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Related Concept Videos

Attention-Deficit/Hyperactivity Disorder01:30

Attention-Deficit/Hyperactivity Disorder

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by persistent inattention, hyperactivity, and impulsivity. It affects approximately 5-8% of children globally, with around 60-70% of cases persisting into adulthood. ADHD has significant implications for educational attainment, social interactions, and occupational success.
Diagnostic Criteria and Symptoms
To diagnose ADHD, symptoms must manifest before age 12 and be evident across multiple settings.
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Regression toward the mean (“RTM”) is a phenomenon in which extremely high or low values—for example, and individual’s blood pressure at a particular moment—appear closer to a group’s average upon remeasuring. Although this statistical peculiarity is the result of random error and chance, it has been problematic across various medical, scientific, financial and psychological applications. In particular, RTM, if not taken into account, can interfere when researchers try to extrapolate results...

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Related Experiment Video

Updated: Jul 10, 2026

Event Related Potentials (ERPs) and other EEG Based Methods for Extracting Biomarkers of Brain Dysfunction: Examples from Pediatric Attention Deficit/Hyperactivity Disorder (ADHD)
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Event Related Potentials (ERPs) and other EEG Based Methods for Extracting Biomarkers of Brain Dysfunction: Examples from Pediatric Attention Deficit/Hyperactivity Disorder (ADHD)

Published on: March 12, 2020

Theta beta ratio in attention deficit hyperactivity disorder using a multiverse analysis.

Dawid Strzelczyk1,2, Andrea Vetsch1, Nicolas Langer1,2

  • 1Methods of Plasticity Research, Department of Psychology, University of Zurich, Zürich, Switzerland.

Elife
|July 9, 2026
PubMed
Summary

The theta/beta ratio (TBR) from electroencephalography (EEG) is not a reliable biomarker for attention deficit hyperactivity disorder (ADHD). Multiverse analyses revealed that reported ADHD-related TBR differences are highly dependent on analytical choices, not genuine neurobiological markers.

Keywords:
ADHDEEGTBRhumanmultiverseneuroscience

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Published on: January 23, 2017

Area of Science:

  • Neuroscience
  • Psychiatry
  • Biomarker Research

Background:

  • Attention deficit hyperactivity disorder (ADHD) diagnosis relies on clinical assessments, with limited objective neurobiological markers.
  • The theta/beta ratio (TBR) from electroencephalography (EEG) has been proposed as a potential ADHD biomarker, but its reliability is debated.
  • Previous studies reported elevated TBR in ADHD, but concerns exist regarding methodological sensitivity and generalizability.

Purpose of the Study:

  • To systematically evaluate the robustness and generalizability of the theta/beta ratio (TBR) as a neurobiological marker for attention deficit hyperactivity disorder (ADHD).
  • To investigate how analytical choices, termed researcher degrees of freedom, influence conclusions regarding the association between TBR and ADHD.
  • To determine if TBR differences are a reliable indicator of ADHD subtypes or if they are confounded by other factors.

Main Methods:

  • Utilized multiverse analyses across two large, independent datasets (N=1499 and N=381) to test 576 analytical specifications.
  • Varied parameters including recording conditions, reference schemes, frequency band definitions, aperiodic activity treatment, regions of interest, sample criteria, and covariates.
  • Examined associations between TBR and ADHD using both categorical and dimensional definitions, and explored interactions with age and individual alpha frequency (IAF).

Main Results:

  • Group differences in TBR were highly contingent on analytical choices, with no robust main effects of ADHD diagnosis found.
  • No reliable differences in TBR were observed between healthy controls and ADHD-inattentive or ADHD-combined subtypes.
  • Significant effects were primarily driven by interactions with age and IAF, particularly when analyzing aperiodic activity, suggesting these, not oscillatory dynamics, explain prior findings.

Conclusions:

  • The theta/beta ratio (TBR) is not a reliable standalone biomarker for attention deficit hyperactivity disorder (ADHD) due to high sensitivity to analytical choices.
  • Previously reported associations between TBR and ADHD appear to be artifacts of analytical variability and confounds like aperiodic activity and individual alpha frequency.
  • Multiverse approaches are crucial for rigorously evaluating candidate neurobiological markers in complex clinical populations like ADHD.