Microstate dynamics and spectral components as markers of persistent and remittent attention-deficit/hyperactivity disorder.

OBJECTIVE: We leveraged microstate characteristics and power features to examine temporal and spectral deviations underlying persistent and remittent attention-deficit/hyperactivity disorder (ADHD). METHODS: 50 young adults with childhood ADHD (28 persisters, 22 remitters) and 28 demographically similar healthy controls (HC) were compared on microstates features and frequency principal components (f-PCs) of eye-closed resting state. Support vector machine model with sequential forward selection (SVM-SFS) was utilized to discriminate three groups. RESULTS: Four microstates and four comparable f-PCs were identified. Compared to HC, ADHD persisters showed prolonged duration in microstate C, elevated power of the delta component (D), and compromised amplitude of the two alpha components (A1 and A2). Remitters showed increased duration and coverage of microstate C, together with decreased activity of D, relatively intact amplitude of A1, and amplitude reduction in A2. The SVM-SFS algorithm achieved an accuracy of 93.59% in classifying persisters, remitters and controls. The most discriminative features selected were those exhibiting group differences. CONCLUSIONS: We found widespread anomalies in ADHD persisters in brain dynamics and intrinsic EEG components. Meanwhile, the neural features in remitters exhibited multiple patterns. SIGNIFICANCE: This study underlines the use of microstate dynamics and spectral components as potential markers of persistent and remittent ADHD.

Overactivated contextual visual perception and response to a single dose of methylphenidate in children with ADHD.

The pathogenesis of overactivated visual perception in attention-deficit hyperactivity disorder (ADHD) remains unclear, which is interpreted as a cognitive compensation. The existing studies have proposed that perceptual abnormalities in neurodevelopmental disorders are associated with dysfunction of the contextual knowledge system, which influences the development and formation of perception. We hypothesized that alterations in contextual states may also be responsible for inducing perceptual abnormalities in ADHD. Therefore, the present study evaluated the characteristics of pre-stimulus alpha and its response to a single dose of methylphenidate (MPH). A total of 135 Chinese children participated in the first study, including 70 children with ADHD (age = 10.61 ± 1.93 years, female = 17) and 65 age- and sex-matched control children (age = 10.73 ± 1.93 years, female = 20). The second clinical trial included 19 Chinese children with ADHD (age = 11.85 ± 1.72 years, female = 4), with an identical visual spatial search task. Pre-stimulus alpha oscillations and P1 activity were significantly greater in children with ADHD than in the controls. Overactivated pre-stimulus alpha positively predicted P1. Both pre-stimulus alpha and P1 overactivation have beneficial effects on cognitive performance in children with ADHD. No intervening effect of a single dose of MPH on the compensatory activation of pre-stimulus alpha and P1 were observed. Our findings extended the perceptual activation to the contextual knowledge system, suggesting that compensatory perception in children with ADHD is more likely to be a top-down regulated cognitive operational process.

Automatic sensory change processing in adults with attention deficit and hyperactivity disorder: a visual mismatch negativity study.

In addition to higher-order executive functions, underlying sensory processing ability is also thought to play an important role in Attention-Deficit/Hyperactivity Disorder (AD/HD). An event-related potential feature, the mismatch negativity, reflects the ability of automatic sensory change processing and may be correlated with AD/HD symptoms and executive functions. This study aims to investigate the characteristics of visual mismatch negativity (vMMN) in adults with AD/HD. Twenty eight adults with AD/HD and 31 healthy controls were included in this study. These two groups were matched in age, IQ and sex. In addition, both groups completed psychiatric evaluations, a visual ERP task used to elicit vMMN, and psychological measures about AD/HD symptoms and day-to-day executive functions. Compared to trols, the late vMMN (230-330 ms) was significantly reduced in the AD/HD group. Correlation analyses showed that late vMMN was correlated with executive functions but not AD/HD symptoms. However, further mediation analyses showed that different executive functions had mediated the relationships between late vMMN and AD/HD symptoms. Our findings indicate that the late vMMN, reflecting automatic sensory change processing ability, was impaired in adults with AD/HD. This impairment could have negative impact on AD/HD symptoms via affecting day-to-day executive functions.

Exploring the Potential "Brain-Cognition-Behavior" Relationship in Children With ADHD Based on Resting-State Brain Local Activation and Functional Connectivity.

OBJECTIVE: Exploring how abnormal brain function in children with ADHD affects executive function and ultimately leads to behavioral impairment provides a theoretical basis for clinically targeted neurotherapy and cognitive training. METHOD: Amplitude of low frequency fluctuations (ALFF), regional homogeneity (ReHo), and seed-based FC were analyzed in 53 ADHD and 52 healthy controls. The "brain-cognition-behavior" relationship was further explored using mediation analysis. RESULTS: ADHD showed abnormal local activation in the middle temporal gyrus (MTG), inferior occipital gyrus and inferior frontal gyrus (IFG) and reduced FC between the IFG and the cerebellum. ADHD diagnosis may affect ALFF of MTG and further modulate shift and finally affect inattentive symptoms. It may also affect the total symptoms through the FC of the IFG with the cerebellum. CONCLUSION: ADHD showed extensive spontaneous activity abnormalities and frontal-cerebellar FC impairments. Localized functional abnormalities in the MTG may affect the shift in EF, resulting in attention deficit behavior.

Functional reorganization of brain activity in children with attention-deficit/hyperactivity disorder: Evidence from the modulatory effect of cognitive demand during visuospatial attention task.

Previous studies reported that the inferior parietal lobule (IPL) had lower activation during visuospatial attention in children with attention-deficit/hyperactivity disorder (ADHD), while the functional connectivity (FC) between the IPL and other brain regions and how cognitive demand might modulate IPL's FC remain unclear. We performed a functional magnetic resonance imaging experiment recruiting two task conditions with relatively low and high cognitive demand of visuospatial attention. Forty-four children with ADHD and 36 age- and sex-matched healthy controls were included. IPL's regional activation and FC intensities were compared between groups and correlated with clinical measurements. We found that the IPL had significantly reduced activation in children with ADHD compared to healthy controls and this abnormal activation was not modulated by the cognitive demand of visuospatial attention. Importantly, further analysis revealed that the functional connectivity between IPL and inferior frontal gyrus was modulated by the cognitive demand of visuospatial attention in children with ADHD. These results revealed a modulatory effect of cognitive demand of visuospatial attention on IPL's functional connectivity but not IPL's activation in children with ADHD. More generally, these results highlight the functional reorganization of the brain activity as a possible compensatory strategy in response to the symptoms of ADHD.

Symptom-guided multimodal neuroimage fusion patterns in children with attention-deficit/hyperactivity disorder and its potential "brain structure-function-cognition-behavior" pathological pathways.

The "brain-cognition-behavior" process is an important pathological pathway in children with attention-deficit/hyperactivity disorder (ADHD). Symptom guided multimodal neuroimaging fusion can capture behaviorally relevant and intrinsically linked structural and functional features, which can help to construct a systematic model of the pathology. Analyzing the multimodal neuroimage fusion pattern and exploring how these brain features affect executive function (EF) and leads to behavioral impairment is the focus of this study. Based on gray matter volume (GMV) and fractional amplitude of low frequency fluctuation (fALFF) for 152 ADHD and 102 healthy controls (HC), the total symptom score (TO) was set as a reference to identify co-varying components. Based on the correlation between the identified co-varying components and EF, further mediation analysis was used to explore the relationship between brain image features, EF and clinical symptoms. This study found that the abnormalities of GMV and fALFF in ADHD are mainly located in the default mode network (DMN) and prefrontal-striatal-cerebellar circuits, respectively. GMV in ADHD influences the TO through Metacognition Index, while fALFF in HC mediates the TO through behavior regulation index (BRI). Further analysis revealed that GMV in HC influences fALFF, which further modulates BRI and subsequently affects hyperactivity-impulsivity score. To conclude, structural brain abnormalities in the DMN in ADHD may affect local brain function in the prefrontal-striatal-cerebellar circuit, making it difficult to regulate EF in terms of inhibit, shift, and emotional control, and ultimately leading to hyperactive-impulsive behavior.

Abnormal Reactivity of Brain Oscillations to Visual Search Target in Children With Attention-Deficit/Hyperactivity Disorder.

BACKGROUND: Previous studies have shown that impaired goal-directed alpha lateralization and functional disconnection within attention networks during the cue period are significant features of attention-deficit/hyperactivity disorder (ADHD). This study aimed to explore the role of brain oscillations in the visual search process, focusing on target-induced posterior alpha lateralization, midfrontal theta synchronization, and their functional connection in children with ADHD. METHODS: Electroencephalograms were recorded from typically developing (TD) children (n = 72) and children with ADHD (n = 96) while they performed a visual search task. RESULTS: Both the TD and ADHD groups showed significant midfrontal theta event-related synchronization (ERS) and posterior alpha lateralization. Compared with TD children, children with ADHD showed significantly lower theta ERS and higher target-induced alpha lateralization. TD children showed a positive trial-based correlation between theta ERS and alpha lateralization and a negative correlation between theta ERS and reaction time variability. However, all these correlations were absent in children with ADHD. CONCLUSIONS: Abnormal brain oscillations in children with ADHD indicate insufficient executive control function and the compensation of attention networks for attention deficits in visual selective attention. Cross-frequency disconnection reflects the common deficiency of executive control in the gating of target information. Our findings provide novel evidence for interpreting the features of brain oscillations during stimulus-driven selective attention in children with ADHD.

A randomized controlled study of remote computerized cognitive, neurofeedback, and combined training in the treatment of children with attention-deficit/hyperactivity disorder.

There is an increasing interest in non-pharmacological treatments for children with attention-deficit/hyperactivity disorder (AD/HD), especially digital techniques that can be remotely delivered, such as neurofeedback (NFT) and computerized cognitive training (CCT). In this study, a randomized controlled design was used to compare training outcomes between remotely delivered NFT, CCT, and combined NFT/CCT training approaches. A total of 121 children with AD/HD were randomly assigned to the NFT, CCT, or NFT/CCT training groups, with 80 children completing the training program. Pre- and post-training symptoms (primary outcome), executive and daily functions were measured using questionnaires as well as resting EEG during eyes-closed (EC) and eyes-open (EO) conditions. After 3 months of training, the inattentive and hyperactive/impulsive symptoms, inhibition, working memory, learning and life skills of the three groups of children were significantly improved. The objective EEG activity showed a consistent increase in the relative alpha power in the EO condition among the three training groups. Training differences were not observed between groups. There was a positive correlation between pre-training EO relative alpha power and symptom improvement scores of inattention and hyperactivity/impulsivity, as well as a negative correlation between pre-training inattention scores and change in EO relative alpha. This study verified the training effects of NFT, CCT, and combined NFT/CCT training in children with AD/HD and revealed an objective therapeutic role for individual relative alpha activity. The verified feasibility and effectiveness of home-based digital training support promotion and application of digital remote training.

Information-based multivariate decoding reveals imprecise neural encoding in children with attention deficit hyperactivity disorder during visual selective attention.

Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in school-age children. Attentional orientation is a potential clinical diagnostic marker to aid in the early diagnosis of ADHD. However, the underlying pathophysiological substrates of impaired attentional orienting in childhood ADHD remain unclear. Electroencephalography (EEG) was measured in 135 school-age children (70 with childhood ADHD and 65 matched typically developing children) to directly investigate target localization during spatial selective attention through univariate ERP analysis and information-based multivariate pattern machine learning analysis. Compared with children with typical development, a smaller N2pc was found in the ADHD group through univariate ERP analysis. Children with ADHD showed a lower parieto-occipital multivariate decoding accuracy approximately 240-340 ms after visual search onset, which predicts a slower reaction time and larger standard deviation of reaction time. Furthermore, a significant correlation was found between N2pc and decoding accuracy in typically developing children but not in children with ADHD. These observations reveal that impaired attentional orienting in ADHD may be due to inefficient neural encoding responses. By using a personalized information-based multivariate machine learning approach, we have advanced the understanding of cognitive deficits in neurodevelopmental disorders. Our study provides potential research directions for the early diagnosis and optimization of personalized intervention in children with ADHD.

Aberrant brain dynamics and spectral power in children with ADHD and its subtypes.

Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder in children, usually categorized as three subtypes, predominant inattention (ADHD-I), predominant hyperactivity-impulsivity (ADHD-HI), and a combined subtype (ADHD-C). Yet, common and unique abnormalities of electroencephalogram (EEG) across different subtypes remain poorly understood. Here, we leveraged microstate characteristics and power features to investigate temporal and frequency abnormalities in ADHD and its subtypes using high-density EEG on 161 participants (54 ADHD-Is and 53 ADHD-Cs and 54 healthy controls). Four EEG microstates were identified. The coverage of salience network (state C) were decreased in ADHD compared to HC (p = 1.46e-3), while the duration and contribution of frontal-parietal network (state D) were increased (p = 1.57e-3; p = 1.26e-4). Frequency power analysis also indicated that higher delta power in the fronto-central area (p = 6.75e-4) and higher power of theta/beta ratio in the bilateral fronto-temporal area (p = 3.05e-3) were observed in ADHD. By contrast, remarkable subtype differences were found primarily on the visual network (state B), of which ADHD-C have higher occurrence and coverage than ADHD-I (p = 9.35e-5; p = 1.51e-8), suggesting that children with ADHD-C might exhibit impulsivity of opening their eyes in an eye-closed experiment, leading to hyper-activated visual network. Moreover, the top discriminative features selected from support vector machine model with recursive feature elimination (SVM-RFE) well replicated the above results, which achieved an accuracy of 72.7% and 73.8% separately in classifying ADHD and two subtypes. To conclude, this study highlights EEG microstate dynamics and frequency features may serve as sensitive measurements to detect the subtle differences in ADHD and its subtypes, providing a new window for better diagnosis of ADHD.

The effects of first-dose methylphenidate on the neural signatures of visual selective attention in children with attention-deficit/hyperactivity disorder.

Although methylphenidate (MPH) has been shown to significantly improve selective attention in children with attention-deficit/hyperactivity disorder (ADHD), the neural mechanism of this effect remains unclear. We investigated the effects of first-dose MPH on the neural signatures of visual selective attention in children with ADHD. We measured the impact of first-dose MPH on electrophysiological indexes from eighteen children with ADHD (8.9-15.2 years; 15 boys) while they performed a visual search task. MPH was administered in a double-blind placebo-controlled crossover design. MPH led to decreases in behavioral error rates and reaction times. For the electrophysiological indexes, MPH significantly increased the target-elicited N2pc amplitude and posterior P3 amplitude during the selective attention process. The trial-based correlation analysis revealed that the enhanced N2pc (more negative) and P3 (more positive) promoted the behavioral response speed for children with ADHD. The lower individual P3 amplitude was associated with higher severity of inattention symptoms. The severer inattention symptoms were related to weaker MPH effect on N2pc amplitude. These findings suggest that N2pc and P3 are closely related to the mechanism of MPH in the ADHD treatment.

Lack of an association between anticipatory alpha oscillations and attentional selection in children with attention-deficit/hyperactivity disorder.

OBJECTIVE: Attention-deficit/hyperactivity disorder (ADHD) is characterized by attention problems. The current study investigated whether and how anticipatory alpha oscillations, the subsequent target-elicited N2 posterior-contralateral component (N2pc) and their relationship contributed to attention problems in children with ADHD. METHODS: Electroencephalograms (EEGs) were recorded from 8-13-year-old children with ADHD and typically developing children during a cued visuospatial covert attention task. RESULTS: Children with ADHD could not sustain hemispheric alpha lateralization during the late stage of the cued period. Similar to the pattern of adults, high-accuracy typically developing children showed a strong positive correlation between the degree of cue-induced anticipatory alpha lateralization and the subsequent target-evoked N2pc amplitude, the latter of which further predicted behavioral performance. However, only the aberrant "cue alpha-target N2pc" temporal relationship was related to symptom severity and behavioral performance in children with ADHD. CONCLUSIONS: We showed that the temporal association of "cue alpha-target N2pc" was already present in some typically developing children. However, children with ADHD might need more time to develop this temporal association. SIGNIFICANCE: Our results provide neurophysiological evidence that the developmental origin of covert spatial attention is related to the temporal association between low-frequency brain oscillations and event-related potentials (ERPs).

Investigating ADHD subtypes in children using temporal dynamics of the electroencephalogram (EEG) microstates.

Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder in children, usually categorized as three predominant subtypes, persistent inattention (ADHD-I), hyperactivity-impulsivity (ADHD-HI) and a combination of both (ADHD-C). Identifying reliable features to distinguish different subtypes is significant for clinical individualized treatment. In this work, we conducted a two-stage electroencephalogram (EEG) microstate analysis on 54 healthy controls and 107 ADHD children, including 54 ADHD-Is and 53 ADHD-Cs, aiming to examine the dynamic temporal alterations in ADHDs compared to healthy controls (HCs), as well as different EEG signatures between ADHD subtypes. Results demonstrated that the dynamics of resting-state EEG microstates, particularly centering on salience (state C) and frontal-parietal network (state D), were significantly aberrant in ADHDs. Specifically, the occurrence and coverage of state C were decreased in ADHDs (p=0.002; p=0.0015), while the duration and contribution of state D were observably increased (p=0.0016; p=0.0001) compared to HCs. Moreover, the transition probability between state A and C was significantly decreased (p=9.85e-7; p=2.33e-7) in ADHDs, but otherwise increased between state B and D (p=1.02e-7; p=1.07e-6). By contrast, remarkable subtype differences were found primarily on the visual network (state B) between ADHD-Is and ADHD-Cs. Specifically, ADHD-Cs have higher occurrence and coverage of state B than ADHD-Is (p=9.35e-5; p=1.51e-8), suggesting these patients more impulsively aimed to open their eyes when asked to keep eyes closed during the data collection. In summary, this work carefully leveraged EEG temporal dynamics to investigate the aberrant microstate features in ADHDs and provided a new window to look into the subtle differences between ADHD subtypes, which may help to assist precision diagnosis in future.Clinical Relevance- This work established the use of EEG microstate features to investigate ADHD dysfunction and its subtypes, providing a new window for better diagnosis of ADHD.

Regulation of nitrogen configurations and content in 3D porous carbons for improved lithium storage.

The incorporation of active nitrogen species in carbon materials has been widely demonstrated as a viable means to produce superior lithium storage materials, while the precise regulation of nitrogen configurations as well as their content still remains a formidable challenge. Herein, nitrogen-free porous carbon frameworks were synthesized by a self-templating strategy from disodium citrate, and post-annealing yielded 10.4 at% N that was primarily pyrrolic-N and pyridinic-N with an atomic ratio of about 3 : 1, with negligible inactive graphitic-N. A gravimetric capacity of 570 mA h g-1 at a current density of 4 A g-1 was measured for a Li half-cell based on the as-prepared N-doped 3D carbon materials. Lithium-ion capacitors with this N-doped carbon as the anode and commercial AC as the cathode yielded energy densities of 58.9 and 142.6 W h kg-1 with the corresponding power densities of 7400 and 185 W kg-1, respectively. We suggest that the carbon materials with high content of pyrrolic-N and pyridinic-N especially pyrrolic-N have improved lithium storage.

Atypical Developmental Trajectories of Early Perception Among School-Age Children With Attention Deficit Hyperactivity Disorder During a Visual Search Task.

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by cognitive deficits associated with attention. Prior studies have revealed the potential impact of ADHD on basic perception and cognitive ability in patients with ADHD. In this study, bilateral posterior P1 and N1 were measured in 122 Chinese children aged 7-12 years (64 with ADHD) to investigate the developmental characteristics of early perception during visual processing in school-age children with ADHD. For children with ADHD, a larger P1 activity with an atypical developmental pattern was evoked and observed for the visual search performance. These findings offer new insights into the mechanisms of cognitive developmental deficits and intervention techniques in children with ADHD.

Abnormal modulation of theta oscillations in children with attention-deficit/hyperactivity disorder.

Previous studies have found that theta activities exhibit posterior lateralized modulation as well as midfrontal event-related synchronization (ERS) during covert visual attention in adults. The present study investigated whether these theta modulations existed in children and whether they were associated with attentional problems in attention-deficit/hyperactivity disorder (ADHD). Electroencephalography signals were recorded from typically developing (TD) children and children with ADHD (TD: n = 24; ADHD: n = 22) while they performed a cued covert visual attention task. The participants responded to a target following a cue designed as human eyes that gazed to the left or right visual field (70% validity). Compared with the TD children, the children with ADHD showed increased midfrontal theta ERS and significant posterior theta lateralization in response to the cues. More importantly, we found that the stronger posterior theta lateralization in the right hemisphere exhibited a positive trial-based correlation with the larger midfrontal theta ERS and predicted lower RT variability at the trial level in the children with ADHD. We suggest that ADHD may be associated with some enhanced systems in the frontal and posterior areas via theta oscillations, which may be involved in the compensatory maturation for their attention deficits in childhood, thereby promoting the stability of behavioral responses.

Neural Correlates of Working Memory Deficits in Different Adult Outcomes of ADHD: An Event-Related Potential Study.

BACKGROUND: We investigated working memory (WM) processing in a longitudinal sample of young adults with persistent and remittent childhood-onset ADHD to investigate the neural correlates of working memory with adult outcomes of ADHD. METHODS: Forty-seven young Chinese adults who had been diagnosed with ADHD during childhood underwent follow-up assessments for an average of 9 years. The ADHD sample consisted of 25 ADHD persisters (mean age =18.38 ± 0.5 years) and 22 remitters (mean age = 18.78 ± 1.10 years), who were compared with 25 sex ratio- and IQ-matched healthy adults (mean age = 19.60 ± 1.22 years) in a verbal n-back task. RESULTS: No differences in behavioral measures were observed across the three groups. Compared with the healthy controls, the ADHD persisters and remitters had larger N1 amplitudes and smaller P2 amplitudes, while no significant differences between the persistence and remission groups were observed. The P3 amplitudes of the remission and control groups were higher than that of the persistence group, but there was no significant difference between the remitters and healthy controls. CONCLUSION: The P3 amplitudes reflecting postdecisional processing and/or WM updating were sensitive to ADHD remission, as they might improve concurrently with ADHD symptoms. These results indicate that the N1, P2, and P3 components of WM processing might be potential biomarkers for different ADHD outcomes.

Abnormal alpha modulation in response to human eye gaze predicts inattention severity in children with ADHD.

Attention-deficit/hyperactivity disorder (ADHD) is characterized by problems in directing and sustaining attention. Recent behavioral studies indicated that children with ADHD are more likely to fail to show the orienting effect in response to human eye gaze. The present study aimed to identify the neurophysiological bases of attention deficits directed by social human eye gaze in children with ADHD, focusing on the relationship between alpha modulations and ADHD symptoms. The electroencephalography data were recorded from 8-13-year-old children (typically developing (TD): n = 24; ADHD: n = 21) while they performed a cued visuospatial covert attention task. The cues were designed as human eyes that might gaze to the left or right visual field. The results revealed that TD children showed a significant alpha lateralization in response to the gaze of human eyes, whereas children with ADHD showed an inverse pattern of alpha modulation in the left parieto-occipital area. Importantly, the abnormal alpha modulation in the left hemisphere predicted inattentive symptom severity and behavioral accuracy in children with ADHD. These results suggest that the dysfunction of alpha modulation in the left hemisphere in response to social cues might be a potential neurophysiologic marker of attention deficit in children with ADHD.

The neural correlations of spatial attention and working memory deficits in adults with ADHD.

Working memory impairment is a typical cognitive abnormality in patients with attention-deficit/hyperactivity disorder (ADHD) and is closely related to attention. Exploring the interaction between working memory and attention in patients with ADHD is of great significance for studying the pathological mechanism of this disease. In this study, electrophysiological markers of attention, posterior contralateral N2 (N2pc), and working memory, contralateral delay activity (CDA), were used to explore the relationship between these two cognitive abilities in patients with ADHD. EEG data were collected from adults with ADHD and age-, sex-, and IQ-matched normal controls while performing a classical visuospatial working memory task that consisted of low-load and high-load memory conditions. In different memory load conditions, the memory array elicited a smaller N2pc (220-260 ms) and a smaller CDA (400-800 ms) in adults with ADHD than in normal controls. Further analysis revealed that the reduced CDA amplitude could be significantly predicted by the earlier and reduced N2pc amplitude in adults with ADHD. Moreover, when the number of memory items increased, the increase in N2pc highly predicted the increases in CDA. Our findings illustrate the relationship between spatial working memory and attention ability in ADHD adults from the neurophysiological aspect that reduced working memory is closely related to insufficient attention ability and provide a potential physiological basis for the pathological mechanism of ADHD.

The role of resting-state EEG localized activation and central nervous system arousal in executive function performance in children with Attention-Deficit/Hyperactivity Disorder.

OBJECTIVE: This study explored the relationships between resting-state electroencephalogram (RS-EEG) localized activation and two important types of executive functions (EF) to extend the prognostic utilization of RS-EEG in children with Attention-Deficit/Hyperactivity Disorder (AD/HD). Also, the role of central nervous system (CNS) arousal in the relationships was examined. METHODS: Fifty-eight children with AD/HD participated in the study. RS-EEG localized activation was derived from spectral power differences between EEG in eyes-closed and eyes-open conditions. CNS arousal was measured based on alpha band power. Common and everyday EF scores were obtained as EF outcomes. RESULTS: Frontal delta activation predicted common EF ability and posterior alpha activation predicted everyday EF. A serial mediation analysis found that lower CNS baseline arousal was related to greater arousal and delta activation in series, which in turn related to worse common EF. A follow-up study found that baseline arousal was related to larger interference cost. CONCLUSIONS: RS-EEG is indicative of individual differences in two important types of EF in children with AD/HD. Lower CNS arousal may be a driving force for the poorer common EF performance. SIGNIFICANCE: The current study supports prognostic utilization of RS-EEG and AD/HD models that take resting brain activity into consideration in children with AD/HD.