15 Dec ADHD: Collaborative Study Finds Symptom Improvement in Children Identified by EEG Marker and Treated with Transcranial Random Noise Stimulation

MedicalResearch.com Interview with:

Dr. Dakwar-Kawar, PhD

Dr. Ornella Dakwar-Kawar
Hebrew University with
Prof. Mor Nahum and Prof. Itai Berger
Hebrew University 

in collaboration with Prof. Jyoti Mishra from the University of California San Diego (UCSD)
Prof. Roi Cohen Kadosh from the University of Surre,
Dr. Pragathi Priyadharsini and
Ashwin Amal from ITT Karpur, India and InnoSphere Ltd

MedicalResearch.com: What is the background for this study?

Response: Children with ADHD often exhibit aberrant neural activity, specifically imbalances in excitation and inhibition levels alongside dysfunction in brain networks like the frontoparietal network. While our previous research showed that Transcranial Random Noise Stimulation or tRNS improves clinical symptoms, the specific neural modulation effects during cognitive tasks remained unclear. This study investigated these mechanisms by analyzing the aperiodic exponent, a marker of excitation inhibition balance, during an inhibitory control task to compare children with ADHD to healthy controls and assess changes following tRNS combined with cognitive training. 

MedicalResearch.com: What are the main findings?

Response: At baseline, children with ADHD displayed elevated aperiodic exponents and higher error rates compared to healthy controls, reflecting lower excitation inhibition balance. Following the intervention, the active tRNS group exhibited a significant reduction in these exponents and a shift toward neural patterns seen in typically developing peers. This neural modulation coincided with a behavioral speed accuracy trade off, as children became slower but more accurate, demonstrating improved inhibitory control rather than impulsive responding.

MedicalResearch.com:  How early can these changes be detected?  What might be the side effects of tRNS, ie could other characteristics be influenced ie creativity?

Response: Significant neural and behavioral changes were detected immediately following the ten-session intervention, with a weaker but still significant reduction in the aperiodic exponent observed at the three-week follow-up. Regarding side effects, participants reported only minor itching that disappeared toward the end of the session. As for creativity, we did not assess this directly. However, parents from our previous trial reported that alongside clinical improvements, children appeared much calmer at home, with some showing enhanced engagement in creative or social activities, such as playing the piano or enjoying family time, though these were anecdotal observations rather than measured outcomes. 

MedicalResearch.com: What should readers take away from your report?

Response: The primary takeaway is that the aperiodic exponent may offer a new way to understand the brain’s internal balance in ADHD, appearing more sensitive than traditional EEG measures in this context. Our results suggest that tRNS combined with cognitive training can actively modulate this marker, driving a shift toward neural patterns seen in typically developing peers. Crucially, this neural change appears to underpin a behavioral transformation where children adopt a more controlled and accurate response strategy, offering a potential mechanistic pathway for how this treatment improves inhibitory control.

MedicalResearch.com: What recommendations do you have for future research as a results of this study?

Response: We recommend three key directions.

• First, future studies should use larger, more diverse samples to improve statistical power and generalizability.
• Second, it is critical to incorporate longer-term follow-ups beyond three weeks to assess the durability of these neural and behavioral changes.
• Finally, further validation of the aperiodic exponent is needed to establish it as a reliable biomarker for diagnosing ADHD and guiding personalized treatments.

MedicalResearch.com: Is there anything else you would like to add? Any disclosures?

Response:  This work is part of a broader series of studies led by Dr. Ornella Dakwar-Kawar under the supervision of Prof. Mor Nahum and Prof. Itai Berger at the Hebrew University of Jerusalem. Notably, these were the first studies to investigate tRNS in children with ADHD, utilizing technology developed by Tech InnoSphere Engineering Ltd. The research was a collaborative effort with Prof. Roi Cohen Kadosh (University of Surrey) and Prof. Jyoti Mishra (UCSD).  Dr. Pragathi Priyadharsini Balasubramani and her team, Amal Jude Ashwin Francis and Renu Arya (IIT Kanpur), led the advanced signal processing that isolated unique neural signatures of ADHD. While results are promising, the small sample size necessitates replication in larger cohorts to be fully validated.

Citation:

Dakwar-Kawar Ornella, Jude Ashwin Amal, Arya Renu, Mairon Noam, Mishra Jyoti, Berger Itai, Cohen Kadosh Roi, Balasubramani Pragathi Priyadharsini, Nahum Mor. The effects of transcranial random noise stimulation on excitation/inhibition balance in ADHD,
NeuroImage: Clinical, 2025,103923, ISSN 2213-1582,

https://doi.org/10.1016/j.nicl.2025.103923.

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Last Updated on December 15, 2025 by Marie Benz MD FAAD