Attention-deficit/hyperactivity disorder: cognitive evoked potential (P300) amplitude predicts treatment response to atomoxetine.
OBJECTIVE
Auditory cognitive evoked potential (P300) topography was reported to predict robust response to the stimulants pemoline and extended-release methylphenidate in patients with attention-deficit/hyperactivity disorder (ADHD). Patients with a right fronto-central to parietal auditory P300 amplitude ratio >0.5 respond robustly to stimulants, others do not. This exploratory study was performed to demonstrate whether the P300 predicts treatment response to the selective norepinephrine re-uptake inhibitor, atomoxetine.


METHODS
Patients aged 6-17 with DSM-IV diagnosis of ADHD were administered P300 testing. They then underwent open-label treatment with atomoxetine. Robust response was defined as a 60% decrease from baseline in the ADHD rating scale (parent version, investigator rated).


RESULTS
Ten of 17 subjects responded robustly. They did not differ from the non-robust responders in age, baseline attention or hyperactivity ratings, or any P300 parameter except 31-electrode mean auditory P300 amplitude (mean AA). Mean AA >6.8 microV predicted robust response with positive predictive value of 0.88 and negative predictive value of 0.67.


CONCLUSIONS
Mean AA seems to predict response to atomoxetine in patients with ADHD.


CONCLUSIONS
As non-stimulant treatments are approved for the treatment of ADHD, tests such as this may help pinpoint whether to use a stimulant or a medicine with some other mechanism of action.
Sangal
R Bart
RB
Attention Disorders Institute, 44199 Dequindre, Ste. 311, Troy, MI 48085, USA. sangalrb@sbcglobal.net
Sangal
Joanne M
JM
D000161:Acoustic Stimulation / Q000379:methods; D000293:Adolescent; D018759:Adrenergic Uptake Inhibitors / Q000627:therapeutic use*; D000069445:Atomoxetine Hydrochloride; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy*; D001303:Auditory Cortex / Q000187:drug effects* / Q000503:physiopathology; D001931:Brain Mapping; D002648:Child; D004566:Electrodes; D004569:Electroencephalography / Q000379:methods; D018913:Event-Related Potentials, P300 / Q000187:drug effects*; D005260:Female; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011437:Propylamines / Q000627:therapeutic use*
D018759:Adrenergic Uptake Inhibitors; D011437:Propylamines; D000069445:Atomoxetine Hydrochloride