Use of EEG to Diagnose ADHD

Abstract

Electroencephalography (EEG) has, historically, played a focal role in the assessment of neural function in children with attention deficit hyperactivity disorder (ADHD). We review here the most recent developments in the utility of EEG in the diagnosis of ADHD, with emphasis on the most commonly used and emerging EEG metrics and their reliability in diagnostic classification. Considering the clinical heterogeneity of ADHD and the complexity of information available from the EEG signals, we suggest that considerable benefits are to be gained from multivariate analyses and a focus towards understanding of the neural generators of EEG. We conclude that while EEG cannot currently be used as a diagnostic tool, vast developments in analytical and technological tools in its domain anticipate future progress in its utility in the clinical setting.

Age‐related change in brain rhythms from early to middle childhood: Links to executive function

“…Research on theta/beta has been dominated by investigations of its diagnostic value, which, to date, has yielded mixed evidence. Some studies have shown that high theta/beta is predictive of ADHD (Monastra, Linden, Lubar, & Vandeusen, 1999) whereas others have not (Ogrim, Kropotov, & Hestad, 2012; for excellent reviews, see Arns, Conners, & Kraemer, 2011;Barry, Clarke, & Johnstone, 2003;Lenartowicz & Loo, 2014;Loo et al, 2012). A series of studies by Shutter and colleagues have shown that theta/beta is associated with executive control processes.…”

Research Review: Use of EEG biomarkers in child psychiatry research – current state and future directions

“…Collectively, this broader focus on etiologic and symptomatic heterogeneity within psychiatric disorders and new focus on examination of domains of function across disorders has implications for efforts to develop more robust, highly cost effective EEG‐based biomarkers for psychiatric disorders. It seems unlikely that a single biomarker measure of any type can capture all of the variance within a diagnostic category (Lenartowicz & Loo, ). Instead, finding biomarkers for neural circuits associated with domains of functioning that are abnormal across several disorders seems a potentially more fruitful approach.…”

Editorial Perspective: How should child psychologists and psychiatrists interpret FDA device approval? Caveat emptor

“…In brief, studies at the end of the 1990s through 2009 have reported a higher TBR among children and adolescents with ADHD compared to non‐ADHD groups, with overall large effect sizes (ES) of 1 Standard Deviation or greater. Since 2009, however, several independent research groups have reported findings that have contradicted these earlier TBR‐ADHD results (Lenartowicz & Loo, ). Effect sizes have diminished significantly over the past 6 years, with a highly significant correlation between effect size and year of publication (Pearson r = −.97) emerging in a meta‐analysis by Arns et al.…”

“…The TBR is a ratio of spectral power in the theta frequency band (4–7 Hz) relative to power in the faster, beta frequency band (13–21 Hz), which is sometimes measured at a single electrode site (Cz) during rest. This measure has often been investigated in ADHD samples, with widely disparate findings depending on the publication date of the study (see Arns, Conners, & Kraemer, ; Lenartowicz & Loo, , for review). In brief, studies at the end of the 1990s through 2009 have reported a higher TBR among children and adolescents with ADHD compared to non‐ADHD groups, with overall large effect sizes (ES) of 1 Standard Deviation or greater.…”