Attention-deficit/hyperactivity disorder: cognitive evoked potential (P300) topography predicts treatment response to methylphenidate

Clin Neurophysiol. 2004 Jan;115(1):188-93. doi: 10.1016/j.clinph.2003.08.023.

Abstract

Objective: Auditory cognitive evoked potential (P300) topography predicts robust response to the stimulant pemoline in patients with attention-deficit/hyperactivity disorder (ADHD). Patients with a right fronto-central to parietal (FC2:P4) auditory P300 amplitude ratio >0.5 respond robustly to pemoline, whereas others do not. This study was performed to demonstrate whether the same test and ratio predict treatment response to methylphenidate.

Methods: Patients aged 6-12 with DSM-IV diagnosis of ADHD were administered auditory and visual cognitive evoked potential (P300) testing. They then underwent single-blind treatment with an extended-release version of methylphenidate. Robust response was defined as a 60% decrease from baseline in a parent rated ADHD rating scale.

Results: Nine of 20 subjects responded robustly. They did not differ from the non-robust responders in age, baseline attention or hyperactivity ratings, or any P300 parameter except auditory P300 topography. A FC2:P4 auditory P300 amplitude ratio >0.5 predicted robust response with a positive predictive value of 0.67 and a negative predictive value of 0.73.

Conclusions: The ratio of right fronto-central to parietal auditory P300 amplitude predicts response to stimulants in patients with ADHD. As non-stimulant treatments are approved for the treatment of ADHD, tests such as this may help pinpoint whether to use a stimulant or a medicine with some other mechanism of action.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Attention Deficit Disorder with Hyperactivity / drug therapy*
  • Attention Deficit Disorder with Hyperactivity / physiopathology*
  • Attention Deficit Disorder with Hyperactivity / psychology
  • Central Nervous System Stimulants / therapeutic use*
  • Child
  • Cognition / physiology*
  • Double-Blind Method
  • Electroencephalography
  • Event-Related Potentials, P300 / physiology*
  • Female
  • Frontal Lobe / physiopathology
  • Humans
  • Male
  • Methylphenidate / therapeutic use*
  • Parietal Lobe / physiopathology
  • Pemoline / therapeutic use
  • Predictive Value of Tests
  • Temporal Lobe / physiopathology

Substances

  • Central Nervous System Stimulants
  • Methylphenidate
  • Pemoline