EEG-vigilance and response to stimulants in paediatric patients with attention deficit/hyperactivity disorder.
OBJECTIVE
In a pilot study it was investigated whether assessment of EEG-vigilance is useful for the prediction of treatment outcome in ADHD patients.


METHODS
Resting EEG recordings of 49 unmedicated ADHD patients and 49 age-matched controls were analyzed. Vigilance level was determined for 1-s segments with a computer-based algorithm, distinguishing six stages from higher vigilance stages A1, A2 and A3 with dominant alpha activity to lower stages B1 and B2/3 with low amplitude non-alpha and increasing theta and delta activity and further onto stage C characterizing sleep onset. Treatment outcome was measured as changes in continuous performance test (CPT) results from baseline after at least 4 weeks of medication.


RESULTS
ADHD patients spend less time in higher A1-stages (ADHD=66%, controls=81%) and showed more switching between vigilance stages (ADHD=26.02%, controls=19.09%), indicating a more unstable vigilance regulation. Patients with less stable vigilance showed a worse pre-treatment CPT performance but achieved a better post-treatment result compared to patients with more stable vigilance regulation. These differences did not reach statistical significance.


CONCLUSIONS
Signs of vigilance instability where found in ADHD patients compared to controls. Those patients with a higher degree of vigilance instability seemed to benefit more from stimulant medication.


CONCLUSIONS
This is the first investigation of EEG-vigilance in ADHD-patients. Results are limited by a short recording time but the results strongly suggest further investigation of the vigilance regulation in ADHD patients.
Sander
Christian
C
Department of Psychiatry, University Hospital Leipzig, Leipzig, Germany. Electronic address: Christian.Sander@medizin.uni-leipzig.de.
Arns
Martijn
M
Brainclinics Diagnostics B.V., Nijmegen, The Netherlands; Department of Experimental Psychology, University of Utrecht, The Netherlands.
Olbrich
Sebastian
S
Department of Psychiatry, University Hospital Leipzig, Leipzig, Germany.
Hegerl
Ulrich
U
Department of Psychiatry, University Hospital Leipzig, Leipzig, Germany.
D000293:Adolescent; D018759:Adrenergic Uptake Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use; D000704:Analysis of Variance; D001143:Arousal / Q000187:drug effects* / Q000502:physiology*; D000069445:Atomoxetine Hydrochloride; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy / Q000503:physiopathology*; D016022:Case-Control Studies; D002648:Child; D004569:Electroencephalography / Q000379:methods; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D011437:Propylamines / Q000494:pharmacology* / Q000627:therapeutic use; D011930:Reaction Time / Q000187:drug effects / Q000502:physiology; D013997:Time Factors
D018759:Adrenergic Uptake Inhibitors; D011437:Propylamines; D000069445:Atomoxetine Hydrochloride