Neurometric subgroups in attentional and affective disorders and their association with pharmacotherapeutic outcome

To determine if quantitative electrophysiologic measures correlate with pharmacotherapeutic response, we conducted a retrospective analysis of treatment outcomes in sequential patients with attention deficit disorder and affective disorders. One hundred medication-free patients meeting DSM-III-R criteria for attentional and affective disorders underwent pretreatment EEG, quantitative Neurometric EEG, and physical/laboratory examinations. Attention-disordered patients were first treated with a stimulant, secondarily with an antidepressant, and tertially with an anticonvulsant. Affectively disordered patients were treated initially with antidepressant, and secondarily augmented with anticonvulsant or lithium. Tertiary treatment was a stimulant. Patients were assessed up to 6 months. A Clinical Global Improvement score was assigned. Similar Neurometric subgroups were identified within both the attentional and the affectively disordered patients. Subgroups were relative alpha frequency excess, relative theta frequency excess, and/or inter-hemispheric hypercoherence. Without regard to DSM-III-R diagnosis, there were robust correlations between Neurometric subgroup membership, responsivity to selected pharmacologic agent class(es), and clinical outcome. The frontal alpha excess subgroup was 87% responsive to antidepressants. The frontal theta excess subgroup was 100% responsive to stimulants. The frontal alpha excess/hypercoherent subgroup was 85% or more responsive to anticonvulsants/lithium. The frontal theta excess/hypercoherent subgroup was 80% responsive to anticonvulsants. Patients with similar Neurometric features responded to the same class(es) of psychopharmacologic agent(s) despite their DSM-III-R classification.