The Boston Globe’s weekly Ocean State Innovators column features a Q&A with Rhode Island innovators who are starting new businesses and nonprofits, conducting groundbreaking research, and reshaping the state’s economy. Send tips and suggestions to reporter Alexa Gagosz at alexa.gagosz@globe.com.
Researchers at Bradley Hospital are recruiting teenagers that were previously diagnosed with attention-deficit/ hyperactivity disorder, or better known as ADHD, to investigate whether magnetic brain stimulation can change dysfunctional brain dynamics and subsequently improve ADHD clinical symptoms in teenagers.
According to the Centers for Disease Control and Prevention, ADHD is one of the most common neuro-developmental disorders in children, which can also last into adulthood. Those diagnosed with the disorder have trouble focusing, sometimes have controlling impulsive behaviors, and can be overly active.
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And it affects millions of children each year.
Pediatric neuropsychologist Dr. Brian Kavanaugh, who is the lead researcher on the study, said he hopes it could help develop a brain-based treatment for ADHD.
“We have treatments for ADHD and they work really well for a lot of people, but they don’t work for everyone,” said Kavanaugh in a recent interview. “One trend that we’re seeing in psychiatry is moving away from our current treatments that focus on the symptoms. Now we are moving toward developing brain-based approaches that instead, focus on the origin or cause.”
Q: What are you testing in this study?
Kavanaugh: We’re testing whether a new type of brain stimulation can change the dysfunctional brain circuitry and test whether it can actually improve symptoms of ADHD in kids. This is one of the many attempts to develop the treatment that actually focuses on changing brain dynamics to have an improved symptom presentation and symptom response.
Q: How does this brain-based treatment work?
Kavanaugh: TMS, or transcranial magnetic stimulation, has been around since the mid-1980s. It’s a clinical treatment for adult depression [since 2008] and it became OCD approved for adults in 2018 and became approved for smoking in adults since 2020. It’s non-invasive and the coil is the size of a textbook, which rests on the part of the head where you’ll be stimulating. It’s attached to, essentially, a large computer. There’s two magnets that are rotating back and forth and creates an electric current, which can travel through the skull a few centimeters to the upper layers of the cortex and depolarize or activate brain activate there.
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When the kids get their dose, it sends pulse into the brain for about three minutes while they’re sitting in a Lazy-Boy style chair. Everyone gets an MRI beforehand, and we can target specific sections of the brain.
Q: How long does it take to see improvement?
Kavanaugh: We don’t know yet. In depression, they’ve found that brain changes can occur after a few weeks of daily stimulation. So one session won’t really cause the lasting effect. But for this study, we’re doing two weeks of daily stimulation. Everyday, they come in and get their three minutes. In some studies, it’s shown to have a therapeutic effect on people. But we’re still exploring, and we’re going to be measuring brain activity intermittently after every so often so we can track and plot the brain activity’s improvement. We want to know if there’s an optimal dose or if it’s linear (as you get more doses, you get better).
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Q: How many teens are you recruiting, and who is eligible?
Kavanaugh: We are stopping at about 25 teens who have ADHD who continue to be affected by their symptoms. It’s a small cohort, and they are 13 to 17 years old.
Q: Why only 25 teens, and can those 25 still be doing their regular treatments for ADHD?
Kavanaugh: It’s part funding, but its participation is pretty intensive and requires 24 visits. It will also be a randomized treatment, so for half the time, they will have the treatment and for the second half, they won’t. But all the participants will get the treatment at some point.
And yes, we just ask that patients maintain stability in their treatments and to check with their psychiatrist to make sure that we can keep this same dose and medication they are on for a few weeks.
Q: Are there any risks?
Kavanaugh: What we know, is that TMS is further along for teenage depression that it is in teenage ADHD. Hundreds of kids have gone through clinical trials for using this to help teenage depression and we know it’s safe. And preliminary research in teens with ADHD show that this is also safe for them.
Alexa Gagosz can be reached at alexa.gagosz@globe.com. Follow her @alexagagosz and on Instagram @AlexaGagosz.