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Updated: Apr 4, 2026
Cortical Source Analysis of High-Density EEG Recordings in Children
Published on: June 30, 2014
Correlation of EEG with neuropsychological status in children with epilepsy
David A Hsu1, Katherine Rayer1, Daren C Jackson1
1Department of Neurology, University of Wisconsin, Madison, WI, USA.
Insights
The EEG alpha rhythm, not spike counts, correlates with cognitive function in children with epilepsy. The theta/beta ratio is not a reliable ADHD marker in this population.
Area of Science:
- Neuroscience
- Pediatric Neurology
- Epileptology
Background:
- Idiopathic epilepsy in children affects cognitive function.
- Electroencephalography (EEG) frequency spectra and spike counts are used to assess brain activity.
- The theta/beta ratio is a proposed EEG marker for attention-deficit hyperactivity disorder (ADHD).
Purpose of the Study:
- To investigate correlations between EEG frequency spectra and neuropsychological status in children with idiopathic epilepsy.
- To evaluate the theta/beta ratio and EEG spike count as indicators of ADHD and cognitive status.
Main Methods:
- Retrospective analysis of 46 children (ages 8-18) with idiopathic epilepsy.
- Multivariate linear regression to correlate EEG spectra with neuropsychological test results.
- Calculation of theta/beta ratio and EEG spike count for each subject.
Main Results:
- Neuropsychological status showed complex correlations with posterior alpha (8-15 Hz) EEG activity, varying by cognitive task and alpha sub-band.
- The theta/beta ratio was specific but insensitive for ADHD in children with epilepsy; most had normal ratios.
- EEG spike count did not correlate with neuropsychological status.
Conclusions:
- The alpha rhythm's role in cognition is complex and may involve distinct sub-bands.
- The theta/beta ratio is not a sensitive ADHD indicator in epileptic children.
- EEG frequency spectra provide more robust correlations with neuropsychological status than spike counts in pediatric epilepsy.
Objective:
To determine correlations of the EEG frequency spectrum with neuropsychological status in children with idiopathic epilepsy.
Methods:
Forty-six children ages 8-18 years old with idiopathic epilepsy were retrospectively identified and analyzed for correlations between EEG spectra and neuropsychological status using multivariate linear regression. In addition, the theta/beta ratio, which has been suggested as a clinically useful EEG marker of attention-deficit hyperactivity disorder (ADHD), and an EEG spike count were calculated for each subject.
Results:
Neuropsychological status was highly correlated with posterior alpha (8-15 Hz) EEG activity in a complex way, with both positive and negative correlations at lower and higher alpha frequency sub-bands for each cognitive task in a pattern that depends on the specific cognitive task. In addition, the theta/beta ratio was a specific but insensitive indicator of ADHD status in children with epilepsy; most children both with and without epilepsy have normal theta/beta ratios. The spike count showed no correlations with neuropsychological status.
Conclusions:
(1) The alpha rhythm may have at least two sub-bands which serve different purposes. (2) The theta/beta ratio is not a sensitive indicator of ADHD status in children with epilepsy. (3) The EEG frequency spectrum correlates more robustly with neuropsychological status than spike count analysis in children with idiopathic epilepsy.
Significance:
(1) The role of posterior alpha rhythms in cognition is complex and can be overlooked if EEG spectral resolution is too coarse or if neuropsychological status is assessed too narrowly. (2) ADHD in children with idiopathic epilepsy may involve different mechanisms from those in children without epilepsy. (3) Reliable correlations with neuropsychological status require longer EEG samples when using spike count analysis than when using frequency spectra.
