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In Quest of Pathognomonic/Endophenotypic Markers of Attention Deficit Hyperactivity Disorder (ADHD): Potential of EEG-Based Frequency Analysis and ERPs to Better Detect, Prevent and Manage ADHD

Authors Miranda P, Cox CD, Alexander M, Danev S, Lakey JRT

Received 5 December 2019

Accepted for publication 16 April 2020

Published 22 May 2020 Volume 2020:13 Pages 115—137


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Scott Fraser

Priya Miranda,1 Christopher D Cox,2 Michael Alexander,1 Slav Danev,3 Jonathan RT Lakey1

1Department of Surgery and Biomedical Engineering, University of California Irvine, Irvine, California, USA; 2Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, California, USA; 3Medeia Inc, Santa Barbara, CA, USA

Correspondence: Jonathan RT Lakey
Department of Surgery, 333 City Blvd West, Suite 1600, Orange, CA 92868, USA
Tel +1-949-824-8022
Fax +1-714-456-6188

Abstract: Attention deficit hyperactivity disorder (ADHD) is a chronic heritable developmental delay psychiatric disorder requiring chronic management, characterized by inattention, hyperactivity, hyperkinectivity and impulsivity. Subjective clinical evaluation still remains crucial in its diagnosis. Discussed are two key aspects in the “characterizing ADHD” and on the quest for objective “pathognomonic/endophenotypic diagnostic markers of ADHD”. The first aspect briefly revolves around issues related to identification of pathognomonic/endophenotypic diagnostic markers in ADHD. Issues discussed include changes in ADHD definition, remission/persistence and overlapping-symptoms cum shared-heritability with its co-morbid cross-border mental disorders. The second aspect discussed is neurobiological and EEG-based studies on ADHD. Given the neurobiological and temporal aspects of ADHD symptoms the electroencephalograph (EEG) like NeuralScan by Medeia appears as an appropriate tool. The EEGs appropriateness is further enhanced when coupled with suitable behavior/cognitive/motor/psychological tasks/paradigms yielding EEG-based markers like event-related-potential (ERPs like P3 amplitudes and latency), reaction time variability (RTV), Theta:Beta ratio (TBR) and sensorimotor rhythm (SMR). At present, these markers could potentially help in the neurobiological characterization of ADHD and either help in identifying or lay the groundwork for identifying pathognomonic and/or endophenotypic EEG-based markers enabling its diagnosis, treatment and management.

Keywords: ADHD, EEG, event related potential, reaction time

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