A Signature of Attention-Elicited Electrocortical Activity Distinguishes Response From Non-Response to the Non-Stimulant Atomoxetine in Children and Adolescents With ADHD

Griffiths, Kristi R.; Jurigova, B.; Leikauf, John; Palmer, Donna M.; Clarke, Simon; Tsang, Tracey W; Teber, Erdahl; Kohn, Michael; Williams, Leanne M.

doi:10.1177/1087054717733044

Cited by 4 publications

(4 citation statements)

References 53 publications

(66 reference statements)

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“…In the largest study to date, theta/beta ratio did not predict MPH response, and frontal alpha slowing predicted non-response only in a male adolescent subgroup (Arns et al, 2018 ). The response to ATX was predicted by stronger cognitive N2 activity (Griffiths et al, 2017 ). The EEG and ERP markers predicting pharmacological and non-pharmacological treatment response partly overlap.…”

Section: Adhdmentioning

confidence: 99%

Toward Precision Medicine in ADHD

Buitelaar¹,

Bölte²,

Brandeis³

et al. 2022

Front. Behav. Neurosci.

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Attention-Deficit Hyperactivity Disorder (ADHD) is a complex and heterogeneous neurodevelopmental condition for which curative treatments are lacking. Whilst pharmacological treatments are generally effective and safe, there is considerable inter-individual variability among patients regarding treatment response, required dose, and tolerability. Many of the non-pharmacological treatments, which are preferred to drug-treatment by some patients, either lack efficacy for core symptoms or are associated with small effect sizes. No evidence-based decision tools are currently available to allocate pharmacological or psychosocial treatments based on the patient's clinical, environmental, cognitive, genetic, or biological characteristics. We systematically reviewed potential biomarkers that may help in diagnosing ADHD and/or stratifying ADHD into more homogeneous subgroups and/or predict clinical course, treatment response, and long-term outcome across the lifespan. Most work involved exploratory studies with cognitive, actigraphic and EEG diagnostic markers to predict ADHD, along with relatively few studies exploring markers to subtype ADHD and predict response to treatment. There is a critical need for multisite prospective carefully designed experimentally controlled or observational studies to identify biomarkers that index inter-individual variability and/or predict treatment response.

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Section: Adhdmentioning

confidence: 99%

Toward Precision Medicine in ADHD

Buitelaar¹,

Bölte²,

Brandeis³

et al. 2022

Front. Behav. Neurosci.

View full text Add to dashboard Cite

show abstract

“…Higher pre-treatment absolute power in all frequency bands (especially frontal and central) in non-responders relative to controls. Griffiths et al [ 45 ] Australia 52 (all medication free) 52 M = 11.9, SD = 2.5 83% Not reported 6-week ATX vs. placebo, cross-over RCT N2 amplitude during an auditory oddball task Lower pre-treatment N2 amplitudes (especially right fronto-central) in responders relative to non-responders and controls. N2 predicted responders vs. non-responders with specificity = 80.8% and sensitivity = 47.1% in a leave-one-out cross validation analyses.…”

Section: Predictive Biomarkersmentioning

confidence: 99%

“…A 12-month study of ATX found broad pre-treatment increases in power in children classified as non-responders relative to controls, whereas responders only showed elevations in slower frequencies such as the delta (<4 Hz), theta and alpha (8–12 Hz) bands [ 44 ]. Lower pre-treatment N2 amplitudes [ 45 ] and greater pre-treatment P3 amplitudes [ 41 , 46 ] during auditory tasks have been associated with better response after 6–10 weeks of ATX treatment, although non-significant P3 effects were also reported [ 45 ]. Both in children and in adults, greater change in temporo-parietal theta cordance (a measure of regional spectral power) at 1 week predicted clinical outcomes at 6–12 weeks [ 47 , 48 ].…”

Section: Predictive Biomarkersmentioning

confidence: 99%

Treatment biomarkers for ADHD: Taking stock and moving forward

et al. 2022

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The development of treatment biomarkers for psychiatric disorders has been challenging, particularly for heterogeneous neurodevelopmental conditions such as attention-deficit/hyperactivity disorder (ADHD). Promising findings are also rarely translated into clinical practice, especially with regard to treatment decisions and development of novel treatments. Despite this slow progress, the available neuroimaging, electrophysiological (EEG) and genetic literature provides a solid foundation for biomarker discovery. This article gives an updated review of promising treatment biomarkers for ADHD which may enhance personalized medicine and novel treatment development. The available literature points to promising pre-treatment profiles predicting efficacy of various pharmacological and non-pharmacological treatments for ADHD. These candidate predictive biomarkers, particularly those based on low-cost and non-invasive EEG assessments, show promise for the future stratification of patients to specific treatments. Studies with repeated biomarker assessments further show that different treatments produce distinct changes in brain profiles, which track treatment-related clinical improvements. These candidate monitoring/response biomarkers may aid future monitoring of treatment effects and point to mechanistic targets for novel treatments, such as neurotherapies. Nevertheless, existing research does not support any immediate clinical applications of treatment biomarkers for ADHD. Key barriers are the paucity of replications and external validations, the use of small and homogeneous samples of predominantly White children, and practical limitations, including the cost and technical requirements of biomarker assessments and their unknown feasibility and acceptability for people with ADHD. We conclude with a discussion of future directions and methodological changes to promote clinical translation and enhance personalized treatment decisions for diverse groups of individuals with ADHD.

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“…In the largest study to date, theta/beta ratio did not predict MPH response, and frontal alpha slowing predicted non-response only in a male adolescent subgroup (Arns et al, 2018). The response to ATX was predicted by stronger cognitive N2 activity (Griffiths et al, 2017). The EEG and ERP markers predicting pharmacological and non-pharmacological treatment response partly overlap.…”

Section: Appetitementioning

confidence: 83%

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A Signature of Attention-Elicited Electrocortical Activity Distinguishes Response From Non-Response to the Non-Stimulant Atomoxetine in Children and Adolescents With ADHD

Abstract: The N2 amplitude is a biomarker that may have utility in predicting response to atomoxetine for youth with ADHD.

Cited by 4 publications

References 53 publications

Toward Precision Medicine in ADHD

Toward Precision Medicine in ADHD

Treatment biomarkers for ADHD: Taking stock and moving forward

Presentation_1.pdf

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