Attention-deficit/hyperactivity disorder: using P300 topography to choose optimal treatment

Abstract

Attention-deficit/hyperactivity disorder is the most prevalent behavioral disorder in children, and persists into adulthood. Stimulants (methylphenidate and amphetamines) with dopaminergic mechanisms are the most commonly used pharmacological treatment. Nonselective (desipramine and imipramine) and selective (atomoxetine) norepinephrine reuptake inhibitors can also be effective. What constitutes a sufficient response to treatment? Too often a partial response, leaving the patient symptomatic, is accepted. If response is defined more strictly, allowing for a return to normal, then the usually quoted 70% response rates to any given attention-deficit/hyperactivity disorder medicine drop to approximately 40%. With different medicines and not enough patients responding robustly to any given medicine, we can use medicines sequentially to find the medicine that produces a robust response. Alternatively, P300 topography can be used to select optimal treatment.

Altered Auditory P300 Performance in Parents with Attention Deficit Hyperactivity Disorder Offspring

“…Sangal et al . reported that the P300 topography could predict stimulant efficacy [19–21], and P300 amplitude is related to response to atomoxetine [22]. The potential use of ERP in diagnosis and tailored pharmacological treatment for ADHD subjects addressed the importance of further research in this area.…”

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

“…The discrepancy in results may be accounted for by methodological differences between the present and previous studies. For instance, one of the previous studies was a 10-week long open label study (Sangal & Sangal, 2005), while the latter study was a double-blind crossover design with atomoxetine and methylphenidate treatment periods each lasting 5 weeks with 2-week washout period in between (Sangal & Sangal, 2006b). Furthermore, Sangal and Sangal (2006a) excluded all comorbid psychiatric disorders except for oppositional defiant and conduct disorders, while our sample included participants with various anxiety and mood disorders.…”

Attention deficit hyperactivity disorder in children

“…В последние годы некоторые авторы предлагают ис-пользовать исследование когнитивных вызванных потен-циалов Р300 для определения оптимальной тактики лече-ния пациентов с СДВГ, прогнозирования эффективности различных групп препаратов [32].…”