title: Neurophysiologic predictors of response to atomoxetine in young adults with attention deficit hyperactivity disorder: a pilot project.
abstract: Atomoxetine is a non-stimulant medication with sustained benefit throughout the day, and is a useful pharmacologic treatment option for young adults with Attention-Deficit/Hyperactivity Disorder (ADHD). It is difficult to determine, however, those patients for whom atomoxetine will be both effective and advantageous. Patients may need to take the medication for several weeks before therapeutic benefit is apparent, so a biomarker that could predict atomoxetine effectiveness early in the course of treatment could be clinically useful. There has been increased interest in the study of thalamocortical oscillatory activity using quantitative electroencephalography (qEEG) as a biomarker in ADHD. In this study, we investigated qEEG absolute power, relative power, and cordance, which have been shown to predict response to reuptake inhibitor antidepressants in Major Depressive Disorder (MDD), as potential predictors of response to atomoxetine. Forty-four young adults with ADHD (ages 18-30) enrolled in a multi-site, double-blind placebo-controlled study of the effectiveness of atomoxetine and underwent serial qEEG recordings at pretreatment baseline and one week after the start of medication. qEEG measures were calculated from a subset of the sample (N = 29) that provided useable qEEG recordings. Left temporoparietal cordance in the theta frequency band after one week of treatment was associated with ADHD symptom improvement and quality of life measured at 12 weeks in atomoxetine-treated subjects, but not in those treated with placebo. Neither absolute nor relative power measures selectively predicted improvement in medication-treated subjects. Measuring theta cordance after one week of treatment could be useful in predicting atomoxetine treatment response in adult ADHD.
authors.affiliation: Department of Psychiatry and Biobehavioral Sciences, and the Laboratory of Brain, Behavior, and Pharmacology, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; UCLA Depression Research and Clinic Program, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA. Electronic address: afl@ucla.edu.
authors.forename: Andrew F
authors.initials: AF
authors.lastname: Leuchter
authors.affiliation: Child and Adolescent Psychopharmacology and Attention-Deficit/Hyperactivity Disorder Programs, Division of Child and Adolescent Psychiatry, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
authors.forename: James J
authors.initials: JJ
authors.lastname: McGough
authors.affiliation: Department of Psychiatry and Biobehavioral Sciences, and the Laboratory of Brain, Behavior, and Pharmacology, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; UCLA Depression Research and Clinic Program, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA.
authors.forename: Alexander S
authors.initials: AS
authors.lastname: Korb
authors.affiliation: Department of Psychiatry and Biobehavioral Sciences, and the Laboratory of Brain, Behavior, and Pharmacology, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; UCLA Depression Research and Clinic Program, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA.
authors.forename: Aimee M
authors.initials: AM
authors.lastname: Hunter
authors.affiliation: Departments of Psychiatry, Pediatrics, and Anatomy and Neurobiology, University of Kentucky, Lexington, KY, USA.
authors.forename: Paul E A
authors.initials: PE
authors.lastname: Glaser
authors.affiliation: Eli Lilly and Company and/or one of its subsidiaries, Indianapolis, IN, USA.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Deldar
authors.affiliation: Eli Lilly and Company and/or one of its subsidiaries, Indianapolis, IN, USA.
authors.forename: Todd M
authors.initials: TM
authors.lastname: Durell
authors.affiliation: Department of Psychiatry and Biobehavioral Sciences, and the Laboratory of Brain, Behavior, and Pharmacology, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; UCLA Depression Research and Clinic Program, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA.
authors.forename: Ian A
authors.initials: IA
authors.lastname: Cook
mesh_terms: D000293:Adolescent; D018759:Adrenergic Uptake Inhibitors / Q000627:therapeutic use*; D000328:Adult; D000704:Analysis of Variance; D000069445:Atomoxetine Hydrochloride; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy* / Q000503:physiopathology*; D058256:Brain Waves / Q000187:drug effects*; D004311:Double-Blind Method; D004569:Electroencephalography; D005260:Female; D006801:Humans; D008297:Male; D010865:Pilot Projects; D011437:Propylamines / Q000627:therapeutic use*; D011569:Psychiatric Status Rating Scales; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D018759:Adrenergic Uptake Inhibitors; D011437:Propylamines; D000069445:Atomoxetine Hydrochloride
keywords: Atomoxetine; Attention-deficit/hyperactivity disorder (ADHD); Biomarker; Cordance; Quality of life; Quantitative electroencephalography (qEEG); Thalamocortical circuits and oscillations; Treatment response