Theta/beta ratio in EEG correlated with attentional capacity assessed by Conners Continuous Performance Test in
Tzong-Shi Wang1, Syu-Siang Wang2, Chang-Li Wang3
1Department of Psychiatry, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan.
Insights
The theta/beta ratio (TBR) from EEG may indicate attention issues in ADHD, but it doesn't strongly correlate with behavioral tests like the CPT-3. Comprehensive ADHD diagnosis requires more than just EEG or CPT-3 alone.
Area of Science:
- Neuroscience
- Child Psychology
- Biomarker Research
Background:
- Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder with complex diagnosis.
- The theta/beta ratio (TBR) from electroencephalography (EEG) is a proposed biomarker for ADHD.
- Behavioral assessments like the Conners Continuous Performance Test-3rd edition (CPT-3) are used to evaluate attention in ADHD.
Purpose of the Study:
- To investigate the correlation between TBR and CPT-3 scores in children and adolescents diagnosed with ADHD.
- To assess the potential of TBR as a neurophysiological biomarker for ADHD in conjunction with behavioral measures.
Main Methods:
- Retrospective analysis of EEG and CPT-3 data from 55 ADHD patients and 45 controls.
- ADHD severity assessed using Swanson, Nolan, and Pelham (SNAP)-IV rating scales.
- Comparison of TBR values between ADHD patients with normal and abnormal CPT-3 scores.
Main Results:
- Elevated TBR was observed in ADHD patients with abnormal CPT-3 scores.
- No significant correlations were found between TBR values and CPT-3 variables or SNAP-IV scores.
- Considerable overlap in TBR values across groups limited its sensitivity and negative predictive value as an ADHD biomarker.
Conclusions:
- Both TBR and CPT-3 have utility in assessing attentional capacity but show limited diagnostic sensitivity for ADHD.
- A comprehensive ADHD diagnostic approach integrating clinical judgment, parental reports, and neuropsychometric testing is essential.
- TBR alone is insufficient as a standalone neurophysiological biomarker for ADHD diagnosis in children and adolescents.
Introduction:
Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder affecting children worldwide; however, diagnosing ADHD remains a complex task. Theta/beta ratio (TBR) derived from electroencephalography (EEG) recordings has been proposed as a potential biomarker for ADHD, but its effectiveness in children with ADHD remains controversial. Behavioral assessments, such as the Conners Continuous Performance Test-3rd edition (CPT-3), have been utilized to assess attentional capacity in individuals with ADHD. This study aims to investigate the correlation between TBR and CPT-3 scores in children and adolescents with ADHD.
Methods:
In a retrospective analysis, we examined patients regularly monitored for ADHD at Taipei Tzu Chi Hospital, who underwent both EEG and CPT-3 assessments. Severity of ADHD was evaluated using parent- and teacher-completed Swanson, Nolan, and Pelham (SNAP)-IV rating scales.
Results:
The study encompassed 55 ADHD patients (41 with abnormal CPT-3 scores, 14 with normal CPT-3 scores) and 45 control subjects. TBR demonstrated elevation in ADHD patients with abnormal CPT-3 scores, indicating its potential to represent attentional capacity akin to behavioral assessments like CPT-3. However, significant correlations between TBR values and CPT-3 variables or SNAP-IV rating scales were not observed. Moreover, TBR values exhibited considerable overlap across the groups, leading to diminished sensitivity and negative predictive value as a potential neurophysiological ADHD biomarker.
Discussion:
While our study underscores the utility of both TBR and CPT-3 in assessing attentional capacity, their sensitivity in diagnosing ADHD is limited. A comprehensive evaluation, integrating clinical expertise, parental input, and detailed neuropsychometric tests, remains pivotal for a thorough and precise diagnosis of ADHD.
