Slow oscillating transcranial direct current stimulation during non-rapid eye movement sleep improves behavioral inhibition in attention-deficit/hyperactivity disorder
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BACKGROUND: Behavioral inhibition, which is a later-developing executive function (EF) and anatomically located in prefrontal areas, is impaired in attention-deficit and hyperactivity disorder (ADHD). While optimal EFs have been shown to depend on efficient sleep in healthy subjects, the impact of sleep problems, frequently reported in ADHD, remains elusive. Findings of macroscopic sleep changes in ADHD are inconsistent, but there is emerging evidence for distinct microscopic changes with a focus on prefrontal cortical regions and non-rapid eye movement (non-REM) slow-wave sleep. Recently, slow oscillations (SO) during non-REM sleep were found to be less functional and, as such, may be involved in sleep-dependent memory impairments in ADHD. OBJECTIVE: By augmenting slow-wave power through bilateral, slow oscillating transcranial direct current stimulation (so-tDCS, frequency = 0.75 Hz) during non-REM sleep, we aimed to improve daytime behavioral inhibition in children with ADHD. METHODS: Fourteen boys (10-14 years) diagnosed with ADHD were included. In a randomized, double-blind, cross-over design, patients received so-tDCS either in the first or in the second experimental sleep night. Inhibition control was assessed with a visuomotor go/no-go task. Intrinsic alertness was assessed with a simple stimulus response task. To control for visuomotor performance, motor memory was assessed with a finger sequence tapping task. RESULTS: SO-power was enhanced during early non-REM sleep, accompanied by slowed reaction times and decreased standard deviations of reaction times, in the go/no-go task after so-tDCS. In contrast, intrinsic alertness, and motor memory performance were not improved by so-tDCS. CONCLUSION: Since behavioral inhibition but not intrinsic alertness or motor memory was improved by so-tDCS, our results suggest that lateral prefrontal slow oscillations during sleep might play a specific role for executive functioning in ADHD.
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Cognitive improvements with so-tDCS were in declarative memory and faster reaction times and decreased intra-subject variability in a motor response inhibition Go/no-go task, while no effects were observed on inhibitory processes or on intrinsic alertness and motor memory.
“Cognitive improvements were in declarative memory (Prehn-Kristensen et al., 2014) and faster reaction times and decreased intra-subject variability in a motor response inhibition Go/no-go task, while no effects were observed on inhibitory processes or on intrinsic alertness and motor memory (Munz et al., 2015).”
From Cognitive Neuroscience of Attention Deficit Hyperactivity Disorder (ADHD) and Its Clinical Translation (2018) · cites this paper as Munz et al., 2015
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Experimental — accuracy not yet measuredSlow oscillatory power during deep sleep was increased with so-tDCS over lateral prefrontal cortex, indicating an enhancement of endogenous oscillatory activity.
“Slow oscillatory power during deep sleep was increased, indicating an enhancement of endogenous oscillatory activity with the intervention.”
From Cognitive Neuroscience of Attention Deficit Hyperactivity Disorder (ADHD) and Its Clinical Translation (2018) · cites this paper as Munz et al., 2015
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“…and decreased intra-subject variability in a Frontiers in Human Neuroscience | www.frontiersin.org 13 March 2018 | Volume 12 | Article 100 motor response inhibition Go/no-go task, while no effects were observed on inhibitory processes or on intrinsic alertness and motor memory (Munz et al., 2015).”
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“[72] since accuracy data for the experimental conditions are not reported in the manuscript, nor in any appendices.”
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- Authors
- Munz, M. T., Prehn-Kristensen, A., Thielking, F., Mölle, M., Göder, R., & Baving, L.
- Affiliations
- Christian-Albrechts-Universität zu Kiel (DE)
- University of Lübeck (DE)
- Corresponding author
- Munz, Manuel T.
- Venue
- Frontiers in Cellular Neuroscience
- Publisher
- Frontiers Media SA
- Published
- 2015-08-11
- Volume
- 9
- Pages
- 307-307
- ISSN
- 1662-5102 (ISSN-L)
- PMC
- PMC4531340
- OpenAlex
- W1492926077
- Cited by
- 95
- References
- 63
- Citations by year
- 2026: 5 · 2025: 8 · 2024: 11 · 2023: 8 · 2022: 5 · 2021: 16 · 2020: 8 · 2019: 10 · 2018: 8 · 2017: 6 · 2016: 10
- FWCI
- 4.19
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Frontiers in Cellular Neuroscience (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Deutsche Forschungsgemeinschaft (SFB654)
- Topics
- Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
- Keywords
- attention deficit hyperactivity disorder, slow oscillations, transcranial direct current stimulation, NREM sleep, slow-wave sleep, behavioral inhibition, executive function, prefrontal cortex, children, go/no-go task, motor memory
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