rTMS and executive functioning training for working memory deficits in adolescent psychopathology
Brian Kavanaugh, PsyD
BACKGROUND: EF training utilizes learning principles to teach, train, and improve EF, although at times EF training results have been modest and inconsistent. Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive neuromodulation tool that can activate neural networks underlying EF and subsequently enhance EF performance. GAP: This will be the first study to target EF deficits in adolescents with a combined neuromodulation and cognitive training (i.e., rTMS + EF training) paradigm, which has been recommended by experts as the most promising approach to cognitive deficit remediation. HYPOTHESIS: The primary hypothesis is that the addition of rTMS to EF training will result in increased EF task performance and increased resting-state fronto-parietal gamma activity, with rTMS administered prior to EF training producing a stronger effect than rTMS administered after EF training. METHODS: The objective of this application is to conduct a randomized, sham-controlled pilot study to investigate the temporary EF-enhancing effect of rTMS (10 Hz at left DLPFC) to EF training. We will target a sample of 21 adolescents (age 13-17 years) with working memory deficits (based on performance-based and rater-based measures) across multiple traditional psychiatric diagnoses (e.g., major depressive disorder, attention deficit hyperactivity disorder). RESULTS: Pending. IMPACT: Treatment of cognitive deficits will fill a critical treatment gap and directly improve the long-term outcomes of these severely affected adolescents. If our research is successful, we expect that cognition-targeted neuromodulation treatments will become integrated into psychiatric care for the next generation of adolescents.