Boxum Marit, Voetterl Helena, van Dijk Hanneke, Gordon Evian, DeBeus Roger, Arnold L Eugene, Arns Martijn
Radboud University, Nijmegen, The Netherlands.
Research Institute Brainclinics, Brainclinics Foundation, Bijleveldsingel 32, 6524 AD, Nijmegen, The Netherlands.
Appl Psychophysiol Biofeedback. 2024 Jun 10. doi: 10.1007/s10484-024-09649-y.
The frequently reported high theta/beta ratio (TBR) in the electroencephalograms (EEGs) of children with attention-deficit/hyperactivity disorder (ADHD) has been suggested to include at least two distinct neurophysiological subgroups, a subgroup with high TBR and one with slow alpha peak frequency, overlapping the theta range. We combined three large ADHD cohorts recorded under standardized procedures and used a meta-analytical approach to leverage the large sample size (N = 417; age range: 6-18 years), classify these EEG subtypes and investigate their behavioral correlates to clarify their brain-behavior relationships. To control for the fact that slow alpha might contribute to theta power, three distinct EEG subgroups (non-slow-alpha TBR (NSAT) subgroup, slow alpha peak frequency (SAF) subgroup, not applicable (NA) subgroup) were determined, based on a halfway cut-off in age- and sex-normalized theta and alpha, informed by previous literature. For the meta-analysis, Cohen's d was calculated to assess the differences between EEG subgroups for baseline effects, using means and standard deviations of baseline inattention and hyperactivity-impulsivity scores. Non-significant, small Grand Mean effect sizes (-0.212 < d < 0.218) were obtained when comparing baseline behavioral scores between the EEG subgroups. This study could not confirm any association of EEG subtype with behavioral traits. This confirms previous findings suggesting that TBR has no diagnostic value for ADHD. TBR could, however, serve as an aid to stratify patients between neurofeedback protocols based on baseline TBR. A free online tool was made available for clinicians to calculate age- and sex-corrected TBR decile scores (Brainmarker-IV) for stratification of neurofeedback protocols.
注意力缺陷多动障碍（ADHD）儿童的脑电图（EEG）中经常报告的高θ/β比率（TBR）被认为至少包括两个不同的神经生理亚组，一个是高TBR亚组，另一个是慢α波峰值频率亚组，与θ范围重叠。我们合并了在标准化程序下记录的三个大型ADHD队列，并采用荟萃分析方法利用大样本量（N = 417；年龄范围：6 - 18岁），对这些EEG亚型进行分类，并研究它们与行为的相关性，以阐明它们的脑-行为关系。为了控制慢α波可能对θ功率有贡献这一事实，根据先前文献，在年龄和性别标准化的θ波和α波的中间分界点，确定了三个不同的EEG亚组（非慢α波TBR（NSAT）亚组、慢α波峰值频率（SAF）亚组、不适用（NA）亚组）。对于荟萃分析，计算了Cohen's d来评估EEG亚组之间基线效应的差异，使用基线注意力不集中和多动-冲动评分的均值和标准差。比较EEG亚组之间的基线行为评分时，获得了不显著的小总体平均效应大小（-0.212 < d < 0.218）。本研究无法证实EEG亚型与行为特征之间的任何关联。这证实了先前的研究结果，表明TBR对ADHD没有诊断价值。然而，TBR可以作为根据基线TBR在神经反馈方案之间对患者进行分层的辅助工具。我们提供了一个免费的在线工具，供临床医生计算年龄和性别校正后的TBR十分位数评分（Brainmarker-IV），用于神经反馈方案的分层。
