Mark Selikowitz

Age and sex effects in the EEG: development of the normal child

OBJECTIVES This study investigated age-related changes and sex differences in the EEGs of normal children. METHODS Forty boys and 40 girls, between the ages of 8 and 12 years, participated in this study. The EEG was recorded during an eyes-closed resting condition and Fourier transformed to provide estimates for total power, absolute and relative power in the delta, theta, alpha and beta bands, and for theta/alpha and theta/beta ratios. RESULTS Absolute delta activity decreased with age. Relative delta and theta decreased and alpha and beta increased with increasing age. The theta/alpha and theta/beta ratios decreased with increasing age. All of these indicated a developmental reduction in slow wave activity. Maturational differences were found in the rates of change between the midline and the two hemispheres. In the absolute delta and the theta/beta ratio, the midline and the two hemispheres became more equipotential with age. In the beta band, power increased at a greater rate than in the two hemispheres. Sex differences were found, with males having less theta and more alpha than females. CONCLUSIONS These results indicated that maturation occurs earlier at the midline than in the two hemispheres. Females were also found to have a developmental lag in the EEG compared with males.

EEG analysis in Attention-Deficit/Hyperactivity Disorder: a comparative study of two subtypes

This study investigated differences in the EEG between children with Attention-Deficit/Hyperactivity Disorder of the Combined Type, Attention-Deficit/Hyperactivity Disorder of the Predominantly Inattentive Type and control subjects. All subjects were between the ages of 8 and 12 years, and groups were matched on age and gender. The EEG was recorded during an eyes-closed resting condition from 21 monopolar derivations and these were clustered into nine regions prior to analysis. One minute of trace was analysed using Fourier transformation to obtain both absolute and relative power estimates in the delta, theta, alpha and beta frequency bands. The patient groups were found to have greater levels of theta and deficiencies of alpha and beta in comparison to the control group. Children with Attention-Deficit/Hyperactivity Disorder of the Predominantly Inattentive type were found to be significantly different from those of the Combined type in the same measures, appearing to be closer to the normal profiles. The general results support a maturational lag model of the central nervous system in Attention Deficit/Hyperactivity Disorder. The differences between the subtypes suggest a difference in the severity of the disorder rather than a different neurological dysfunction.

EEG-defined subtypes of children with attention-deficit/hyperactivity disorder

OBJECTIVES This study investigated the presence of EEG clusters within a sample of children with the combined type of attention-deficit/hyperactivity disorder (ADHD). METHODS Subjects consisted of 184 boys with ADHD and 40 age-matched controls. EEG was recorded from 21 sites during an eyes-closed resting condition and Fourier transformed to provide estimates for total power, and relative power in the delta, theta, alpha and beta bands, and for the theta/beta ratio. Factor analysis was used to group sites into 3 regions, covering frontal, central and posterior regions. These data were subjected to cluster analysis. RESULTS Three distinct EEG clusters of children with ADHD were found. These were characterized by (a) increased slow wave activity and deficiencies of fast wave, (b) increased high amplitude theta with deficiencies of beta activity, and (c) an excess beta group. CONCLUSIONS These results indicate that children with ADHD do not constitute a homogenous group in EEG profile terms. This has important implications for studies of the utility of EEG in the diagnosis of ADHD. Efforts aimed at using EEG as a tool to discriminate ADHD children from normals must recognize the variability within the ADHD population if such a tool is to be valid and reliable in clinical practice.

Age and sex effects in the EEG: differences in two subtypes of attention-deficit/hyperactivity disorder

OBJECTIVES This study investigated age-related changes and sex differences in the EEGs of two groups of children with attention-deficit/hyperactivity disorder (ADHD) combined type and ADHD predominantly inattentive type, in comparison with a control group of normal children. METHODS Forty boys and forty girls were included in each group. The EEG was recorded during an eyes-closed resting condition and Fourier transformed to provide estimates for total power, absolute and relative power in the delta, theta, alpha and beta bands, and for theta/alpha and theta/beta ratios. RESULTS Total power, relative alpha, and the theta/alpha and theta/beta ratios were differentiated between all 3 groups. Sex differences between the ADHD subjects and the control group were greater in males than females and matured faster in males. With increasing age, the EEG of the ADHD inattentive group was found to change at a similar rate to the changes found in the normal group, with the differences in power levels remaining constant. In the ADHD combined group, the power was found to change at a greater rate than in the ADHD inattentive group, with power levels of the two ADHD groups becoming similar with age. CONCLUSIONS These results are supportive of a two-component model of ADHD, with the hyperactive/impulsive component maturing with age and the inattentive component remaining more stable.

Electroencephalogram differences in two subtypes of Attention-Deficit/Hyperactivity Disorder

This study investigated EEG differences between children with two subtypes of Attention-Deficit/Hyperactivity Disorder (ADHD) and normal control subjects. EEG was recorded during an eyes-closed resting condition and Fourier transformed to provide absolute and relative power estimates for the delta, theta, alpha, and beta bands, and the mean frequency for each band was calculated. Ratio coefficients were also calculated between frequency bands. Mean group differences were found in the theta, alpha, and beta bands between all three groups. Similarly, differences were found between all three groups for the theta/alpha and theta/beta ratios and for the mean frequency of the total EEG. These results support a model of ADHD resulting from a developmental deviation rather than a maturational lag in the central nervous system. Differences between the clinical groups in frontal activity suggest that different neuroanatomical systems are involved in the different subtypes of ADHD.

Excess beta activity in children with attention-deficit/hyperactivity disorder: an atypical electrophysiological group

Studies of children with attention deficit/hyperactivity disorder (ADHD) have typically found elevated levels of slow wave activity in their EEGs, but in two of our previous studies, a small subset of ADHD children with excess beta activity in the EEG was identified. The aim of this study was to determine whether children with excess beta activity represent a distinct electrophysiological subtype of ADHD, to quantify the differences in their EEGs, and to determine if this group of children with ADHD have behavioural profiles different from other children with ADHD. Results indicated that children with excess beta represent a small independent subset of children diagnosed with ADHD, which primarily consists of children with a diagnosis of ADHD combined type. Behaviourally, this group was similar to other children with ADHD, although the excess-beta group were more prone to temper tantrums and to be moody. The excess in beta activity was found primarily in the frontal regions and may be associated with frontal lobe self-regulation and inhibition control.

EEG evidence for a new conceptualisation of attention deficit hyperactivity disorder

OBJECTIVES This study investigated the presence of electroencephalographic (EEG) clusters within a sample of children with the inattentive type of attention-deficit/hyperactivity disorder (ADHD). METHODS Subjects consisted of 100 boys with ADHD and 40 age-matched controls. EEG was recorded from 21 sites during an eyes-closed resting condition and Fourier transformed to provide estimates for total power, and relative power in the delta, theta, alpha and beta bands. Factor analysis was used to group sites into 3 regions; frontal, central and posterior. These data were subjected to cluster analysis. RESULTS Two distinct EEG clusters of children with the inattentive type of ADHD were found. These were characterised by (a) increased high-amplitude theta with deficiencies of delta and beta activities, and (b) increased slow wave and deficiencies of fast wave activity. CONCLUSIONS These two subtypes are independent of current diagnostic categories, and consist of a cortically hypoaroused group and a group typified by a maturational lag in central nervous system (CNS) development. These results support a re-conceptualisation of ADHD based on the CNS abnormality underlying the disorder rather than the behavioural profile of the child. This has the potential to add a level of predictive validity, which is currently lacking in the present diagnostic systems.

EEG Analysis of Children with Attention-Deficit/Hyperactivity Disorder and Comorbid Reading Disabilities

This study investigated electroencephalographic differences between two groups of children with attention-deficit/hyperactivity disorder, combined type, with reading disabilities (ADHD + RD) or without (ADHD) and typical control participants. Twenty participants were included in each group. All participants were between the ages of 8 and 12 years, and groups were matched on age and gender. The electroencephalographic (EEG) was recorded during an eyes-closed resting condition from 21 monopolar derivations, which were clustered into nine regions for analysis. The EEGs were Fourier-transformed to provide absolute and relative power estimates for the delta, theta, alpha, and beta bands. Ratio coefficients were also calculated for the theta/alpha and theta/beta ratios. Compared with controls, the clinical groups demonstrated the increased slow-wave and reduced fast-wave activity commonly reported in the ADHD literature. The ADHD + RD group had more relative theta, less relative alpha, and a higher theta/alpha ratio than the ADHD group. A number of hemispheric differences were also found in the delta and alpha bands. These results suggested that some of the EEG divergences found in the ADHD + RD group represent an electrophysiological component associated with the reading disability that is independent of the EEG divergences found in ADHD.

Electroencephalogram θ/β Ratio and Arousal in Attention-Deficit/Hyperactivity Disorder: Evidence of Independent Processes

BACKGROUND For nearly 20 years, the theta/beta power ratio in the electroencephalogram (EEG) has been used within the attention-deficit/hyperactivity disorder (ADHD) literature as a marker of central nervous system (CNS) arousal, underpinning current models of the disorder. However, this usage has not been validated. We aimed to directly test the theta/beta ratio as a marker of arousal within this population. METHODS Resting state EEG activity was investigated as a function of CNS arousal in two age-matched groups of boys (each n = 30), with and without ADHD. Arousal was defined in terms of skin conductance level (SCL), which has a long history as a measure of CNS arousal. RESULTS Relative theta power and the theta/beta ratio were elevated, and SCL and relative alpha and beta power were reduced, in the ADHD group compared with control subjects. In both groups, mean alpha level correlated negatively with SCL. There was no significant correlation between the theta/beta ratio and SCL. CONCLUSIONS These data contradict the supposed linkage between the theta/beta ratio and arousal in ADHD, confirming previous results from normal children. They suggest the need for reevaluation of current models of the disorder and reconceptualization of existing EEG data from both normal and atypical populations.

Effects of stimulant medications on the EEG of children with attention-deficit/hyperactivity disorder.

Abstract Rationale. Stimulant medications are the most commonly used treatments for attention deficit/hyperactivity disorder (ADHD) in North America and Australia, although it is still not entirely known how these medications work. Objectives. This study aimed to investigate the effects of stimulant medications on the EEG of children with the Combined subtype of ADHD. Method. An initial EEG was recorded during an eyes-closed resting condition and Fourier transformed to provide absolute and relative power estimates for the delta, theta, alpha and beta bands. Theta/alpha and theta/beta ratios were also calculated. Subjects were placed on a 6-month trial of a stimulant and a second EEG was recorded at the end of the trial. Results. The ADHD group had significantly greater absolute delta and theta, less posterior absolute beta, more relative theta, and less relative alpha than the control group, which is typical of EEG studies of children with ADHD. The use of stimulant medications resulted in normalisation of the EEG, primarily evident in changes in the theta and beta bands. Conclusions. These results suggest that stimulants act to increase cortical arousal in children with ADHD, normalising their brain activity.