# The Impact of Transcranial Magnetic Stimulation on Symptoms of Attention Deficit Hyperactivity Disorder and Sleep Parameters: Preliminary Study

## TL;DR

This study explores how transcranial magnetic stimulation affects attention and sleep in people with ADHD.

## Contribution

It is the first preliminary study to investigate the effects of 10 Hz TMS on time estimation and sleep quality in ADHD patients.

## Key findings

- 10 Hz TMS improved performance in estimating long time intervals in ADHD individuals.
- No significant changes in sleep quality or actigraphic sleep parameters were observed after TMS.
- ADHD symptom scores did not show statistically significant changes post-TMS.

## Abstract

Background: Individuals with attention deficit hyperactivity disorder (ADHD) can exhibit neurocognitive deficits, psychosocial alterations, and changes in sleep regulation. In this sense, non-invasive techniques such as transcranial magnetic stimulation (TMS) can be used to assess and treat people with neurocognitive disorders. Studies using neuromodulation to estimate the timing and regulation of sleep remain scarce, revealing a gap in its understanding and treatment. Aim: To analyze whether the application of 10 Hz TMS modifies time estimation and sleep quality in people with ADHD for characteristics of inattention and hyperactivity. Material and Methods: Twelve adult male participants with high scores on the assessment of ADHD scale underwent a 10 Hz TMS protocol and a visual stimulus time estimation task. Daily rhythmicity was assessed by actigraphy before and after the repetitive transcranial magnetic stimulation (rTMS) intervention. Sleep quality was evaluated using the Pittsburg Sleep Quality Index and the Morning and Evening Questionnaire. Results: The results showed that rTMS modulated the interpretation of the 9 s long interval (p = 0.028). For the ADHD-AD instrument, no statistically significant differences were observed (p > 0.05). In relation to actigraphic variables—sleep time, bedtime, latency, sleep efficiency, and wakefulness after sleep onset—there were no differences after excitatory neuromodulation (p > 0.05). Conclusions: The findings demonstrate that the application of 10 Hz TMS enhances performance in long intervals during the time estimation task for individuals with ADHD, but does not affect sleep quality.