Brainmarker-I Differentially Predicts Remission to Various Attention-Deficit/Hyperactivity Disorder Treatments: A Discovery, Transfer, and Blinded Validation Study

Voetterl, Helena; Wingen, Guido van; Michelini, Giorgia; Griffiths, Kristi R.; Gordon, Evian; deBeus, Roger; Korgaonkar, Mayuresh S.; Loo, Sandra K.; Palmer, Donna M.; Breteler, Rien; Denys, Damiaan; Arnold, L. Eugene; Jour, Paul du; Ruth, Rosalinde van; Jansen, Jeanine; Arns, Martijn

doi:10.1016/j.bpsc.2022.02.007

Cited by 17 publications

(26 citation statements)

References 69 publications

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“…Neurofeedback studies indicate that increased theta predicts response to theta-modulating neurofeedback (Gevensleben et al, 2009 ; Janssen et al, 2016 ), and parietal alpha plus a strong CNV reflecting cognitive preparation together explain nearly 30% of the variance in slow cortical potential neurofeedback outcome. Recent work describes that a high individual peak frequency (iAPF) of the EEG is associated with higher remissions rates both to neurofeedback and medication treatment (Voetterl et al, 2022 ). Medication studies report that increased theta and absence of frontal slowing is associated with better stimulant response in some (Chabot et al, 1999 ; Clarke et al, 2002 ; Arns et al, 2008 ) but not all (Janssen et al, 2016 ) studies.…”

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

“…No difference between pre-treatment and 1 week in non-responders. Voetterl et al [ 52 ] Netherlands, Australia, USA Transfer: 336 MPH & 136 NF; validation: 41 MPH & 71 NF. Exploration: 55 GUAN & 47 ATX 0 Range = 7–15 100% Not reported Various duration, MPH, multimodal NF with with sleep coaching, GUAN, ATX, open label or RCTs iAPF during rest Transfer phase: predicted gain in normalized remission of 17% to 30% after stratifying boys with a higher iAPF to MPH and boys with a lower iAPF to multimodal NF, respectively.…”

Section: Predictive Biomarkersmentioning

confidence: 99%

“…Only a few studies tested EEG predictors of more than one type of treatment [ 52 , 56 , 57 ]. An 8-week randomized controlled trial (RCT) comparing MPH, guanfacine and their combination found that event-related EEG power profiles during a working memory task showed treatment-specific associations with clinical improvements [ 57 ].…”

Section: Predictive Biomarkersmentioning

confidence: 99%

“…Another noteworthy exemplar based on different treatments is a recent multi-sample study of iAPF [ 52 ]. Guided by previous literature showing associations of slow iAPF with worse stimulant response [ 38 , 58 ] but better neurofeedback response [ 50 ], particularly in boys and men, this study tested whether iAPF differentially predicted ADHD remission following MPH and multimodal neurofeedback treatments in boys with ADHD [ 52 ].…”

Section: Predictive Biomarkersmentioning

confidence: 99%

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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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“…Neurofeedback studies indicate that increased theta predicts response to theta-modulating neurofeedback (Gevensleben et al, 2009;Janssen et al, 2016), and parietal alpha plus a strong CNV reflecting cognitive preparation together explain nearly 30% of the variance in slow cortical potential neurofeedback outcome. Recent work describes that a high individual peak frequency (iAPF) of the EEG is associated with higher remissions rates both to neurofeedback and medication treatment (Voetterl et al, 2022). Medication studies report that increased theta and absence of frontal slowing is associated with better stimulant response in some (Chabot et al, 1999;Clarke et al, 2002;Arns et al, 2008) but not all (Janssen et al, 2016) studies.…”

Section: Appetitementioning

confidence: 99%

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Brainmarker-I Differentially Predicts Remission to Various Attention-Deficit/Hyperactivity Disorder Treatments: A Discovery, Transfer, and Blinded Validation Study

Cited by 17 publications

References 69 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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