Beyond homogeneity: charting the landscape of heterogeneity in neurodevelopmental and psychiatric electroencephalography

Transl Psychiatry. 2025 Jul 2;15(1):223. doi: 10.1038/s41398-025-03441-0.

Abstract

Electroencephalography (EEG) has been thoroughly studied for decades in neurodevelopmental and psychiatric research. Yet its integration into clinical practice as a diagnostic/prognostic tool remains unachieved. We hypothesize that a key reason is the underlying patient's heterogeneity, overlooked in EEG research relying on a case-control approach. We combine high-density EEG with normative modeling to quantify this heterogeneity using two well-established and extensively investigated EEG characteristics -spectral power and functional connectivity- across a cohort of 1674 patients with attention-deficit/hyperactivity disorder, autism spectrum disorder, learning disorder, or anxiety, and 560 matched controls. Normative models showed that deviations from population norms among patients were highly heterogeneous and frequency-dependent. Deviation spatial overlap across patients did not exceed 40% and 24% for spectral and connectivity, respectively. Considering individual deviations in patients has significantly enhanced comparative analysis, and the identification of patient-specific markers has demonstrated a correlation with clinical assessments, representing a crucial step towards attaining precision psychiatry through EEG.

MeSH terms

  • Adolescent
  • Adult
  • Anxiety Disorders* / physiopathology
  • Attention Deficit Disorder with Hyperactivity* / diagnosis
  • Attention Deficit Disorder with Hyperactivity* / physiopathology
  • Autism Spectrum Disorder* / diagnosis
  • Autism Spectrum Disorder* / physiopathology
  • Brain* / physiopathology
  • Case-Control Studies
  • Child
  • Electroencephalography*
  • Female
  • Humans
  • Learning Disabilities* / physiopathology
  • Male
  • Neurodevelopmental Disorders* / physiopathology
  • Young Adult