Comparison of a standard psychiatric evaluation to rating scales and EEG in the differential diagnosis of attention-deficit/hyperactivity disorder

Quintana, Humberto; Snyder, Steven M.; Purnell, William; Aponte, Carolina; Sita, Janis

doi:10.1016/j.psychres.2006.04.015

Cited by 47 publications

(36 citation statements)

References 52 publications

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“…There is low diagnostic certainty for replacing a standard clinical evaluation with a measurement of EEG theta/beta power ratio because of the lack of generalizability of the 2 Class I studies. 11,12 One study used a medication washout period of more than 3 days, 12 a timeframe that may have mixed acceptance in a clinical setting. The studies also excluded participants on more than one medication and failed to assess for sleep deprivation.…”

Section: 3mentioning

confidence: 99%

“…A total of 32 articles addressed this question; 30 were rated as Class IV and 2 were rated as Class I (table). 11,12 The first Class I study was a prospective blinded cohort study examining 26 children and adolescents who presented with a suspected diagnosis of ADHD. 11 The study appropriately enrolled people whose conditions could be mistaken diagnostically for ADHD, and thus avoided spectrum bias.…”

mentioning

confidence: 99%

“…11,12 The first Class I study was a prospective blinded cohort study examining 26 children and adolescents who presented with a suspected diagnosis of ADHD. 11 The study appropriately enrolled people whose conditions could be mistaken diagnostically for ADHD, and thus avoided spectrum bias. Two quantitative EEG criteria were used for determining an ADHD diagnosis: frontal beta power and theta/ beta power ratio.…”

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confidence: 99%

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Practice advisory: The utility of EEG theta/beta power ratio in ADHD diagnosis

et al. 2016

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Objective: To evaluate the evidence for EEG theta/beta power ratio for diagnosing, or helping to diagnose, attention-deficit/hyperactivity disorder (ADHD). Methods:We identified relevant studies and classified them using American Academy of Neurology criteria.Results: Two Class I studies assessing the ability of EEG theta/beta power ratio and EEG frontal beta power to identify patients with ADHD correctly identified 166 of 185 participants. Both studies evaluated theta/beta power ratio and frontal beta power in suspected ADHD or in syndromes typically included in an ADHD differential diagnosis. A bivariate model combining the diagnostic studies shows that the combination of EEG frontal beta power and theta/beta power ratio has relatively high sensitivity and specificity but is insufficiently accurate. Conclusions:It is unknown whether a combination of standard clinical examination and EEG theta/ beta power ratio increases diagnostic certainty of ADHD compared with clinical examination alone.Recommendations: Level B: Clinicians should inform patients with suspected ADHD and their families that the combination of EEG theta/beta power ratio and frontal beta power should not replace a standard clinical evaluation. There is a risk for significant harm to patients from ADHD misdiagnosis because of the unacceptably high false-positive diagnostic rate of EEG theta/beta power ratio and frontal beta power. Level R: Clinicians should inform patients with suspected ADHD and their families that the EEG theta/beta power ratio should not be used to confirm an ADHD diagnosis or to support further testing after a clinical evaluation, unless such diagnostic assessments occur in a research setting. In 2013, the US Food and Drug Administration (FDA) approved the Neuropsychiatric EEG-Based ADHD Assessment Aid (NEBA), stating that the NEBA "uses the theta/beta ratio of the EEG measured at electrode CZ on a patient 6-17 years of age combined with a clinician's evaluation to aid in the diagnosis of ADHD" and "should only be used by a clinician as confirmatory support for a completed clinical evaluation or as support for the clinician's decision to pursue further testing following a clinical evaluation."1 The FDA further stated that "(t)he device is NOT to be used as a stand-alone in the evaluation or diagnosis of ADHD." The NEBA calculates the ratio of the power of the EEG theta and beta bands at Cz, which is the EEG electrode halfway between the inion and the nasion.Individuals with attention-deficit/hyperactivity disorder (ADHD) demonstrate a persistent pattern of inattention or hyperactivity/impulsivity, or both, that interferes with functioning and is inappropriate for developmental age. ADHD is typically diagnosed with a clinical examination. Appendix e-1 at Neurology.org presents the DSM-5 clinical criteria used for ADHD diagnosis.2 The American Academy of Pediatrics clinical practice guideline for the diagnosis, evaluation, and treatment of ADHD in children and adolescents provides a strong recommendation that when asses...

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Practice advisory: The utility of EEG theta/beta power ratio in ADHD diagnosis

et al. 2016

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“…An individual who suffers from this type of ADHD shows the following symptoms: a) Constant fidgeting (moving fingers and/or feet while sitting) b) Difficulty in staying seated for a long time c) Has trouble doing work quietly ADHD is usually defined as a neuro-biological disorder which has been linked to structural (Ivanov et al, 2010;Kobel et al, 2010;Valera, Faraone, Murray, & Seidman, 2007), functional (Dickstein, Bannon, Castellanos, & Milham, 2006), physiological (Liotti et al, 2007;Quintana, Snyder, Purnell, Aponte, & Sita, 2007;Synder & Hall, 2006), and chemical (Costa et al, 2013;Volkow et al, 2007;Volkow et al, 2009) changes in specific parts of the brain (Shire: ADHD Institute, 2014).…”

Section: Predominant Hyperactive -Impulsive Type (Adhd -Hi)mentioning

confidence: 99%

Comparing Attention Deficit Hyperactivity Level with the Work Experiences of Nurses Working at a Private Hospital in Istanbul

Demirelli¹,

Tapan²

2016

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The most important factor in the healthcare industry is focusing on customer satisfaction and patient care. This article aims to prevent malpractice resulting from inattentiveness and to incorporate the use of attention deficit/ hyperactivity tests in the application process for healthcare staff. This study compares the attention deficit/ hyperactivity level and the work experience of nurses in a private hospital. The attention deficit/hyperactivity level of 35 nurses in Istanbul was measured using the MOXO test and compared in terms of their work experience; two groups were created based upon this characteristic. Those nurses with five or less years of work experience (n = 21) were expected to perform better in attention, timing, impulsiveness, and hyperactivity than nurses with more than five years of work experiences (n = 14). The results show that nurses with five or less years of work experience were found to perform better in attention than those nurses with more work experience. However, those nurses with five or more years of work experience were found to perform better in timing, impulsiveness, and hyperactivity than their less-experienced coworkers.

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“…12 c. Chemical abnormalities ADHD is associated with abnormalities in the neural systems that govern release of neurotransmitters such as dopamine (DA) and noradrenaline (NA). 13,14,15 The DA is thought to influence behaviours such as impulsivity, 15 and NA is thought to control attention, arousal and mood. 16,17,18 The patients with predominantly inattentive ADHD had changes in their norepinephrine transporter gene, which affects norepinephrine levels in their brains.…”

Section: Disease Pathogenesis Amentioning

confidence: 99%

Management of Attention Deficit Hyperactivity Disorder (Adhd) Through Panchakarma

Bohra¹,

Sharma²,

Sharma³

2015

Int. J. Res. Ayurveda Pharm.

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Attention Deficit Hyperactivity Disorder (ADHD) is among the commonest childhood neurological disorders affecting the focusing, behaviour and activity controlling abilities. This disorder not only influence the learning abilities of the child but also has a significant impact on patient's social, professional and family life, affecting their relationships with parents and siblings, causing disruption at work because of decreased concentration abilities and less stable relationships thus crippling the self-esteem in every aspect. The prevalence of the disease is increasing and treatment options are just limited to the management of symptoms and that too not very efficient, no permanent cure is reported till date. So, there is need to expand the treatment modality. In Ayurveda, it can be correlated with various types of abnormal behaviours due to increased Vata and symptoms arising due to imbalance in the homeostasis between the components of Prajya (intellect). The relaxation and concentration improving Panchakarma therapies along with Vedic chant recitation (Music Therapy) for enhancing the concentration and focussing abilities can be proved as a promising treatment in the management of ADHD.

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Comparison of a standard psychiatric evaluation to rating scales and EEG in the differential diagnosis of attention-deficit/hyperactivity disorder

Cited by 47 publications

References 52 publications

Practice advisory: The utility of EEG theta/beta power ratio in ADHD diagnosis

Practice advisory: The utility of EEG theta/beta power ratio in ADHD diagnosis

Comparing Attention Deficit Hyperactivity Level with the Work Experiences of Nurses Working at a Private Hospital in Istanbul

Management of Attention Deficit Hyperactivity Disorder (Adhd) Through Panchakarma

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