Neuropsychiatric Disease and Treatment (Nov 2022)
Characteristics of Attention-Deficit/Hyperactivity Disorder Subtypes in Children Classified Using Quantitative Electroencephalography
Abstract
Yoonmi Ji,1 Tae Young Choi,1 Jonghun Lee,1 Seoyoung Yoon,1 Geun Hui Won,1 Hyerin Jeong,2 Seung Wan Kang,2,3 Jun Won Kim1 1Department of Psychiatry, Daegu Catholic University School of Medicine, Daegu, Republic of Korea; 2iMediSync Inc, Seoul, Republic of Korea; 3National Standard Reference Data Center for Korean EEG, Seoul National University College of Nursing, Seoul, Republic of KoreaCorrespondence: Jun Won Kim, Department of Psychiatry, Daegu Catholic University School of Medicine, 3056-6 Daemyeong-4 dong, Nam-gu, Daegu, 705-718, Republic of Korea, Tel +82-53-650-4786, Fax +82-53-623-1694, Email [email protected]: This study used quantitative electroencephalography (QEEG) to investigate the characteristics of attention-deficit/hyperactivity disorder (ADHD) subtypes in children.Patients and Methods: There were 69 subjects (42 with ADHD and 27 neurotypical (NT)) in this study. A semi-structured interview was conducted with each participant for psychiatric diagnostic evaluation. We measured the absolute and relative power in 19 channels and analyzed QEEG using the following frequency ranges: delta (1– 4 Hz), theta (4– 8 Hz), alpha 1 (8– 10 Hz), alpha 2 (10– 12 Hz), beta 1 (12– 15 Hz), beta 2 (15– 20 Hz), beta 3 (20– 30 Hz), and gamma (30– 45 Hz). Group analyses and EEG noise preprocessing were conducted using iSyncBrain, a cloud-based, artificial intelligence EEG analysis platform. Analysis of covariance adjusted for IQ, age, and sex was used.Results: QEEG analysis revealed three ADHD subtypes, characterized by (A) elevated relative fast alpha and beta power, (B) elevated absolute slow frequency (delta and theta power), or (C) elevated absolute and relative beta power. A significant difference was found in the Korean ADHD Rating Scale (K-ARS) among the four groups (df=3, F=8.004, p< 0.001); group C had the highest score (25.31± 11.16), followed by group A (21.67± 13.18). The score of group B (12.64± 7.84) was similar to that of the NT group (11.07± 6.12) and did not reach the cut-off point of the K-ARS. In the Wender–Utah Rating Scale (WURS), group B score (55.82± 23.17) was significantly higher than the NT group score (42.81± 13.26).Conclusion: These results indicate that children with ADHD do not constitute a neurophysiologically homogenous group. Children with QEEG subtype B (elevated slow frequency) may be difficult to distinguish from normal children using the K-ARS, which is the most common screening tool for ADHD. Moreover, parents of children with this subtype may be less sensitive to observing ADHD symptoms.Keywords: attention-deficit/hyperactivity disorder, quantitative electroencephalography, subtype, clinical characteristics
