psychiatric clinics in Kerman City, Iran, 30 eligible volunteers were included in the study in a simple random manner. Then, 15 were randomly assigned to the intervention group and 15 in the control group. The inclusion criteria for subjects to enter the research were as follows: having ADHD confirmed by a psychiatrist, having an age range of 14 to 18 years, and not using other treatment methods, such as behavioral therapy and drug therapy. The exclusion criteria were absence for more than one session from transcranial electrical stimulation of the brain and not completing the questionnaire during the study. The cognitive regulation of emotion was compared using the Cognitive Emotion Regulation Questionnaire (CERQ) (Garnefski & Kraaij, 2007) before and after treating anodic electrical stimulation. Data analysis was done using covariance analysis. The significance level of the tests was set at 0.05.

The results showed that the scores of the Cognitive Emotion Regulation Questionnaire scores in adolescents with ADHD in the intervention group and after receiving treatment increased significantly compared to the control group (p<0.001). The results related to the effect size determined that 58% of the difference between the intervention group and the control group in the variable of cognitive emotion regulation was caused by the implementation of brain anodal electrical stimulation.

According to the findings, 10 sessions of 20 minutes of 2–mA tDCS on the left dorsolateral prefrontal cortex significantly affected cognitive emotion regulation in patients with ADHD and can lead to improved cognitive emotion regulation in these patients.