Abstract
Objective: In children with attention-deficit/hyperactivity disorder (ADHD), an increased theta/beta ratio in the resting EEG typically serves as a rationale to conduct theta/beta neurofeedback (NF) training. However, this finding is increasingly challenged. As NF may rather target an active than a passive state, we studied the EEG in a condition that requires attention.Methods: In children with ADHD of the DSM-IV combined type (ADHD-C; N = 15) and of the predominantly inattentive type (ADHD-I; N = 9) and in typically developing children (N = 19), EEG spectral analysis was conducted for segments during the attention network test (ANT) without processing of stimuli and overt behavior. Frontal (F3, Fz, F4), central (C3, Cz, C4) and parietal (P3, Pz, P4) electrodes were included in the statistical analysis. To investigate if EEG spectral parameters are related to performance measures, correlation coefficients were calculated.Results: Particularly in the ADHD-C group, higher theta and alpha activity was found with the most prominent effect in the upper-theta/lower-alpha (5.5–10.5 Hz) range. In the ADHD-I group, a significantly higher theta/beta ratio was observed at single electrodes (F3, Fz) and a tendency for a higher theta/beta ratio when considering all electrodes (large effect size). Higher 5.5–10.5 Hz activity was associated with higher reaction time variability with the effect most prominent in the ADHD-C group. A higher theta/beta ratio was associated with higher reaction times, particularly in the ADHD-I group.Conclusions: (1) In an attention demanding period, children with ADHD are characterized by an underactivated state in the EEG with subtype-specific differences. (2) The functional relevance of related EEG parameters is indicated by associations with performance (reaction time) measures. (3) Findings provide a rationale for applying NF protocols targeting theta (and alpha) activity and the theta/beta ratio in subgroups of children with ADHD.
Highlights
Theta/beta training belongs to the neurofeedback (NF) protocols which are frequently applied in children with attention-deficit/hyperactivity disorder (ADHD); for review see Arns et al (2014) and Gevensleben et al (2014)
Higher 5.5–10.5 Hz activity was associated with higher reaction time variability with the effect most prominent in the ADHD of the DSM-IV combined type (ADHD-C) group
Conclusions: (1) In an attention demanding period, children with ADHD are characterized by an underactivated state in the EEG with subtype-specific differences
Summary
Theta/beta training belongs to the neurofeedback (NF) protocols which are frequently applied in children with ADHD; for review see Arns et al (2014) and Gevensleben et al (2014). Higher baseline theta activity in the resting EEG (recorded in an eyes open condition) over centro-parietal regions was associated with a larger reduction of the severity of ADHD symptoms after theta/beta training and larger decreases of theta activity from preto post-training were accompanied by larger clinical improvements. These findings indicate that it should be possible to derive EEG-based indication criteria for which children theta/beta training may be more appropriate
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