Predictive Value of Slow and Fast EEG Oscillations for Methylphenidate Response in ADHD

Abstract

Attention-deficit/hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder and is characterized by symptoms of inattention and/or hyperactivity and impulsivity. In the current study, we obtained quantitative EEG (QEEG) recordings of 51 children aged between 6 and 12 years before the initiation of methylphenidate treatment. The relationship between changes in the scores of ADHD symptoms and initial QEEG features (power/power ratios values) were assessed. In addition, the children were classified as responder and nonresponder according to the ratio of their response to the medication (>25% improvement after medication). Logistic regression analyses were performed to analyze the accuracy of QEEG features for predicting responders. The findings indicate that patients with increased delta power at F8, theta power at Fz, F4, C3, Cz, T5, and gamma power at T6 and decreased beta powers at F8 and P3 showed more improvement in ADHD hyperactivity symptoms. In addition, increased delta/beta power ratio at F8 and theta/beta power ratio at F8, F3, Fz, F4, C3, Cz, P3, and T5 showed negative correlations with Conners’ score difference of hyperactivity as well. This means, those with greater theta/beta and delta/beta powers showed more improvement in hyperactivity following medication. Theta power at Cz and T5 and theta/beta power ratios at C3, Cz, and T5 have significantly classified responders and nonresponders according to the logistic binary regression analysis. The results show that slow and fast oscillations may have predictive value for treatment response in ADHD. Future studies should seek for more sensitive biomarkers.

Electrophysiological and Clinical Predictors of Methylphenidate, Guanfacine, and Combined Treatment Outcomes in Children With Attention-Deficit/Hyperactivity Disorder

“…Finally, as our hypothesis-driven study focused a priori on clinical and EEG markers suggested by previous literature, 26,27 we cannot rule out the possibility that treatment-related improvements may be further predicted by EEG and other measures not included in this study. 15,23,24 This is consistent with our multivariate results, in which the majority of the variance in treatment outcome remained unexplained even in models combining clinical and EEG predictors. Future studies should investigate whether EEG measures from other cortical sources or functional connectivity measures between sources predict treatment outcomes in children with ADHD.…”

“…20 The majority of available EEG studies found that better psychostimulant treatment outcome (ie, reduction in ADHD symptomatology) is predicted by atypical EEG patterns that commonly distinguish children with ADHD from controls, for example higher theta and lower beta resting-state power. [21][22][23][24] Despite these promising findings, it remains unclear which EEG measures predict improvements with other medications. Identifying EEG measures that predict response to different treatments (ie, moderators) would be especially useful for treatment stratification, which is a particularly promising way to inform personalized treatment decisions in psychiatry given its less stringent specificity and sensitivity requirements.…”

EEG Signal Complexity Is Reduced During Resting-State in Fragile X Syndrome

“…Gamma frequency bands are associated with high-level cognitive functions in healthy controls while performing cognitively demanding tasks (20,23). However, perturbations in gamma oscillations during resting-state recordings have been reported in psychiatric disorders, as well as in neurodevelopmental conditions (20,(23)(24)(25)(26). In fact, altered gamma power is thought to be associated with the cognitive deficits present in these populations, notably impaired social communication skills in FXS (20).…”

Treatment biomarkers for ADHD: Taking stock and moving forward

“…The most consistent findings suggest that higher spectral power in the theta band (4–7 Herz [Hz]) during resting states (eyes open or closed) is associated with better clinical outcomes following stimulant treatment [ 17 , 35 , 36 ] (Table 2 ). A common interpretation of this finding is that lower pre-treatment levels of arousal and vigilance, commonly displayed by children with ADHD [ 37 ], predict better response.…”

“… Sangal & Sangal [ 41 ] Not reported (probably USA) 58 (all medication free for >1 month) 0 M = 10.5, SD = 2.1 72% Not reported 4-week ATX vs. MPH, cross-over RCT Auditory P3 amplitude during visual and oddball tasks Greater pre-treatment P3 amplitude across regions in ATX responders relative to non-responders; greater pre-treatment P3 amplitude at right temporal region in MPH responders relative to non-responders. Sari Gokten et al [ 35 ] Turkey 51 0 M = 8.57, SD = 1.75 82% Not reported 13-month MPH, open label Delta, theta, gamma power, delta/beta, and TBR during rest Higher pre-treatment delta power at F8, theta power at Fz, F4, C3, Cz, T5, gamma power at T6, lower beta power at F8 and P3, delta/beta ratio at F8 and TBR at F8, F3, Fz, F4, C3, Cz, P3, and T5 predicted greater hyperactivity improvement. Theta power at Cz and T5 and TBR at C3, Cz, and T5 also accurately classified responders vs. non-responders in logistic regressions.…”