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Diagnostic Value of Resting Electroencephalogram in Attention-Deficit/Hyperactivity Disorder Across the Lifespan

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Abstract

The resting electroencephalogram (EEG) reflects development and arousal, but whether it can support clinical diagnosis of attention-deficit/hyperactivity disorder (ADHD) remains controversial. Here we examined whether theta power and theta/beta ratio are consistently elevated in ADHD and younger age as proposed. Topographic 48-channel EEG from 32 children (8–16 years) and 22 adults (32–55 years) with ADHD and matched healthy controls (n = 30 children/21 adults) was compared. Following advanced artefact correction, resting EEG was tested for increased theta and theta/beta activity due to ADHD and due to normal immaturity. Discriminant analyses tested classification performance by ADHD and age using these EEG markers as well as EEG artefacts and deviant attentional event-related potentials (ERPs). No consistent theta or theta/beta increases were found with ADHD. Even multivariate analyses indicated only marginal EEG power increases in children with ADHD. Instead, consistent developmental theta decreases were observed, indicating that maturational lags of fewer than 3 years would have been detected in children. Discriminant analysis based on proposed simple spectral resting EEG markers was successful for age but not for ADHD (81 vs. 53 % accuracy). Including ERP markers and EEG artefacts improved discrimination, although not to diagnostically useful levels. The lack of consistent spectral resting EEG abnormalities in ADHD despite consistent developmental effects casts doubt upon conventional neurometric approaches towards EEG-based ADHD diagnosis, but is consistent with evidence that ADHD is a heterogeneous disorder, where the resting state is not consistently characterised by maturational lag.

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Abbreviations

ADHD:

Attention-deficit/hyperactivity disorder

CD:

Conduct disorder

CNV:

Contingent negative variation

DA:

Discriminant analysis

Goodsegs:

Artefact-free segments

CPT:

Continuous performance tests

CTRL:

Healthy control group

Ec:

Eyes-closed

EEG:

Electroencephalogram

Eo:

Eyes-open

EOG:

Electrooculogram

ERP:

Event-related potential

ICA:

Independent component analysis

ODD:

Oppositional defiant disorder

R:

Pearson correlation coefficient

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Acknowledgments

This study was supported by the Swiss National Science Foundation (SNSF) grant 32-109591 and by grants from Eli Lilly to H.-C. Steinhausen. Recruitment of ADHD sibling pairs was supported by National Institute of Mental Health Grant R01MH062873 to Steve Faraone (PI) and H.-C. Steinhausen (site PI). We thank the children and their families for participation, Antonia Bak, Gudrun Schneider, Guyslaine Thalmann, Lea Meier, Nadia Mock, and Yamilée Schwitter for help with testing and data processing, and Markus Mächler and Stefano Maurizio for their support with data analysis.

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Authors and Affiliations

  1. Brain Mapping Research, Department of Child and Adolescent Psychiatry, University of Zürich, Neumünsterallee 9/Fach, 8032, Zürich, Switzerland

    Martina D. Liechti, Lilian Valko, Ueli C. Müller, Mirko Döhnert, Renate Drechsler, Hans-Christoph Steinhausen & Daniel Brandeis

  2. Neuroscience Center Zürich, University of Zurich and ETH Zürich, Zürich, Switzerland

    Martina D. Liechti & Daniel Brandeis

  3. University Children’s Hospital, Zürich, Switzerland

    Lilian Valko

  4. Hochschule für Heilpädagogik, Zürich, Switzerland

    Ueli C. Müller

  5. Department of Child and Adolescent Psychiatry, University of Leipzig, Leipzig, Germany

    Mirko Döhnert

  6. Aalborg Psychiatric Hospital, Aarhus University Hospital, Aalborg, Denmark

    Hans-Christoph Steinhausen

  7. Clinical Psychology and Epidemiology, Institute of Psychology, University of Basel, Basel, Switzerland

    Hans-Christoph Steinhausen

  8. Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany

    Daniel Brandeis

  9. Center for Integrative Human Physiology, University of Zürich, Zürich, Switzerland

    Daniel Brandeis

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  1. Martina D. Liechti
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  2. Lilian Valko
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Correspondence to Daniel Brandeis.

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Liechti, M.D., Valko, L., Müller, U.C. et al. Diagnostic Value of Resting Electroencephalogram in Attention-Deficit/Hyperactivity Disorder Across the Lifespan. Brain Topogr 26, 135–151 (2013). https://doi.org/10.1007/s10548-012-0258-6

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