Main Article Content
Background. The Diagnostic and Statistical Manual of Mental Disorders (DSM) grouping the types of ADD is based on the clinical symptoms of neurobehavioral disorders, regardless of the possible underlying etiology. This means that the same ADD type group may have a different etiology of functional brain disorders. Meanwhile, QEEG has been known to describe the possible etiology that underlies an ADD event. This study aims to identify differences in QEEG features in the same ADD type group.
Methods. Subjects consisted of 40 boys with ADD. QEEG was recorded from 21 sites, and Fourier transformed to provide estimates for relative power in the delta, theta, alpha, and beta bands in the frontotemporal and central regions. These data were converted to Z-scores based on the normal value data; afterward, they were subjected to cluster analysis. Independent sample t-tests were used to determine how the total ADD group and the ADD cluster subgroups differed from the normal value.
Results. The total ADD group had increased relative delta (Z-score-frontotemporal region = 3,26 ± 1,59; Z-score-central region = 4,04 ± 1,71), decreased relative alpha (Z-score-frontotemporal region = -2,78 ± 1,29; Z-score-central region = -2,86 ± 1,36), decreased relative beta (Z-score-frontotemporal region = -5,33 ± 1,61; Z-score-central region = -6,19 ± 1,86), increased rasio teta/alpha (Z-score-frontotemporal region = 2,806 ± 1,41; Z-score-central region = 2,59 ± 1,26), and increased rasio teta/beta (Z-score-frontotemporal region = 4,36 ± 1,69; Z-score-central region = 4,94 ± 1,46). Two distinct QEEG clusters subgroups were found. The first cluster was characterized by increased central relative delta (Z-score-central region = 3,02 ± 1,17), decreased relative beta (Z-score-frontotemporal region = -4,29 ± 0,73; Z-score-central region = -5,06 ± 1,19) and increased rasio teta/beta (Z-score-frontotemporal region = 3,83 ± 1,91; Z-score-central region = 4,94 ± 1,96). The second cluster was characterized by increased relative delta (Z-score-frontotemporal region = 4,71 ± 1,02; Z-score-central region = 5,72 ± 0,98), decreased relative alpha (Z-score-frontotemporal region = -3,92 ± 1,12; Z-score-central region = -4,24 ± 0,69), decreased relative beta (Z-score-frontotemporal region = -7,08 ± 1,06; Z-score-central region = -8,09 ± 0,99), increased rasio teta/alpha (Z-score-frontotemporal region = 3,08 ± 1,04; Z-score-central region = 2,86 ± 1,02), and increased rasio teta/beta (Z-score-frontotemporal region = 5,23 ± 1,16; Z-score-central region = 5,71 ± 1,35)
Conclusions. These results indicate that boys with ADD do not constitute a homogenous group in QEEG profile terms. Two distinct QEEG clusters were found. The first cluster was typified by a cortically hypoaroused, while the second cluster was typified by a maturational-lag in central nervous system development. This difference in possible etiology may have implications for studies of the utility of QEEG in the diagnosis of ADD and the differences in therapeutic response between the two groups.
- Wolraich ML, Hagan JF, Allan C, et al. AAP Subcommittee on Children and Adolescents with Attention-Deficit/Hyperactive Disorder. Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents. Pediatrics. 2019;144(4): e20192528
- Rashid A, Llanwarne N, Lehman R. Prescribing for ADHD in Primary Care. Br J Gen Pract. 2018;68(669):170-171
- French, B., Perez Vallejos, E., Sayal, K. et al. Awareness of ADHD in Primary Care: Stakeholder Perspectives. BMC Fam Pract. 2020. 21, 45
- Sharma P, Gupta RK, Banal R, et al. Prevalence and Correlates of Attention Deficit Hyperactive Disorder (ADHD) Risk Factors among School Shildren in a Rural Area of North India. J Family Med Prim Care, 2020;9:115-8
- Lenard A. Adler, Sepehr Farahbakhshian, Beverly Romero, et al. Healthcare Provider Perspectives on Diagnosing and Treating Adults with Attention-Deficit/Hyperactivity Disorder, Postgraduate Medicine, 2019, 131:7, 461-472
- Ayano, G., Yohannes, K. & Abraha, M. Epidemiology of Attention-Deficit/Hyperactivity Disorder (ADHD) in Children and Adolescents in Africa: a Systematic Review and Meta-Analysis. Ann Gen Psychiatry, 2020, 19, 21
- Kooij JJS, Bijlenga D, Salerno L, et al. Updated European Consensus Statement on Diagnosis and Treatment of Adult ADHD. Eur Psychiatry, 2019; 56: 14-34
- American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, 5th ed, 2013, Washington, DC
- Clarke R. A. R., Robert J. B., Rory M. C., Mark S., Christopher R., Brown, EEG Evidence For a New Conceptualisation of Attention Deficit Hyperactivity Disorder, Clinical Neurophysiology, 2002, 113: 1036–1044
- Clarke R. A. R., Robert J. B., Rory M. C., Mark S., EEG-Defined Subtypes of Children with Attention-Deficit/Hyperactivity Disorder, Clinical Neurophysiology, 2001, 112: 2098–2105
- Grace A. A., Psychostimulant Actions on Dopamine and Limbic System Function: Relevance to The Pathophysiology and Treatment of ADHD, dalam Stimulant Drugs and ADHD, eds M. V. Solanto, A. F. Arnsten, & F. X. Castellanos, 2000, 134-157, New York: Oxford University Press
- Satterfield J., Cantwell D., Saul R., Lesser M., Podsin R., Response to Stimulant Drug Treatment in Hyperactive Children: Predictions from EEG and Neurological Findings, J Autism Child Schizophr, 1973, 3:36–48
- El-Sayed E. M., Brain Maturation, Cognitive Tasks, and Quantitative Electroencephalography: A Study in Children with Attention Deficit Hyperactivity Disorder, 2002, Karolinska Institutet, Department of Woman and Child Health, Child and Adolescent Psichiatric Unit, Stockholm
- John, Ahn, Prichep, Trepetin, Brown, Kaye, Developmental Equations for the Electroencephalogram, Science, 1980, vol. 210, 1255-1258
- Levy F., Swanson J. M., Timing, Space and ADHD: The Dopamine Theory Revisited, Australian and New Zealand Journal of Psychiatry, 2001, 35:504–511
- Larry S. M., The Use of Auditory and Visual Stimulation for the Treatment of Attention Deficit Hyperactivity Disorder in Children, 1999, Dissertation Doctor of Philosophy in Social Work in the Graduate School of Social Work of the University of Houston, Texas