Behavioral and Electrophysiologic Predictors of Treatment Response to Stimulants in Children with Attention Disorders

Abstract

Behavioral and quantitative electroencephalography (EEG) techniques were used to evaluate treatment response to stimulant therapy in children with attention disorders. A sample of 130 children with attention disorders were evaluated with Conners and Diagnostic and Statistical Manual of Mental Disorders--III rating scales, and with neurometric quantitative EEG before and 6 to 14 months after treatment with stimulants. Significant quantitative EEG differences were found between the normal control population (N = 31) and the children with attention problems. Quantitative EEG abnormalities involved increased theta or alpha power, greatest in frontal regions, frontal theta/alpha hypercoherence, and posterior interhemispheric power asymmetry. Behavioral improvement after stimulant treatment was seen in 81.5% of the children with attention-deficit hyperactivity disorder and 44.7% of the children with attention-deficit disorder, with the degree of correspondence between behavioral and quantitative EEG changes at 78.5%. Pretreatment clinical and quantitative EEG features could predict treatment response with a sensitivity of 83.1% and a specificity of 88.2%. A combined behavioral and quantitative EEG approach can be useful for following and predicting treatment response to stimulants in children with attention disorders.

Neurophysiologic predictors of response to atomoxetine in young adults with attention deficit hyperactivity disorder: A pilot project

“…Chabot and colleagues (Chabot et al, 1999) were among the first to report that pretreatment qEEG differences were a reliable predictor of response to stimulants. This group reported that greater beta activity and lesser theta activity were associated with response to stimulants.…”

Electroencephalographic Biofeedback in the Treatment of Attention-Deficit/Hyperactivity Disorder

“…Clarke, Barry, McCarthy, & Selikowitz, 2001b). This pattern has been particularly evident in those patients who have not responded optimally to stimulant medications (Chabot, Orgill, Crawford, Harris, & Serfontein, 1999). In such patients, QEEG analysis has revealed increased relative beta power, decreased relative alpha power, and decreased theta/beta power ratios across all cortical recording sites in comparison to healthy peers.…”

Factors related to methylphenidate response in children with attention deficit/ hyperactivity disorder: a retrospective study

“…The lower response rate to MPH in this study may be related to criteria that were used to define response. It was reported that the response rate can vary from 50% to 80% depending on how medication response is defined (8,9,13).…”

“…The ADHD literature has revealed that the most consistent predictors of a positive response to stimulants include higher levels of attention deficiency (8)(9)(10)(11), higher levels of hyperactivity (10,12,13), younger age (8,11), and higher intellectual functioning (8,14,15). The most consistent predictor of a negative stimulant medication response is comorbidity of internalizing psychopathology (8,13,16,17).…”