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Here, we examined whether a novel form of stimulation, high-frequency transcranial random noise stimulation (tRNS), applied with cognitive training (CT), may impact symptoms and neural oscillations in children with ADHD. We conducted a randomized, double-blind, sham-controlled trial in 23 unmedicated children with ADHD, who received either tRNS over the right inferior frontal gyrus (rIFG) and left dorsolateral prefrontal cortex (lDLPFC) or sham stimulation for 2 weeks, combined with CT. tRNS + CT yielded significant clinical improvements (reduced parent-reported ADHD rating-scale scores) following treatment, compared to the control intervention. These improvements did not change significantly at a 3-week follow-up. Moreover, resting state (RS)-EEG periodic beta bandwidth of the extracted peaks was reduced in the experimental compared to control group immediately following treatment, with further reduction at follow-up. A lower aperiodic exponent, which reflects a higher cortical excitation\/inhibition (E\/I) balance and has been related to cognitive improvement, was seen in the experimental compared to control group. This replicates previous tRNS findings in adults without ADHD but was significant only when using a directional hypothesis. The experimental group further exhibited longer sleep onset latencies and more wake-up times following treatment compared to the control group. No significant group differences were seen in executive functions, nor in reported adverse events. We conclude that tRNS + CT has a lasting clinical effect on ADHD symptoms and on beta activity. These results provide a preliminary direction towards a novel intervention in pediatric ADHD.<\/jats:p>","DOI":"10.1038\/s41398-023-02547-7","type":"journal-article","created":{"date-parts":[[2023,8,1]],"date-time":"2023-08-01T21:02:11Z","timestamp":1690923731000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Transcranial random noise stimulation combined with cognitive training for treating ADHD: a randomized, sham-controlled clinical trial"],"prefix":"10.1038","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0251-3649","authenticated-orcid":false,"given":"Ornella","family":"Dakwar-Kawar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6518-4742","authenticated-orcid":false,"given":"Noam","family":"Mairon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shachar","family":"Hochman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7577-4444","authenticated-orcid":false,"given":"Itai","family":"Berger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roi","family":"Cohen Kadosh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2861-6486","authenticated-orcid":false,"given":"Mor","family":"Nahum","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,8,2]]},"reference":[{"key":"2547_CR1","doi-asserted-by":"publisher","first-page":"214","DOI":"10.1037\/pas0000166","volume":"28","author":"GJ DuPaul","year":"2016","unstructured":"DuPaul GJ, Reid R, Anastopoulos AD, Lambert MC, Watkins MW, Power TJ. 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Prof. Roi Cohen Kadosh serves on the scientific advisory boards of Neuroelectrics Inc. and Tech InnoSphere Engineering Ltd. RCK filed a UK Patent which is manged by the University of Surrey for \u201dmethod for obtaining personalized parameters for transcranial stimulation, transcranial system, method of applying transcranial stimulation\u201d. Furthermore, Prof. Cohen Kadosh is a founder, director, and shareholder of Cognite Neurotechnology Ltd. All the other authors reported no biomedical financial interests or potential conflicts of interest.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"271"}}