Theta/beta ratio in EEG correlated with attentional capacity assessed by Conners Continuous Performance Test in children with ADHD

Tzong-Shi Wang; Syu-Siang Wang; Chang-Li Wang; Shi-Bing Wong

doi:10.3389/fpsyt.2023.1305397

Theta/beta ratio in EEG correlated with attentional capacity assessed by Conners Continuous Performance Test in children with ADHD

Front Psychiatry. 2024 Jan 19:14:1305397. doi: 10.3389/fpsyt.2023.1305397. eCollection 2023.

Authors

Tzong-Shi Wang¹, Syu-Siang Wang², Chang-Li Wang³, Shi-Bing Wong^{4

5}

Affiliations

¹ Department of Psychiatry, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan.
² Department of Electrical Engineering, Yuan Ze University, Taoyuan, Taiwan.
³ Taipei Municipal Jianguo High School, Taipei, Taiwan.
⁴ Department of Pediatrics, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan.
⁵ School of Medicine, Tzu Chi University, Hualien, Taiwan.

Abstract

Introduction: Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder affecting children worldwide; however, diagnosing ADHD remains a complex task. Theta/beta ratio (TBR) derived from electroencephalography (EEG) recordings has been proposed as a potential biomarker for ADHD, but its effectiveness in children with ADHD remains controversial. Behavioral assessments, such as the Conners Continuous Performance Test-3^rd edition (CPT-3), have been utilized to assess attentional capacity in individuals with ADHD. This study aims to investigate the correlation between TBR and CPT-3 scores in children and adolescents with ADHD.

Methods: In a retrospective analysis, we examined patients regularly monitored for ADHD at Taipei Tzu Chi Hospital, who underwent both EEG and CPT-3 assessments. Severity of ADHD was evaluated using parent- and teacher-completed Swanson, Nolan, and Pelham (SNAP)-IV rating scales.

Results: The study encompassed 55 ADHD patients (41 with abnormal CPT-3 scores, 14 with normal CPT-3 scores) and 45 control subjects. TBR demonstrated elevation in ADHD patients with abnormal CPT-3 scores, indicating its potential to represent attentional capacity akin to behavioral assessments like CPT-3. However, significant correlations between TBR values and CPT-3 variables or SNAP-IV rating scales were not observed. Moreover, TBR values exhibited considerable overlap across the groups, leading to diminished sensitivity and negative predictive value as a potential neurophysiological ADHD biomarker.

Discussion: While our study underscores the utility of both TBR and CPT-3 in assessing attentional capacity, their sensitivity in diagnosing ADHD is limited. A comprehensive evaluation, integrating clinical expertise, parental input, and detailed neuropsychometric tests, remains pivotal for a thorough and precise diagnosis of ADHD.

Keywords: Connor's Continuous Performance Test; attention capacity; attention deficit/hyperactivity disorder; quantitative electroencephalography; theta/beta ratio.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by the Taipei Tzu Chi Hospital (Grant Numbers: TCRD-TPE-110–023 and TCRD-TPE-111-RT-2 to S-BW).