Effects of methylphenidate on EEG coherence in Attention-Deficit/Hyperactivity Disorder

Reduced Interhemispheric Coherence and Cognition in Children with Fetal Alcohol Spectrum Disorder (FASD)-A Quantitative EEG Study

BACKGROUND

Magnetic resonance imaging in fetal alcohol spectrum disorder (FASD) children showed altered connectivity, suggesting underlying deficits in networks, which may be related to cognitive outcome. Functional connectivity has been of interest in neurophysiological research with quantitative electroencephalography (QEEG) as useful tool for measuring pathology, not detectable by normal EEG. The aim of this study was to investigate differences in the EEG interhemispheric coherence (ICoh) in children diagnosed with FASD compared with healthy controls and to relate the results to cognitive scores.

METHOD

Analysis of ICoh in 81 FASD children (4-Digit Code) compared with 31 controls. The children underwent cognitive assessment, and EEG was performed and used for analysis. Group comparisons and analysis of covariance interaction models were used to test for differences between FASD and controls but also to look for differences between FASD subgroups. Significant findings were correlated to cognitive scores.

RESULTS

Lower ICoh was found in the frontal and temporal derivations in the FASD group. When comparing FASD subgroups, children with fetal alcohol syndrome had lower ICoh occipital. Reduced ICoh in the temporal alpha band was correlated with lower performance IQ in the FASD group.

CONCLUSION

Our findings could imply hypoconnectivity between the hemispheres with impact on cognition. We suggest that EEG coherence analysis could be a sensitive parameter in the detection of electrophysiological abnormalities in FASD with possible clinical relevance. These results may indicate that QEEG could be used as biomarker for FASD. However, further research is needed to determine the role of QEEG analysis in the diagnosis of FASD.

Exploration of electroencephalogram response to MPH treatment in ADHD patients

Attention-deficit/hyperactivity disorder (ADHD) is known to be associated with several diagnostic resting-state electroencephalography (EEG) patterns, including the theta/beta ratio, but no objective predictive markers for each medication. In this study, we explored EEG markers with which the therapeutic efficacy of medications could be estimated at the 1st clinical visit. Thirty-two ADHD patients and thirty-one healthy subjects participated in this study. EEG was recorded during eyes-closed resting conditions, and ADHD symptoms were scored before and after the therapeutic intervention (8 ± 2 weeks). Although comparing EEG patterns between ADHD patients and healthy subjects showed significant differences, EEG dynamics, e.g., theta/beta ratio, in ADHD patients before and after MPH treatment were not significantly different despite improvements in ADHD symptoms. We demonstrated that MPH good responders and poor responders, defined by the efficacy of MPH, had significantly different theta band power in right temporal areas, alpha in left occipital and frontal areas, and beta in left frontal areas. Moreover, we showed that MPH good responders had significant improvements toward normalization in several coherence measures after MPH treatment. Our study implies the possibility of these EEG indices as predictive markers for ADHD therapeutic efficacy.

Abnormal functional asymmetry and its behavioural correlates in adults with ADHD: A TMS-EEG study

OBJECTIVES

Abnormal functional brain asymmetry and deficient response inhibition are two core symptoms of attention deficit hyperactivity disorder (ADHD). We investigated whether these symptoms are inter-related and whether they are underlined by altered frontal excitability and by compromised interhemispheric connectivity.

METHODS

We studied these issues in 52 ADHD and 43 non-clinical adults by comparing: (1) stop-signal reaction time (SSRT); (2) frontal asymmetry of the N200 event-related potential component, which is evoked during response inhibition and is lateralised to the right hemisphere; (3) TMS-evoked potential (TEP) in the right frontal hemisphere, which is indicative of local cortical excitability; and (4) frontal right-to-left interhemispheric TMS signal propagation (ISP), which is reversely indicative of interhemispheric connectivity.

RESULTS

Compared to controls, the ADHD group demonstrated elongated SSRT, reduced N200 right-frontal-asymmetry, weaker TEP, and stronger ISP. Moreover, in the ADHD group, N200 right-frontal-asymmetry correlated with SSRT, with TEP, and with symptoms severity. Conversely, no relationship was observed between ISP and N200 right-frontal-asymmetry, and both TEP and ISP were found to be unrelated to SSRT.

CONCLUSIONS

Our results indicate that abnormal frontal asymmetry is related to a key cognitive symptom in ADHD and suggest that it is underlined by reduced right-frontal excitability.

Altered frontal connectivity as a mechanism for executive function deficits in fragile X syndrome

BACKGROUND

Fragile X syndrome (FXS) is the leading inherited monogenic cause of intellectual disability and autism spectrum disorder. Executive function (EF), necessary for adaptive goal-oriented behavior and dependent on frontal lobe function, is impaired in individuals with FXS. Yet, little is known how alterations in frontal lobe neural activity is related to EF deficits in FXS.

METHODS

Sixty-one participants with FXS (54% males) and 71 age- and sex-matched typically-developing controls (TDC; 58% males) completed a five-minute resting state electroencephalography (EEG) protocol and a computerized battery of tests of EF, the Test of Attentional Performance for Children (KiTAP). Following source localization (minimum-norm estimate), we computed debiased weighted phase lag index (dWPLI), a phase connectivity value, for pairings between 18 nodes in frontal regions for gamma (30-55 Hz) and alpha (10.5-12.5 Hz) bands. Linear models were generated with fixed factors of group, sex, frequency, and connection. Relationships between frontal connectivity and EF variables also were examined.

RESULTS

Individuals with FXS demonstrated increased gamma band and reduced alpha band connectivity across all frontal regions and across hemispheres compared to TDC. After controlling for nonverbal IQ, increased error rates on EF tasks were associated with increased gamma band and reduced alpha band connectivity.

LIMITATIONS

Frontal connectivity findings are limited to intrinsic brain activity during rest and may not generalize to frontal connectivity during EF tasks or everyday function.

CONCLUSIONS

We report gamma hyper-connectivity and alpha hypo-connectivity within source-localized frontal brain regions in FXS compared to TDC during resting-state EEG. For the first time in FXS, we report significant associations between EF and altered frontal connectivity, with increased error rate relating to increased gamma band connectivity and reduced alpha band connectivity. These findings suggest increased phase connectivity within gamma band may impair EF performance, whereas greater alpha band connectivity may provide compensatory support for EF. Together, these findings provide important insight into neurophysiological mechanisms of EF deficits in FXS and provide novel targets for treatment development.

Atypical functional connectivity during rest and task-related dynamic alteration in young children with attention deficit hyperactivity disorder: An analysis using the phase-locking value

AIM

The study investigated the electroencephalography (EEG) functional connectivity (FC) profiles during rest and tasks of young children with attention deficit hyperactivity disorder (ADHD) and typical development (TD).

METHODS

In total, 78 children (aged 5-7 years) were enrolled in this study; 43 of them were diagnosed with ADHD and 35 exhibited TD. Four FC metrics, coherence, phase-locking value (PLV), pairwise phase consistency, and phase lag index, were computed for feature selection to discriminate ADHD from TD.

RESULTS

The support vector machine classifier trained by phase-locking value (PLV) features yielded the best performance to differentiate the ADHD from the TD group and was used for further analysis. In comparing PLVs with the TD group at rest, the ADHD group exhibited significantly lower values on left intrahemispheric long interelectrode lower-alpha and beta as well as frontal interhemispheric beta frequency bands. However, the ADHD group showed higher values of central interhemispheric PLVs on the theta, higher-alpha, and beta bands. Regarding PLV alterations within resting and task conditions, left intrahemispheric long interelectrode beta PLVs declined from rest to task in the TD group, but the alterations did not differ in the ADHD group. Negative correlations were observed between frontal interhemispheric beta PLVs and the Disruptive Behavior Disorder Rating Scale as rated by teachers.

CONCLUSIONS

These results, which complement the findings of other sparse studies that have investigated task-related brain FC dynamics, particularly in young children with ADHD, can provide clinicians with significant and interpretable neural biomarkers for facilitating the diagnosis of ADHD.

ADHD in University Settings: Predictive Validity of Quantitative EEG Coherence

PURPOSE

Research has demonstrated distinct patterns of electroencephalography (EEG) coherence with attention-deficit/hyperactivity disorder (ADHD) in children; however, few studies have examined coherence measures in adults with ADHD. Further, specific research examining EEG coherence within the subgroup of young adults in post-secondary education is absent from the literature.

METHODS

The current study investigated the utility of quantitative EEG in predicting ADHD behavioral symptoms in 35 college students with a documented ADHD diagnosis and 35 control students.

RESULTS

Increased interhemispheric frontal beta-wave coherence was found in individuals with ADHD. Logistic regression of principle components of quantitative EEG coherence metrics predicted ADHD group membership.

CONCLUSIONS

Suggestions for improving ADHD identification in college populations using quantitative EEG are discussed.

EEG coherence during subjectively-rated psychological state variations

BACKGROUND

Neurofeedback training aims to develop awareness and control of psychological states in order to self-regulate brain activity and while used widely therapeutically, important questions remain unanswered. Central to these aims is an assumed association between the live EEG-based feedback and the subjective experience of a psychological state. To date, there is little evidence to support this relationship. Previous studies examining the association between an EEG index and subjective experience have explored only the presence or absence of the state, or merely assumed state variations. The current study aims to examine this association by considering how different levels of a psychological state (i.e., attention) are reflected in EEG coherence.

METHODS

Our approach aims to allow comparisons of EEG coherence between psychological states (attention vs. rest), and also within subjectively-rated levels of a psychological state (attention) through a purpose-designed questionnaire. Thirty healthy adult participants performed a resting eyes-open (REO) and attention modulation task, while 28 channels of EEG were recorded. Levels within the psychological state were subjectively-attested by participants on a trial-by-trial basis.

RESULTS

The main analyses examined the effect of subjectively-rated attention levels (SRALs) on EEG coherence, with results suggesting that high and low SRALs may be represented by: 1) different levels of alpha and theta coherence at anterior and posterior electrodes of the frontal lobe bilaterally, and 2) different levels of alpha coherence between central and parietal lobes, also bilaterally.

DISCUSSION

These findings provide partial, preliminary evidence for EEG correlates of SRALs. These findings may have implications for understanding underlying mechanisms of NFT, which is an underdeveloped area.

Atypical functional connectivity in adolescents and adults with persistent and remitted ADHD during a cognitive control task

We previously provided initial evidence for cognitive and event-related potential markers of persistence/remission of attention-deficit/hyperactivity disorder (ADHD) from childhood to adolescence and adulthood. Here, using a novel brain-network connectivity approach, we aimed to examine whether task-based functional connectivity reflects a marker of ADHD remission or an enduring deficit unrelated to ADHD outcome. High-density EEG was recorded in a follow-up of 110 adolescents and young adults with childhood ADHD (87 persisters, 23 remitters) and 169 typically developing individuals during an arrow-flanker task, eliciting cognitive control. Functional connectivity was quantified with network-based graph-theory metrics before incongruent (high-conflict) target onset (pre-stimulus), during target processing (post-stimulus) and in the degree of change between pre-stimulus/post-stimulus. ADHD outcome was examined with parent-reported symptoms and impairment using both a categorical (DSM-IV) and a dimensional approach. Graph-theory measures converged in indicating that, compared to controls, ADHD persisters showed increased connectivity in pre-stimulus theta, alpha, and beta and in post-stimulus beta (all p < .01) and reduced pre-stimulus/post-stimulus change in theta connectivity (p < .01). In the majority of indices showing ADHD persister-control differences, ADHD remitters differed from controls (all p < .05) but not from persisters. Similarly, connectivity measures were unrelated to continuous outcome measures of ADHD symptoms and impairment in participants with childhood ADHD. These findings indicate that adolescents and young adults with persistent and remitted ADHD share atypical over-connectivity profiles and reduced ability to modulate connectivity patterns with task demands, compared to controls. Task-based functional connectivity impairments may represent enduring deficits in individuals with childhood ADHD irrespective of diagnostic status in adolescence/young adulthood.

Coherence in children with AD/HD and excess alpha power in their EEG

OBJECTIVE

This study investigated differences in EEG coherence measures between two groups of children with Attention-Deficit/Hyperactivity Disorder (AD/HD) - one with the more common EEG profile (increased theta), and a group with excess alpha activity as the dominant EEG abnormality.

METHODS

26 children (aged 9-13years) with AD/HD were included in each of the excess-theta and excess-alpha groups, and were age- and sex-matched with 26 control subjects. EEG was recorded from 19 electrode sites during an eyes-closed resting condition. Wave-shape coherence was calculated for eight intrahemispheric and eight interhemispheric electrode pairs, for the delta, theta, alpha and beta bands.

RESULTS

In comparison with the controls, the excess-theta AD/HD group had increased theta intrahemispheric coherences at short-medium inter-electrode distances. Frontally, the excess-theta AD/HD group had increased interhemispheric theta and reduced beta coherences. The excess-alpha group primarily showed increased slow wave (delta and theta) intrahemispheric coherence at short-medium inter-electrode distances, and reduced alpha coherence at longer inter-electrode distances, compared with controls. An increase in frontal interhemispheric theta coherence was also found.

CONCLUSIONS

These results suggest that AD/HD children with excess alpha power have an underlying connectivity dysfunction in the frontal lobes, which is found in common with other subjects with the excess-theta EEG profile. However, a number of qualitative differences exist that could be associated with other aspects of the AD/HD diagnosis. The excess-alpha group appeared to have fewer frontal-lobe abnormalities than the excess-theta AD/HD group.

SIGNIFICANCE

This is the first study to investigate coherence in AD/HD children who have the atypical profile of increased alpha power in their EEG.

Electroencephalography signatures of attention-deficit/hyperactivity disorder: clinical utility

The techniques and the most important results on the use of electroencephalography (EEG) to extract different measures are reviewed in this work, which can be clinically useful to study subjects with attention-deficit/hyperactivity disorder (ADHD). First, we discuss briefly and in simple terms the EEG analysis and processing techniques most used in the context of ADHD. We review techniques that both analyze individual EEG channels (univariate measures) and study the statistical interdependence between different EEG channels (multivariate measures), the so-called functional brain connectivity. Among the former ones, we review the classical indices of absolute and relative spectral power and estimations of the complexity of the channels, such as the approximate entropy and the Lempel-Ziv complexity. Among the latter ones, we focus on the magnitude square coherence and on different measures based on the concept of generalized synchronization and its estimation in the state space. Second, from a historical point of view, we present the most important results achieved with these techniques and their clinical utility (sensitivity, specificity, and accuracy) to diagnose ADHD. Finally, we propose future research lines based on these results.

Predicting the clinical outcome of stimulant medication in pediatric attention-deficit/hyperactivity disorder: data from quantitative electroencephalography, event-related potentials, and a go/no-go test

BACKGROUND

We searched for predictors of the clinical outcome of stimulant medication in pediatric attention-deficit/hyperactivity disorder (ADHD), emphasizing variables from quantitative electroencephalography, event-related potentials (ERPs), and behavioral data from a visual go/no-go test.

METHODS

Nineteen-channel electroencephalography (EEG) was recorded during the resting state in eyes-open and eyes-closed conditions and during performance of the cued go/no-go task in 98 medication-naïve ADHD patients aged 7-17 years and in 90 controls with the same age and sex distribution as the patients. For patients, the recording was followed by a systematic trial on stimulant medication lasting at least 4 weeks. Based on data from rating scales and interviews, two psychologists who were blind to the electrophysiological results independently rated the patients as responders (REs) (N=74) or non-responders (non-REs) (N=24). Using a logistic regression model, comparisons were made between REs and non-REs on the EEG spectra, ERPs (cue P3, contingent negative variation, and P3 no-go of the ERP waves and independent components [ICs] extracted from these waves), reaction time, reaction time variability, number of commission and omission errors, intelligence quotient, age, sex, ADHD subtype, and comorbidities.

RESULTS

The two groups differed significantly on eight of the variables, with effect sizes (Cohen's d) ranging from 0.49 to 0.76. In the multivariate logistic regression analysis, only three of these variables were significantly associated with clinical outcome. The amplitude of the IC cue P3, which has a parietal-occipital distribution, was normal in REs but significantly smaller in non-REs, whereas the centrally distributed IC P3 no-go early was smaller in REs than in non-REs and controls. In addition, the REs had more power in the EEG theta band. A quartile-based index was calculated using these three variables. The group with the lowest scores comprised only 36% REs; response rates in the three other groups were 83%, 86%, and 89%.

CONCLUSION

The clinical outcome of stimulant medication was best predicted by electrophysiological parameters. The brain dysfunctions of the REs appear to be primarily associated with prefrontal lobe hypoactivation. The non-REs were deviant from the controls in parietal-occipital functions.

EEG oscillatory activity associated to monetary gain and loss signals in a learning task: effects of attentional impulsivity and learning ability

This study investigated the influence of individual differences in attentional impulsivity (Att-Imp), learning ability, and learning practice on oscillatory activity and phase synchrony responses to monetary gain and loss signals during an instrumental-learning task in healthy women. We used a trial-by-trial wavelet-based time-frequency analysis of the electroencephalographic (EEG) signal to provide amplitude and inter-site phase synchrony measures from 30 electrodes in theta (4-8 Hz, 350-500 ms), alpha (8-12 Hz, 100-200 ms), beta (13-25 Hz, 100-200 ms), and gamma (30-40 Hz, 350-450 ms) time-frequency ranges. Oscillatory amplitude and inter-site phase synchrony were both greater following loss signals as compared to gain signals in theta, beta, and gamma frequency bands. Low Att-Imp subjects had higher theta activity within a 350-500 ms time window over frontocentral, and centroparietal sites than high Att-Imp subjects. Monetary gain signals elicited higher theta and gamma activities in high Att-Imp individuals and loss signals elicited higher activities to loss signals in low Att-Imp individuals. Good learners showed enhanced intrahemispheric theta synchrony between frontoparietal, and fronto-occipital sites to monetary loss compared to gain signals. In good learners, monetary loss produced an increase of gamma synchrony that enhanced in the second stage of learning. In low Att-Imp individuals, there was a reduction of theta synchrony during the second stage, as compared with the first stage of learning, between temporal, parietal and fronto-parietal brain regions. These findings may offer valuable clues to understand outcome processing, attentional impulsivity, and learning ability. We propose that the punishment-related theta and gamma waves play a leading role in learning process.

EEG coherence and symptom profiles of children with Attention-Deficit/Hyperactivity Disorder

OBJECTIVE

We compared EEG coherence in children with and without AD/HD, and sought to relate observed anomalies to AD/HD symptoms.

METHODS

Forty children with AD/HD and 40 age- and sex-matched controls had eyes-closed resting EEG coherence calculated for eight interhemispheric electrode pairs and eight intrahemispheric pairs (four within each hemisphere) in the delta, theta, alpha, beta and "40 Hz" gamma bands.

RESULTS

At short-medium inter-electrode distances, the AD/HD group had increased intrahemispheric coherence in delta and theta, and reduced (L>R) laterality in delta, alpha, beta and gamma. Over longer inter-electrode distances, the AD/HD group had reduced intrahemispheric coherence in alpha. In interhemispheric comparisons, the AD/HD group had reduced frontal coherence in delta, alpha and gamma, increased temporal theta and reduced temporal alpha coherences, and increased central/parietal/occipital coherence in theta. Smaller left-lateralized coherences in AD/HD correlated negatively with DSM Inattentive and DSM Total scores, and smaller frontal interhemispheric coherence in alpha correlated negatively with DSM Hyperactive/Impulsive score.

CONCLUSIONS

The negative correlations between AD/HD coherence anomalies and symptoms suggest that several anomalies reflect compensatory brain function.

SIGNIFICANCE

Coherence differences in AD/HD may reflect anomalous frontal right-hemisphere linkages that help compensate functional brain anomalies in the left frontal regions in this disorder.

EEG coherence in children with attention-deficit/hyperactivity disorder: differences between good and poor responders to methylphenidate

This retrospective study investigated differences in regional derivations of EEG coherence between good and poor responders to methylphenidate (MPH) in children (aged 8-12 years) with the combined type of attention-deficit/hyperactivity disorder (AD/HD). Participants included groups of good and poor male MPH responders and an aged-matched group of male controls. An eyes-closed, resting electroencephalogram (EEG) was recorded from 21 electrode sites. Coherence was calculated from eight intrahemispheric and eight interhemispheric electrode pairs, for the delta, theta, alpha and beta frequency bands. Compared with controls, the AD/HD participants had enhanced laterality over short-medium inter-electrode distances, and elevated frontal interhemispheric coherences, in the theta band. Good MPH responders had higher intrahemispheric coherences than poor MPH responders over short-medium and long inter-electrode distances in the beta band. Enhanced laterality at short-medium inter-electrode distances suggests that the AD/HD children may have a developmental lag in short-axonal connections in the left hemisphere. Elevated frontal interhemispheric theta coherence consistently indicates some frontal dysfunction in AD/HD. The beta coherence differences found between good and poor MPH responders could indicate that good MPH responders have some type of structural dysfunction associated with cortical connections involved in attention/arousal.

Increased theta coherence during Chinese reading

EEG coherence has been used extensively in the investigation of language processing of English words. In contrast, relatively less is known about the EEG coherence pattern in the language processing of Chinese characters. Given the involvement of distinct and overlapping regions in the brain during English and Chinese reading, and activation in the left and right hemisphere found in functional magnetic resonance imaging (fMRI) studies on Chinese reading, the present study aimed to investigate the EEG coherence pattern associated with Chinese reading, and to determine if higher interhemispheric coherence was found in Chinese reading. EEG coherence of 32 healthy normal participants during a resting condition, English, and Chinese reading were computed and compared. The results revealed that Chinese reading was generally associated with higher theta coherence than the resting condition and English reading. Specifically, theta coherence during Chinese reading showed an increased intrahemispheric connection in the left hemisphere and interhemispheric connections over the temporal, central and parietal/occipital regions, compared to English reading. These results suggest that interhemispheric cooperation between neuronal substrates in these regions is associated with Chinese reading, and that both hemispheres are involved in Chinese reading.

QEEG studies in the assessment and treatment of childhood disorders

Quantifying EEG measures across age allows the ability to establish parameters of normalcy at any age which can be used as a reference when children exhibit developmental delays in their abilities and/or other atypical and maladaptive behaviors. A review of the current literature on the utilization of QEEG methods to serve as an aid for identifying these children as distinctively different from normal, and in some cases as distinctive from other clinical considerations has been shown to provide a sufficient sensitivity and specificity worthy of consideration as a diagnostic aid in evaluating clinical deviations in development. Furthermore, these same QEEG measures can provide a means of establishing treatment efficacy for the evident brain dysfunctions underlying these childhood disorders.

Spontaneous EEG Oscillations in Children, Adolescents, and Adults

Data are presented on EEG activity in typically developing controls, focusing on the traditional delta, theta, alpha, and beta bands through childhood, with some extensions into adolescence and adults. Both eyes-closed and eyes-open resting state data are discussed. These reflections of typical development provide a framework for illustrating EEG differences in people with attention deficit/hyperactivity disorder (AD/HD), and its main diagnostic types, from children to adults. Comorbidity effects in the EEG of children with AD/HD, particularly comorbid reading disabilities and conduct disorders, are also described. Some recent explorations of the links between arousal/activation and EEG activity may contribute to our understanding of the functional nature of brain oscillations in this context. Other aspects of oscillatory brain activity, coherence and event-related potentials, are also briefly discussed within this framework.

Functional connectivity of frontal cortex in healthy and ADHD children reflected in EEG coherence

Abnormal functional brain connectivity is a candidate factor in developmental brain disorders associated with cognitive dysfunction. We analyzed a substantial (10 min per subject) record of dense array electroencephalography with spectral power and coherence methods in attention-deficit hyperactivity disorder (ADHD) (n = 42) and control (n = 21) 10- to 13-year-old children. We found topographically distinct narrow band coherence differences between subject groups: ADHD subjects showed elevated coherence in the lower alpha (8 Hz) band and reduced coherence in the upper alpha (10-11 Hz) band. The 8-Hz ADHD elevation and a 2- to 6-Hz control group coherence elevation were independent of stimulus presentation. In response to visual stimulation, the ADHD group exhibited reduced evoked potential power and elevated frontal coherence. Only the upper alpha band control group coherence elevation discriminated according to ADHD group medication status. The findings suggest a static state of deficient connectivity in ADHD and a stimulus-induced state of overconnectivity within and between frontal hemispheres.

Coherence in children with Attention-Deficit/Hyperactivity Disorder and excess beta activity in their EEG

OBJECTIVE

This study investigated differences in coherence measures between two groups of children with Attention-Deficit/Hyperactivity Disorder (ADHD) - with the typical EEG profile (increased theta and decreased beta activity), and with excess beta activity - and a normal control group.

METHODS

Thirty-four children with ADHD were included in each of the typical and excess beta groups, and were age and sex matched with 34 control subjects. EEG was recorded from 21 sites during an eyes-closed resting condition. Wave-shape coherence was calculated for eight intrahemispheric and eight interhemispheric electrode pairs, for the delta, theta, alpha and beta bands.

RESULTS

In comparison to the controls, the typical ADHD group primarily had increased intrahemispheric theta and beta coherence at short-medium inter-electrode distances, and increased interhemispheric coherence for theta in the frontal and central/parietal/occipital regions. Their laterality effect for interhemispheric short-medium inter-electrode distances was reduced in the theta band. Differences between the excess beta group and the control group were primarily found in laterality of the intrahemispheric theta coherence at short-medium electrode distances, and increased interhemispheric theta coherence in the frontal regions. Reduced delta coherence in the temporal regions was also found.

CONCLUSIONS

These results suggest that ADHD children with excess beta power have an underlying brain dysfunction in the frontal lobes which is found in common with children with the typical EEG profile. However a number of qualitative differences exist which could be associated with other aspects of the ADHD diagnosis or another comorbid condition.

SIGNIFICANCE

This is the first study to investigate EEG coherence in ADHD children who have increased beta power.

EEG-Veränderungen unter Methylphenidat - eine Pilotstudie

Zusammenfassung: Fragestellung: Es existieren widersprüchliche Aussagen hinsichtlich der Senkung der sogenannten «Krampfschwelle» als mögliche unerwünschte Nebenwirkung von Methylphenidat. Die vorliegende Pilotstudie galt der empirischen Überprüfung dieser Behauptung sowie der quantitativen Erfassung von Änderungen elektrophysiologischer Parameter unter Methylphenidattherapie. Methodik: 15 Patienten mit ADHS im Alter von 6 bis 14 Jahren wurden elektrophysiologisch untersucht. Die Diagnosestellung des hyperkinetischen Syndroms erfolgte unter Einhaltung aller Kriterien der ICD-10-Klassifikation durch eine multiaxiale Diagnostik. Die EEG-Ableitungen wurden zur Beurteilung der elektrophysiologischen Auswirkungen von Methylphenidat hinsichtlich der spektralen Frequenzzusammensetzung sowie dem Vorhandensein pathologischer Korrelate ausgewertet. Ergebnisse: Die FFT-Analyse der EEG-Daten vor und nach der Behandlung mit Methylphenidat zeigte eine Zunahme der okzipitalen Alpha-Aktivität gegenüber der Delta-Theta-Aktivität. Weiterhin konnte eine Zunahme der Beta-Aktivität in der Zentral-Region und ein Trend zur Zunahme der Beta-Aktivität in der Frontal-Region registriert werden. Es wurden in diesem Patientenkollektiv weder vor noch nach der Behandlung mit Methylphenidat pathologische EEG-Veränderungen registriert. Schlussfolgerung: Die Ergebnisse unterstützen die mehrheitliche Auffassung in der Literatur, dass Methylphenidat nicht zu einer Senkung der Krampfschwelle führt. Vielmehr kann eine EEG-Normalisierung im Sinne einer Beschleunigung der Grundaktivität nachvollzogen werden.

The role of abnormal neural oscillations in the pathophysiology of co-occurring Tourette syndrome and attention-deficit/hyperactivity disorder

OBJECTIVE

To examine the role of aberrant neural oscillatory activity in the pathophysiology of co-occurring Tourette Syndrome (TS) and Attention-Deficit/Hyperactivity Disorder (ADHD).

METHOD

Neural oscillations refer to periodic variations in the recording of neural activity. The temporal synchronization of oscillations represents a mechanism of neural communication implicated in normal brain functioning as well as psychopathology. We reviewed physiological, imaging, and neuropsychological evidence that tics and symptoms of ADHD may result from abnormal oscillatory activity in the brain.

RESULTS

Structural and functional abnormalities in the cortical-striatal-thalamo-cortical circuits may result in the disruption of oscillatory activity within the basal ganglia of individuals with TS and lead to transient hyperpolarization of selected thalamocortical regions. Extended to TS plus ADHD this or similar mechanisms, in turn, would lead to the dysrhythmia of particular vulnerable cortical regions and give rise to various deficits in motor control (TS + ADHD) as well as impulsivity and attention (ADHD). Compensatory systems within the prefrontal cortex could be activated and trained to modulate the misguided striatal and thalamocortical oscillations.

CONCLUSIONS

Although it is highly likely that abnormal neural oscillations have a prominent role in co-occurrence of TS + ADHD, its final relevance in this case deserves further differentiated research (i.e. oscillatory networks disentangled from other neuropsychiatric disorders).

The Deployment of Intersensory Selective Attention

OBJECTIVE

: Ingestion of the nonproteinic amino acid theanine (5-N-ethylglutamine) has been shown to increase oscillatory brain activity in the so-called alpha band (8-14 Hz) during resting electroencephalographic recordings in humans. Independently, alpha band activity has been shown to be a key component in selective attentional processes. Here, we set out to assess whether theanine would cause modulation of anticipatory alpha activity during selective attentional deployments to stimuli in different sensory modalities, a paradigm in which robust alpha attention effects have previously been established.

METHODS

: Electrophysiological data from 168 scalp electrode channels were recorded while participants performed a standard intersensory attentional cuing task.

RESULTS

: As in previous studies, significantly greater alpha band activity was measured over parieto-occipital scalp for attentional deployments to the auditory modality than to the visual modality. Theanine ingestion resulted in a substantial overall decrease in background alpha levels relative to placebo while subjects were actively performing this demanding attention task. Despite this decrease in background alpha activity, attention-related alpha effects were significantly greater for the theanine condition.

CONCLUSION

: This increase of attention-related anticipatory alpha over the right parieto-occipital scalp suggests that theanine may have a specific effect on the brain's attention circuitry. We conclude that theanine has clear psychoactive properties, and that it represents a potentially interesting, naturally occurring compound for further study, as it relates to the brain's attentional system.

EEG abnormalities in adolescent males with AD/HD

OBJECTIVE

This study investigated EEG abnormalities in adolescents with attention-deficit/hyperactivity disorder (AD/HD).

METHODS

Fifteen AD/HD subjects and 15 control subjects participated in this study. All subjects were between 14 and 17 years of age. The EEG was recorded from 19 electrode sites and was analysed to provide estimates of both absolute and relative power in the delta, theta, alpha and beta bands. Theta/alpha and theta/beta ratio coefficients were also calculated.

RESULTS

Across the scalp, AD/HD subjects were characterised by greater absolute delta and theta activity, and an increased theta/beta ratio compared to controls. No group differences were found for either absolute or relative alpha, or absolute beta. However, AD/HD subjects demonstrated a reduction in relative beta activity in the posterior regions.

CONCLUSIONS

The AD/HD group showed significant deviations from normal CNS development, in particular in posterior regions. This supports previous suggestions that individuals with an EEG profile that is not indicative of a maturational lag are more likely to have AD/HD during adolescence.

SIGNIFICANCE

This is the first study to investigate EEG abnormalities in adolescents with AD/HD during an eyes-closed resting condition.

Response variability in Attention-Deficit/Hyperactivity Disorder: a neuronal and glial energetics hypothesis

BACKGROUND

Current concepts of Attention-Deficit/Hyperactivity Disorder (ADHD) emphasize the role of higher-order cognitive functions and reinforcement processes attributed to structural and biochemical anomalies in cortical and limbic neural networks innervated by the monoamines, dopamine, noradrenaline and serotonin. However, these explanations do not account for the ubiquitous findings in ADHD of intra-individual performance variability, particularly on tasks that require continual responses to rapid, externally-paced stimuli. Nor do they consider attention as a temporal process dependent upon a continuous energy supply for efficient and consistent function. A consideration of this feature of intra-individual response variability, which is not unique to ADHD but is also found in other disorders, leads to a new perspective on the causes and potential remedies of specific aspects of ADHD.

THE HYPOTHESIS

We propose that in ADHD, astrocyte function is insufficient, particularly in terms of its formation and supply of lactate. This insufficiency has implications both for performance and development: H1) In rapidly firing neurons there is deficient ATP production, slow restoration of ionic gradients across neuronal membranes and delayed neuronal firing; H2) In oligodendrocytes insufficient lactate supply impairs fatty acid synthesis and myelination of axons during development. These effects occur over vastly different time scales: those due to deficient ATP (H1) occur over milliseconds, whereas those due to deficient myelination (H2) occur over months and years. Collectively the neural outcomes of impaired astrocytic release of lactate manifest behaviourally as inefficient and inconsistent performance (variable response times across the lifespan, especially during activities that require sustained speeded responses and complex information processing).

TESTING THE HYPOTHESIS

Multi-level and multi-method approaches are required. These include: 1) Use of dynamic strategies to evaluate cognitive performance under conditions that vary in duration, complexity, speed, and reinforcement; 2) Use of sensitive neuroimaging techniques such as diffusion tensor imaging, magnetic resonance spectroscopy, electroencephalography or magnetoencephalopathy to quantify developmental changes in myelination in ADHD as a potential basis for the delayed maturation of brain function and coordination, and 3) Investigation of the prevalence of genetic markers for factors that regulate energy metabolism (lactate, glutamate, glucose transporters, glycogen synthase, glycogen phosphorylase, glycolytic enzymes), release of glutamate from synaptic terminals and glutamate-stimulated lactate production (SNAP25, glutamate receptors, adenosine receptors, neurexins, intracellular Ca2+), as well as astrocyte function (alpha1, alpha2 and beta-adrenoceptors, dopamine D1 receptors) and myelin synthesis (lactate transporter, Lingo-1, Quaking homolog, leukemia inhibitory factor, and Transferrin).

IMPLICATIONS OF THE HYPOTHESIS

The hypothesis extends existing theories of ADHD by proposing a physiological basis for specific aspects of the ADHD phenotype - namely frequent, transient and impairing fluctuations in functioning, particularly during performance of speeded, effortful tasks. The immediate effects of deficient ATP production and slow restoration of ionic gradients across membranes of rapidly firing neurons have implications for daily functioning: For individuals with ADHD, performance efficacy would be enhanced if repetitive and lengthy effortful tasks were segmented to reduce concurrent demands for speed and accuracy of response (introduction of breaks into lengthy/effortful activities such as examinations, motorway driving, assembly-line production). Also, variations in task or modality and the use of self- rather than system-paced schedules would be helpful. This would enable energetic demands to be distributed to alternate neural resources, and energy reserves to be re-established. Longer-term effects may manifest as reduction in regional brain volumes since brain areas with the highest energy demand will be most affected by a restricted energy supply and may be reduced in size. Novel forms of therapeutic agent and delivery system could be based on factors that regulate energy production and myelin synthesis. Since the phenomena and our proposed basis for it are not unique to ADHD but also manifests in other disorders, the implications of our hypotheses may be relevant to understanding and remediating these other conditions as well.