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

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.

• Authors: R Bart Sangal, JoAnne M Sangal
• Journal: Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology (Clin Neurophysiol) Vol. 115 Issue 1 Pg. 188-93 (Jan 2004) ISSN: 1388-2457 [Print] Netherlands
• PMID: 14706487 (Publication Type: Clinical Trial, Journal Article, Multicenter Study, Randomized Controlled Trial)

Chemical References

• Central Nervous System Stimulants
• Methylphenidate
• Pemoline

Topics

• Attention Deficit Disorder with Hyperactivity (drug therapy, physiopathology, 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)