DSM-5 Adult Attention-Deficit/Hyperactivity Disorder: Sex Differences in EEG Activity.

This study examined sex differences in the EEG of adults diagnosed with Attention-Deficit/Hyperactivity Disorder (AD/HD) according to DSM-5 criteria. Sixteen females and 16 males with AD/HD, and age- and sex-matched control groups, had an eyes-closed resting EEG recorded from 19 electrode sites. EEGs were Fast Fourier transformed and estimates for total power, absolute and relative power in the delta, theta, alpha, beta and gamma bands, and the theta/beta ratio, were analysed across nine cortical regions. Males with AD/HD, compared with male controls, had globally reduced absolute beta, globally elevated relative theta, and a larger theta/beta ratio. In contrast, no global effects emerged between females with and without AD/HD. Significant group interactions indicated that globally elevated relative theta and elevated frontal-midline theta/beta ratio noted in males with AD/HD differed significantly from results in females. There are statistically significant EEG differences in relative theta and the theta/beta ratio between males and females with and without AD/HD. These results indicate that AD/HD affects the EEG activity of males and females differently. This study helps confirm the need for further independent examination of AD/HD within female populations.

The Theta/Beta Ratio as an Index of Cognitive Processing in Adults With the Combined Type of Attention Deficit Hyperactivity Disorder.

An elevated theta/beta ratio in the EEG has long been observed among individuals with Attention Deficit Hyperactivity Disorder (ADHD). The theta/beta ratio was previously hypothesised to be an index of arousal, but a number of studies failed to find any association between the ratio and indices of arousal, instead proposing that the theta/beta ratio may actually be indicative of cognitive processing. This hypothesis was tested by Clarke et al using a sample of healthy adults, with results indicating that the theta/beta ratio correlated with a marker of cognitive processing (P300 latency in an auditory oddball task), while P300 amplitude correlated with an arousal marker (alpha power). The aim of this study was to test whether similar results could be found in a sample of 41 adults with the combined type of ADHD. EEGs were recorded during an eyes-closed resting condition and an auditory oddball task. Results demonstrated that the theta/beta ratio correlated significantly with P300 latency. Absolute alpha power did not correlate significantly with P300 amplitude or P300 latency. These results support the hypotheses that the theta/beta ratio is a marker of cognitive processing capacity in both the general population and in participants with ADHD, and that the alpha/arousal linkage is anomalous in ADHD.

EEG development in Attention Deficit Hyperactivity Disorder: From child to adult.

OBJECTIVE: Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common psychiatric disorders found in children. While an extensive literature has documented the EEG in this clinical population, few studies have investigated EEG throughout the lifespan in ADHD. This study aimed to investigate EEG maturational changes, in subjects with ADHD combined type, that spanned from childhood into adulthood. METHOD: Twenty five male adults with ADHD were assessed between the ages of 8-12 years and again as adults. At both ages, an EEG was recorded during an eyes-closed resting period, and power estimates were calculated for relative delta, theta, alpha and beta. RESULTS: At the childhood assessment, the ADHD subjects had elevated posterior delta. Relative theta was elevated, with diminished alpha activity across all sites. Significant maturational changes were observed, with reductions in the delta and theta bands, and increases in the alpha and beta bands across all electrodes. In adulthood, relative to controls, diminished frontal delta and elevated global theta activity were apparent. CONCLUSIONS: Substantial developmental changes occurred in the EEG of these subjects. These results identify important issues when using EEG as part of the diagnosis for ADHD. SIGNIFICANCE: This study is the first to explore EEG changes from childhood to adulthood over an 11 year period in the same subjects with ADHD.

An Investigation of Stimulant Effects on the EEG of Children With Attention-Deficit/Hyperactivity Disorder.

Stimulant medications are the most commonly prescribed treatment for Attention-Deficit/Hyperactivity Disorder (AD/HD). These medications result in a normalization of the EEG. However, past research has found that complete normalization of the EEG is not always achieved. One reason for this may be that studies have used different medications interchangeably, or groups of subjects on different stimulants. This study investigated whether methylphenidate and dexamphetamine produce different levels of normalization of the EEG in children with AD/HD. Three groups of 20 boys participated in this study. There were 2 groups with a diagnosis of AD/HD; one group, good responders to methylphenidate, and the second, good responders to dexamphetamine. The third group was a normal control group. Baseline EEGs were recorded using an eyes-closed resting condition, and analyzed for total power and relative delta, theta, alpha, and beta. Subjects were placed on a 6-month trial of methylphenidate or dexamphetamine, after which a second EEG was recorded. At baseline, the children with AD/HD had elevated relative theta, less relative alpha and beta compared with controls. Baseline differences were found between the two medication groups, with the dexamphetamine group having greater EEG abnormalities than the methylphenidate group. The results indicate that good responders to methylphenidate and dexamphetamine have different EEG profiles when assessed before medication, and these differences may represent different underlying central nervous system deficits. The 2 medications were found to result in substantial normalization of the EEG, with no significant differences in EEG changes occurring between the 2 medications. This indicates that the degree of pretreatment EEG abnormality was the major factor contributing to the degree of normalization of the EEG. As good responders to the 2 medications appear to have different central nervous system abnormalities, it is recommended that stimulant medications be treated independently and not used interchangeably in research and treatment of AD/HD.

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.

EEG activity in children with Asperger's Syndrome.

OBJECTIVE: This study investigated differences in the EEG power and coherence of children with Asperger's Syndrome. METHOD: Twenty boys with Asperger's Syndrome, aged 7-12 years, and an age and sex matched control group, participated in this study. The EEG was recorded during an eyes-closed resting condition from 19 electrode sites, which were clustered into nine regions prior to analysis. One minute of trace was analysed using Fourier transformations to obtain both absolute and relative power estimates in the delta, theta, alpha and beta frequency bands. Wave-shape coherence was calculated for 8 intrahemispheric and 8 interhemispheric electrode pairs. RESULTS: The Asperger's group had a global increase in absolute delta and an anterior increase in relative delta. Both absolute and relative theta were globally increased and relative alpha was globally decreased. Subjects with Asperger's Syndrome exhibited a broad pattern of reduced hemispheric asymmetry in intrahemispheric coherence. Reduced anterior interhemispheric coherence in the alpha and beta bands was also found in the Asperger's Syndrome group. CONCLUSIONS: These results suggest the existence of frontal lobe abnormalities in children with Asperger's Syndrome, and possible abnormalities in normal CNS maturational processes. SIGNIFICANCE: This is the first major study to investigate EEG power and coherence anomalies in children with Asperger's Syndrome.

EEG Differences Between the Combined and Inattentive Types of Attention-Deficit/Hyperactivity Disorder in Girls: A Further Investigation.

This study further investigated electroencephalogram (EEG) differences between girls with the Combined and Inattentive types of attention-deficit/hyperactivity disorder (AD/HD). We selected subjects with widely separated scores on hyperactivity-impulsivity symptoms to behaviorally exaggerate diagnostic group differences. Twenty girls with AD/HD Combined type, 20 girls with AD/HD Inattentive type, and 20 controls (aged 7-12 years) had an eyes-closed resting EEG recorded from 19 electrodes. The EEG was fast Fourier transformed, and estimates for total power, absolute and relative power in the delta, theta, alpha, and beta frequency bands, and the theta/beta ratio were calculated and analyzed in 9 scalp regions. Girls of the Combined type, compared with girls of the Inattentive type, had elevated midline total power, elevated temporal absolute alpha activity, elevated posterior absolute beta activity, reduced right hemisphere relative delta and reduced left hemisphere relative alpha activity, and reduced theta/beta ratio in the left hemisphere. Although topographic differences were again found between the AD/HD types, significant global differences remain elusive in the EEGs of girls with the Combined and Inattentive types. Despite creating behaviorally exaggerated AD/HD type groups, girls' EEG activity failed to replicate differences found previously in mixed-sex groups. The EEG profiles of AD/HD types in girls are markedly different from those found in boys. This reinforces the notion that it is no longer appropriate to apply the male-based literature to all AD/HD groups; rather, the use of single-sex subject groups is necessary in EEG research of AD/HD.

Excess beta activity in the EEG of children with attention-deficit/hyperactivity disorder: a disorder of arousal?

Past research has reported that a small proportion of children with attention-deficit/hyperactivity disorder (AD/HD) have excess beta activity in their EEG, rather than the excess theta typical of the syndrome. This atypical group has been tentatively labeled as hyperaroused. The aim of this study was to determine whether these children have a hyperaroused central nervous system. Participants included 104 boys aged 8 to 13 years old, with a diagnosis of either the Combined or Inattentive type of AD/HD (67 combined type), and 67 age-matched male controls. Ten and a half minutes of EEG and skin conductance (SCL) were simultaneously recorded during an eyes-closed resting condition. The EEG was Fourier transformed and estimates of total power, and relative power in the delta, theta, alpha, and beta bands, and the theta/beta ratio, were calculated. AD/HD patients were divided into an excess beta group and a typical excess theta group. Relative to controls, the typical excess theta group had significantly increased frontal total power, theta and theta/beta ratio, with reduced alpha and beta across the scalp. The excess beta group had significantly reduced posterior total power, increased centro-posterior delta, globally reduced alpha, globally increased beta activity, and globally reduced theta/beta ratio. Both AD/HD groups had significantly reduced SCL compared to the control group, but the two groups did not differ from each other on SCL. These results indicate that AD/HD children with excess beta activity are not hyperaroused, and confirm that the theta/beta ratio is not associated with arousal. This is the first study of arousal measures in AD/HD children with excess beta activity, and has implications for existing models of AD/HD.

Sex differences between the combined and inattentive types of attention-deficit/hyperactivity disorder: an EEG perspective.

This study investigated sex differences between the EEGs of Combined and Inattentive types of attention-deficit/hyperactivity disorder (AD/HD) within boys and girls aged 8-12 years. Subject groups included 80 AD/HD Combined type (40 boys and 40 girls), 80 AD/HD Inattentive type (40 boys and 40 girls) and 80 controls (40 boys and 40 girls). An eyes-closed resting EEG was recorded and Fourier transformed to provide estimates for absolute and relative power in the delta, theta, alpha and beta frequency bands, as well as total power and the theta/beta ratio. The boy AD/HD groups, compared with boy controls, had greater absolute and relative theta, greater theta/beta ratio, reduced absolute and relative alpha, and reduced absolute and relative beta. The girl AD/HD groups, compared with girl controls, had greater absolute delta, greater absolute and relative theta, greater theta/beta ratio, greater total power, and reduced relative delta and relative beta. Between AD/HD types, Combined type boys had globally greater absolute and relative theta, greater theta/beta ratio, and less relative alpha than Inattentive type boys. While topographical differences emerged, there were no significant global differences between AD/HD types in girls. That is, EEG differences between AD/HD types are dissimilar in boys and girls. Different EEG maturational patterns between boys and girls also obscure AD/HD-related EEG abnormalities. These results have important implications for our understanding of AD/HD in girls. Ignoring such sex differences may have compromised the value of previous AD/HD investigations, and these sex differences should be recognised in future research.

Caffeine effects on resting-state electrodermal levels in AD/HD suggest an anomalous arousal mechanism.

The effect of a single oral dose of caffeine was examined in a randomised double-blind placebo-controlled repeated-measures cross-over study. Eighteen children with AD/HD, aged between 8 and 13 years, were individually age- and gender-matched with a control group. All children participated in two sessions, one week apart. Skin conductance level (SCL) from a 3 min eyes-closed epoch, commencing 30 min after ingestion of caffeine or placebo, was examined. Across conditions, mean SCL was lower in the AD/HD group than controls, confirming hypoarousal in AD/HD. Caffeine produced an increase in SCL, and this increase did not differ between the groups. However, arousal increases were dose-dependent in controls, but not in AD/HD. Rather, caffeine-induced arousal increases in the AD/HD group were positively related to their hyperactivity/impulsivity levels. This suggests an anomalous arousal mechanism in AD/HD functionally related to impairment in one symptom dimension.

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.

Girls with attention-deficit/hyperactivity disorder: EEG differences between DSM-IV types.

This study investigated EEG differences between the Combined and Inattentive types of Attention-Deficit/Hyperactivity Disorder (AD/HD) in girls. Thirty girls with AD/HD of the Combined type, 30 girls with the inattentive type, and 30 controls (aged 8-12 years) had a resting eyes-closed EEG recorded from 21 electrodes. The EEG was Fast Fourier Transformed and estimates for total power, and absolute and relative power in the delta, theta, alpha and beta frequency bands, were analyzed in nine cortical regions. Across the scalp, girls with AD/HD had elevated total power, elevated absolute delta and theta, reduced relative delta and beta, and increased relative theta compared with controls. Compared with the Inattentive group, the Combined group had greater right hemisphere absolute theta and greater midline posterior absolute beta activity. The Combined group also had reduced right hemisphere relative delta, greater left hemisphere relative theta, reduced midline posterior relative alpha and reduced central relative beta activity. In conclusion, girls with AD/HD had increased slow wave (delta and theta) activity and reduced beta activity, which are robust results in the predominantly-male AD/HD literature, and exhibited the elevated theta/beta abnormality. The lack of global differences between DSM-IV AD/HD types differs from previous studies of boys and mixed-sex groups. The present results highlight the homogeneity of EEG profiles in AD/HD girls, which could be due to sex-bias in the diagnostic criteria. This study is the first to investigate EEG differences between the Inattentive and Combined types of AD/HD with a purely female sample.

Behavioural differences between EEG-defined subgroups of children with Attention-Deficit/Hyperactivity Disorder.

OBJECTIVE: This study investigated the presence and nature of EEG clusters within a clinically-referred sample of children with Attention-Deficit/Hyperactivity Disorder (AD/HD), and whether behavioural differences exist between clusters. METHOD: Participants were 155 boys with AD/HD and 109 age- and gender-matched controls. EEG was recorded during an eyes-closed resting condition and Fourier transformed to provide estimates for total power, and relative delta, theta, alpha, and beta. EEG data were grouped into 3 regions, and subjected to Cluster Analysis. Behavioural data for each cluster were compared against the remaining AD/HD subjects. RESULTS: Four EEG clusters were found. These were characterised by (a) elevated beta activity, (b) elevated theta with deficiencies of alpha and beta, (c) elevated slow wave with less fast wave activity, and (d) elevated alpha. An exploratory analysis of behavioural correlates with these EEG subtypes indicated the presence of interesting trends that need further investigation. CONCLUSIONS: This study found that the AD/HD EEG profiles reported in past studies are robust and not substantially affected by the inclusion of children with other comorbid conditions. The observed group differences in behavioural profiles indicated that different patterns of EEG activity have importance in determining behaviour. SIGNIFICANCE: This is the first study to link behavioural profiles of children with AD/HD to specific EEG abnormalities.

Children with attention-deficit/hyperactivity disorder and autistic features: EEG evidence for comorbid disorders.

Attention-deficit/hyperactivity disorder (AD/HD) is the most common psychiatric disorder of childhood, although AD/HD is rarely the only diagnosis given to these children. Within the literature there is some debate as to whether it is valid to diagnose AD/HD with autism as a comorbid disorder, since the present diagnostic systems exclude the diagnosis of both disorders in the same child. The aim of this study was to determine whether electroencephalography (EEG) differences exist between two groups of children diagnosed with AD/HD, one scoring high (AD/HD+) and one scoring low (AD/HD-) on a measure of autism. The EEG was recorded during an eyes-closed resting condition from 19 electrodes, and Fourier transformed to provide absolute and relative power estimates in delta, theta, alpha and beta bands. Compared to age- and sex-matched controls, the AD/HD- group had increased absolute power in all frequency bands, somewhat higher relative theta activity and decreased relative delta. In comparison to the AD/HD- group, patients with autistic features (AD/HD+) had a number of qualitative differences in the beta and theta bands. These results indicate the presence of two comorbid conditions in the AD/HD+ group, which suggests that AD/HD and autism can occur in the same individual.

Childhood EEG as a predictor of adult attention-deficit/hyperactivity disorder.

OBJECTIVE: The aim of this study was to determine whether EEG differences exist between children with attention-deficit/hyperactivity disorder (AD/HD) who later outgrow the disorder and those who continue to be symptomatic as adults. METHODS: Thirty-eight boys, diagnosed with AD/HD as children, were reassessed 11 years later to determine who met criteria for adult AD/HD. At the childhood assessment, an EEG was recorded from the AD/HD group and a control group, during an eyes-closed resting condition. This was analysed for absolute and relative power in the delta, theta, alpha and beta bands, and the theta/beta ratio. RESULTS: At the childhood assessment, the AD/HD group had an EEG profile typical of the disorder, with increased absolute and relative theta, reduced relative alpha, and increased theta/beta ratio. EEG differences were found between those who outgrew the disorder and those who did not - the adult AD/HD group had greater childhood global relative beta, reduced frontal relative theta, and increased frontal absolute and relative beta. CONCLUSIONS: These results suggest the existence of specific CNS differences in childhood AD/HD that may be used to predict the developmental course of the disorder. SIGNIFICANCE: This is the first study to investigate childhood EEG markers of adult AD/HD.

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.

Resting-state EEG gamma activity in children with attention-deficit/hyperactivity disorder.

OBJECTIVE: Children with Attention-Deficit/Hyperactivity Disorder (AD/HD) have well-described abnormalities in the four traditional EEG bands. However, to date the gamma band has not been widely investigated. This study investigated resting-state EEG in children with AD/HD and matched controls, with a particular focus on gamma activity. METHOD: Forty children with AD/HD, and 40 age- and sex-matched controls, participated. EEG was recorded from 19 sites during an eyes-closed resting condition and Fourier transformed to provide estimates for absolute and relative power in the delta, theta, alpha, beta and gamma bands. RESULTS: Children with AD/HD had elevated levels of absolute delta and theta power, and decreased levels of absolute beta and gamma power, compared to controls. With relative power measures, children with AD/HD showed enhanced delta and theta activity, with reduced alpha, beta and gamma activity. Inattention scores on the Conners' Parent Rating Scale were negatively correlated with absolute gamma. CONCLUSIONS: These patients demonstrate the typical EEG profile in the eyes-closed resting state, over the delta, theta, alpha and beta bands, associated with AD/HD. In addition, compared with controls, they demonstrate reduced absolute and relative gamma activity. These differences appear to contribute importantly to their dysfunctional stimulus processing, and impact their behavioural outcomes. SIGNIFICANCE: This resting-state study extends the well-established fast-wave EEG deficits in children with AD/HD to the gamma band, and links that to increased inattention, which is of special importance in understanding their cognitive-processing problems.

Acute atomoxetine effects on the EEG of children with attention-deficit/hyperactivity disorder.

Although stimulant medications are the most commonly-used treatments for Attention-Deficit/Hyperactivity Disorder (AD/HD), as many as 20% of treated children do not respond clinically to stimulants. This study investigated the effects of an acute dose of atomoxetine, a selective noradrenaline reuptake inhibitor (SNRI), on the electroencephalogram (EEG) and performance of children with AD/HD. An initial pre-medication EEG was recorded during an eyes-closed resting condition. Within two weeks, a second EEG was recorded 1 h after ingestion of 20 mg of atomoxetine. Data were Fourier transformed to provide absolute and relative power estimates for the delta, theta, alpha, beta and gamma bands. Compared to controls, the unmedicated AD/HD children had significantly elevated global absolute and relative delta, with reduced global relative alpha, and absolute and relative gamma, and many topographic differences. Atomoxetine produced significant global increases in absolute and relative beta, with several topographic changes in other bands, and a significant reduction in omission errors on a Continuous Performance Task. These results indicate that SNRIs can produce substantial normalisation of the AD/HD EEG profile, together with behavioural performance improvements. Although EEG changes induced by acute administration of psychostimulants (methylphenidate/dexamphetamine) and atomoxetine are not identical, both classes of AD/HD drugs produce similar EEG band changes. Further analysis of EEG responses to SNRIs and psychostimulants could reveal common neurophysiological processes closely linked to clinical improvement of AD/HD symptoms in response to pharmacotherapy, providing translational markers for clinical efficacy studies and potential translational biomarkers for AD/HD drug discovery.

Electroencephalogram theta/beta ratio and arousal in attention-deficit/hyperactivity disorder: evidence of independent processes.

BACKGROUND: For nearly 20 years, the theta/beta power ratio in the electroencephalogram (EEG) has been used within the attention-deficit/hyperactivity disorder (ADHD) literature as a marker of central nervous system (CNS) arousal, underpinning current models of the disorder. However, this usage has not been validated. We aimed to directly test the theta/beta ratio as a marker of arousal within this population. METHODS: Resting state EEG activity was investigated as a function of CNS arousal in two age-matched groups of boys (each n = 30), with and without ADHD. Arousal was defined in terms of skin conductance level (SCL), which has a long history as a measure of CNS arousal. RESULTS: Relative theta power and the theta/beta ratio were elevated, and SCL and relative alpha and beta power were reduced, in the ADHD group compared with control subjects. In both groups, mean alpha level correlated negatively with SCL. There was no significant correlation between the theta/beta ratio and SCL. CONCLUSIONS: These data contradict the supposed linkage between the theta/beta ratio and arousal in ADHD, confirming previous results from normal children. They suggest the need for reevaluation of current models of the disorder and reconceptualization of existing EEG data from both normal and atypical populations.

Event-related potentials in adults with Attention-Deficit/Hyperactivity Disorder: an investigation using an inter-modal auditory/visual oddball task.

This study investigated whether ERPs from an inter-modal oddball task could distinguish between adults with Attention-Deficit/Hyperactivity Disorder (AD/HD) and controls. Two age-matched groups of young adult males (18 AD/HD, 18 controls) were presented with an inter-modal oddball task in which a counter-phasing checkerboard was the non-target visual stimulus (randomly presented on 80% of trials), and a 2000 Hz tone was the auditory target (20% of trials). Stimuli were presented at a fixed rate (stimulus-onset asynchrony 1.03 s) and participants were required to silently count all targets. The AD/HD group showed globally enhanced P2 and reduced N2 amplitudes to auditory targets, with no differences in target P3, together with topographic differences in N1 to auditory targets, and P1, N1, P2, N2 and P3 to visual non-targets, compared with controls. These results were interpreted in terms of early sensory-processing impairments in adults with AD/HD, which may be partially overcome through effortful processing, as reflected in the later endogenous ERP components.