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Transcranial Magnetic Stimulation (TMS) for Attention Deficit Hyperactivity Disorder (ADHD)


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Transcranial Magnetic Stimulation (TMS) for Attention Deficit Hyperactivity Disorder (ADHD)

Attention-deficit/hyperactivity disorder (ADHD) is a cognitive/behavioral developmental disorder characterized by patterns of hyperactivity (the need to constantly be moving), impulsivity, and difficulty paying attention. It is most often diagnosed during childhood and usually lasts through adolescence and into adulthood.(1)

ADHD is the most common behavioral disorder among children, affecting roughly 9.4% of children between the ages of 2 and 17 in the US, and affects 2.8% of adults worldwide.(2,3)

How Is ADHD Currently Treated?

The current standard treatment for ADHD is medication paired with behavioral treatment. In some cases, especially for young children, behavioral therapy is the first treatment step taken before medication.(4)

Behavioral therapy is a treatment method that helps someone identify harmful behaviors and teach them how to adopt healthy behaviors, instead. Behavioral therapy is also recommended for parents of children with ADHD, as it can help them develop constructive ways to respond to their children’s behavior.(5)

The types of medication used to treat ADHD are called stimulants. Stimulants work by increasing dopamine levels in the brain. Dopamine is a neurotransmitter (chemical messenger) that helps regulate attention, motivation, movement, and pleasure. However, while stimulants are proven to be effective in treating ADHD symptoms, as many as 30% of patients do not see relief from symptoms with medication.(6)

ADHD medication is also associated with possible side effects, including:(7)

  • Headaches
  • Difficulty sleeping
  • Loss of appetite
  • high blood pressure
  • Irritability or moodiness

Patients who don’t find relief from ADHD symptoms with medication, or those who are unable to handle the side effects, may be able to benefit from TMS therapy.(8)

TMS Therapy for ADHD

Are you a candidate for TMS?

How Does TMS Work?

Transcranial magnetic stimulation (TMS) is a non-invasive treatment that uses magnetic pulses, much like those used in magnetic resonance imaging (MRI) machines, to regulate areas of the brain associated with certain mood and behavioral disorders, such as depression, OCD, and ADHD.

How Does TMS Work for ADHD?

Research suggests that the symptoms of ADHD are associated with abnormalities in neural pathways (connection of neurons) in the prefrontal cortex (PFC), a region of the brain responsible for impulse control and attention. TMS therapy for ADHD targets and regulates brain activity in these areas, and early studies on TMS show positive results.(9,10) 

In a 2020 study, patients treated with three weeks of daily TMS therapy showed a significant reduction of ADHD symptoms.(11)

Safety and Side Effects of TMS for ADHD

Studies have found TMS to be a low-risk procedure for both children and adults with ADHD.(12,13)

The most common side effects of TMS are usually mild and include headache, scalp discomfort at the site of the treatment, and twitching of the face muscles. These symptoms tend to subside by the end of the first week of treatment. Patients who experience headaches or scalp discomfort can find relief using over-the-counter pain medication.(14)

Overall, the risk of side effects from TMS therapy is less than those associated with medication for ADHD.

Learn More about TMS Therapy for ADHD

If your child has been diagnosed with ADHD and you’d like to learn whether they are a candidate for TMS, contact us online or call (212) 731-2033. 


Resources:

1. Attention-Deficit / Hyperactivity Disorder (ADHD). Center for Disease Control and Prevention. Last reviewed September 23, 2021. https://www.cdc.gov/ncbddd/adhd/facts.html. Accessed June 16, 2022.

2. Data and Statistics About ADHD. Centers for Disease Control and Prevention. Publication Date Unkown. Updated September 23, 2021. https://www.cdc.gov/ncbddd/adhd/data.html#:~:text=Facts%20about%20ADHD&text=The%20estimated%20number%20of%20children,children%20aged%206%E2%80%9311%20years. Accessed June 16, 2022.

3. Fayyad, J., Sampson, N.A., Hwang, I. et al. The descriptive epidemiology of DSM-IV Adult ADHD in the World Health Organization World Mental Health Surveys. ADHD Atten Def Hyp Disord. 2017;9:47–65. https://link.springer.com/article/10.1007/s12402-016-0208-3. Accessed June 16, 2022.

4. Treatment of ADHD. Centers for Disease Control and Prevention. Publication Date Unknown. Updated September 23, 2021. https://www.cdc.gov/ncbddd/adhd/treatment.html. Accessed June 20, 2022.

5. Cognitive behavior therapy improves symptom control in adult ADHD. Massachusetts General Hospital. Published August 25, 2010. https://www.sciencedaily.com/releases/2010/08/100824161434.htm. Accessed June 20, 2022.

6. Memon AM. Transcranial Magnetic Stimulation in Treatment of Adolescent Attention Deficit/Hyperactivity Disorder: A Narrative Review of Literature. Innov Clin Neurosci. 2021;18(1-3):43-46. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8195561/. Accessed June 16, 2022.

7. ADHD Medicines. Kidshealth.org. Publication Date Unkown. Updated March 2018. https://kidshealth.org/en/teens/ritalin.html#:~:text=Like%20any%20medication%2C%20ADHD%20medicines,rate%2C%20and%20high%20blood%20pressure. Accessed June 20, 2022. 

8. Wong HC, Zaman R. Neurostimulation in Treating ADHD. Psychiatr Danub. 2019;31(Suppl 3):265-275. https://pubmed.ncbi.nlm.nih.gov/31488739/. Accessed June 16, 2022.

9. Rubia K, Alegría AA, Brinson H. Brain abnormalities in attention-deficit hyperactivity disorder: a review. Rev Neurol. 2014;58 Suppl 1:S3-S16. https://pubmed.ncbi.nlm.nih.gov/25252664/. Accessed June 22, 2022.

10. Patel RK, Saeed H, Mekala HM, et al. Transcranial magnetic stimulation for adolescents with ADHD. Prim Care Companion CNS Disord. 2021;23(3):20br02602. https://www.psychiatrist.com/pcc/neurodevelopmental/adhd/transcranial-magnetic-stimulation-adolescents-adhd/. Accessed June 16, 2022.

11. Alyagon U, Shahar H, Hadar A, Barnea-Ygael N, Lazarovits A, Shalev H, Zangen A. Alleviation of ADHD symptoms by non-invasive right prefrontal stimulation is correlated with EEG activity. Neuroimage Clin. 2020;26:102206. https://pubmed.ncbi.nlm.nih.gov/32062566/. Accessed June 20, 2022. 

12. Weaver L, Rostain AL, Mace W, Akhtar U, Moss E, O’Reardon JP. Transcranial magnetic stimulation (TMS) in the treatment of attention-deficit/hyperactivity disorder in adolescents and young adults: a pilot study. J ECT. 2012;28(2):98-103. https://pubmed.ncbi.nlm.nih.gov/22551775/. Accessed June 16, 2022.

13. Alyagon U, Shahar H, Hadar A, et al. Alleviation of ADHD symptoms by non-invasive right prefrontal stimulation is correlated with EEG activity. Neuroimage Clin. 2020;26:102206. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7021642/. Accessed June 16, 2022.

14. Rossi S, Hallett M, Rossini PM, Pascual-Leone A; Safety of TMS Consensus Group. Safety, ethical considerations, and application guidelines for the use of transcranial magnetic stimulation in clinical practice and research. Clin Neurophysiol. 2009;120(12):2008-2039. https://pubmed.ncbi.nlm.nih.gov/19833552/. Accessed June 20, 2022. 

Dr. Woo has been seeing patients in private practice since 2002, always with the goals of combining evidence-based medicine with psychodynamic psychotherapy and collaborating with other mental health professionals to ensure the best possible outcomes for his patients. He has been certified to administer TMS at his practice since 2017. His greatest clinical interests include helping patients suffering from depression, anxiety, and obsessive compulsive disorder.


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