Right prefrontal activation predicts ADHD and its severity: A TMS-EEG study in young adults,Progress in Neuro-Psychopharmacology and Biological Psychiatry

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Right prefrontal activation predicts ADHD and its severity: A TMS-EEG study in young adults
Progress in Neuro-Psychopharmacology and Biological Psychiatry ( IF 5.3 ) Pub Date : 2021-05-03 , DOI: 10.1016/j.pnpbp.2021.110340
Itay Hadas ₁ , Aviad Hadar ₂ , Avi Lazarovits ₃ , Zafiris J Daskalakis ₄ , Abraham Zangen ₃

Affiliation

Objective

Here we bring a neurophysiological diagnostic tool, based on pathophysiologically-relevant brain region, that is critical for reducing the variability between clinicians, and necessary for quantitative measures of ADHD severity.

Methods

54 healthy and 57 ADHD adults participated in the study. Electroencephalography (EEG) was recorded when combined with transcranial magnetic stimulation (TMS) over the right prefrontal cortex and also recorded during the Stop Signal task.

Results

TMS evoked potentials (TEPs) and the event related potential (ERP) components in the Stop Signal task were found to be significantly reduced in ADHD relative to the matched healthy controls. Stop signal reaction time (SSRT) and stopping accuracy was found to correlate with the ERP signal, and ADHD severity correlated with the TEP signal. Cortical activity (early TEP and Stop Signal ERP) diagnostic model yielded accuracy of 72%.

Conclusion

TEPs and ERPs reveal that right PFC excitability was associated with ADHD severity, and with behavioral impulsivity – as a hallmark of ADHD pathology. This electrophysiological biomarker supports the potential of objective diagnosis for ADHD.

Significance

Such tools would allow better assessment of treatment efficacy and prognosis, may advance understanding of the pathophysiology of the disease and better the public's attitudes and stigma towards ADHD.

Trial Registration: Trial to Evaluate the Efficacy of the HLPFC Coil Deep Transcranial Magnetic Stimulation System in Treating Attention Deficit and Hyperactivity Disorder (ADHD) in Adults, https://clinicaltrials.gov/ct2/show/NCT01737476, ClinicalTrials.gov number NCT01737476

中文翻译：

右前额叶激活可预测 ADHD 及其严重程度：一项针对年轻人的 TMS-EEG 研究

客观的

在这里，我们带来了一种基于与病理生理学相关的大脑区域的神经生理学诊断工具，这对于减少临床医生之间的变异性至关重要，并且对于定量测量 ADHD 严重程度是必要的。

方法

54 名健康成人和 57 名 ADHD 成人参加了这项研究。脑电图 (EEG) 在与右侧前额叶皮层的经颅磁刺激 (TMS) 结合时被记录，并且在停止信号任务期间也被记录。

结果

与匹配的健康对照相比，发现停止信号任务中的 TMS 诱发电位 (TEP) 和事件相关电位 (ERP) 组件在 ADHD 中显着降低。发现停止信号反应时间 (SSRT) 和停止准确度与 ERP 信号相关，ADHD 严重程度与 TEP 信号相关。皮层活动（早期 TEP 和停止信号 ERP）诊断模型的准确率为 72%。