Different Spectral Analysis Methods for the Theta/Beta Ratio Calculate Different Ratios But Do Not Distinguish ADHD from
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Different Spectral Analysis Methods for the Theta/Beta Ratio Calculate Different Ratios But Do Not Distinguish ADHD from Controls Hanneke van Dijk1 · Roger deBeus2 · Cynthia Kerson3,4 · Michelle E. Roley‑Roberts5 · Vincent J. Monastra6 · L. Eugene Arnold5 · Xueliang Pan7 · Martijn Arns1,8,9
© The Author(s) 2020
Abstract There has been ongoing research on the ratio of theta to beta power (Theta/Beta Ratio, TBR) as an EEG-based test in the diagnosis of ADHD. Earlier studies reported significant TBR differences between patients with ADHD and controls. However, a recent meta-analysis revealed a marked decline of effect size for the difference in TBR between ADHD and controls for studies published in the past decade. Here, we test if differences in EEG processing explain the heterogeneity of findings. We analyzed EEG data from two multi-center clinical studies. Five different EEG signal processing algorithms were applied to calculate the TBR. Differences between resulting TBRs were subsequently assessed for clinical usability in the iSPOT-A dataset. Although there were significant differences in the resulting TBRs, none distinguished between children with and without ADHD, and no consistent associations with ADHD symptoms arose. Different methods for EEG signal processing result in significantly different TBRs. However, none of the methods significantly distinguished between ADHD and healthy controls in our sample. The secular effect size decline for the TBR is most likely explained by factors other than differences in EEG signal processing, e.g. fewer hours of sleep in participants and differences in inclusion criteria for healthy controls. Keywords ADHD · ICAN · iSPOT-A · Theta-Beta-Ratio · Spectral analysis methods · EEG
Introduction
* Martijn Arns [email protected] Hanneke van Dijk [email protected] 1
Research Institute Brainclinics, Brainclinics Foundation, Bijleveldsingel 32, 6524 AD Nijmegen, The Netherlands
2
Department of Psychology, University of North Carolina, Asheville, USA
3
Saybrook University, Oakland, CA, USA
4
APEd, Napa, CA, USA
5
Department of Psychiatry, Creighton University, Omaha, NE, USA
6
FPI Attention Disorders Clinic, Endicott, NY, USA
7
Department of Biomedical Informatics, Ohio State University, Columbus, OH, USA
8
Department of Experimental Psychology, Utrecht University, Utrecht, The Netherlands
9
neuroCare Group, Munich, Germany
Attention deficit hyperactivity disorder (ADHD) is a disorder characterized by inattention, impulsivity and/or hyperactivity and is the most common of childhood psychiatric disorders. Many studies have investigated EEG in children with ADHD compared to those of children without ADHD. Ever since the first description of deviant fronto-central slow-wave EEG activity (i.e., at frequencies of 5–6/s) in ‘behavioral problem children’ (Jasper et al. 1938), which was included in the 4–8/s band later termed ‘theta activity’ (Walter and Dovey 1944), excess theta EEG power has often been reported in patients with ADHD (Arns et al
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