A decade of EEG Theta/Beta Ratio Research in ADHD: a meta-analysis

J Atten Disord. 2013 Jul;17(5):374-83. doi: 10.1177/1087054712460087. Epub 2012 Oct 19.


Objective: Many EEG studies have reported that ADHD is characterized by elevated Theta/Beta ratio (TBR). In this study we conducted a meta-analysis on the TBR in ADHD.

Method: TBR data during Eyes Open from location Cz were analyzed from children/adolescents 6-18 years of age with and without ADHD.

Results: Nine studies were identified with a total of 1253 children/adolescents with and 517 without ADHD. The grand-mean effect size (ES) for the 6-13 year-olds was 0.75 and for the 6-18 year-olds was 0.62. However the test for heterogeneity remained significant; therefore these ESs are misleading and considered an overestimation. Post-hoc analysis found a decreasing difference in TBR across years, explained by an increasing TBR for the non-ADHD groups.

Conclusion: Excessive TBR cannot be considered a reliable diagnostic measure of ADHD, however a substantial sub-group of ADHD patients do deviate on this measure and TBR has prognostic value in this sub-group, warranting its use as a prognostic measure rather than a diagnostic measure.

Keywords: ADHD; EEG; QEEG; Theta/Beta ratio; beta; neurofeedback; theta.

Publication types

  • Meta-Analysis

MeSH terms

  • Adolescent
  • Attention Deficit Disorder with Hyperactivity / diagnosis
  • Attention Deficit Disorder with Hyperactivity / physiopathology*
  • Attention Deficit Disorder with Hyperactivity / psychology
  • Beta Rhythm / physiology*
  • Cerebral Cortex / physiopathology
  • Child
  • Female
  • Humans
  • Male
  • Reference Values
  • Reproducibility of Results
  • Theta Rhythm / physiology*