Is there a cluster of high theta-beta ratio patients in attention deficit hyperactivity disorder?

Aurore Bussalb, Sidney Collin, Quentin Barthélemy, David Ojeda, Stephanie Bioulac, Hilario Blasco-Fontecilla, Daniel Brandeis, Diane Purper Ouakil, Tomas Ros, Louis Mayaud
Clinical Neurophysiology. 2019-08-01; 130(8): 1387-1396
DOI: 10.1016/j.clinph.2019.02.021

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Bussalb A(1), Collin S(2), Barthélemy Q(2), Ojeda D(2), Bioulac S(3), Blasco-Fontecilla H(4), Brandeis D(5), Purper Ouakil D(6), Ros T(7), Mayaud L(2).

Author information:
(1)Mensia Technologies SA, 130 rue de Lourmel, 75015 Paris, France; Assistance Publique-Hôpitaux de Paris, Robert Debré Hospital, Child and Adolescent
Psychiatry, Paris, France.
(2)Mensia Technologies SA, 130 rue de Lourmel, 75015 Paris, France.
(3)Université de Bordeaux, Sommeil, Addiction et Neuropsychiatrie, USR 3413, F-33000 Bordeaux, France; CNRS, SANPSY, USR 3413, F-33000 Bordeaux, France; CHU Pellegrin, Clinique du Sommeil, F-33076 Bordeaux, France.
(4)Department of Psychiatry, Puerta de Hierro University Hospital-IDIPHIPSA, Autonoma University of Madrid, CIBERSAM, Madrid, Spain.
(5)Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University,
Mannheim, Germany; Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Zurich, Switzerland;
Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland; Zurich Center for Integrative Human Physiology, University of
Zurich, Zurich, Switzerland.
(6)CHU Montpellier-Saint Eloi Hospital, University of Montpellier, Unit of Child and Adolescent Psychiatry (MPEA1), Montpellier, France.
(7)Department of Neuroscience, Geneva, Switzerland.

OBJECTIVE: It has been suggested that there exists a subgroup of ADHD patients that have a high theta-beta ratio (TBR). The aim of this study was to analyze the distribution of TBR values in ADHD patients and validate the presence of a high-TBR cluster using objective metrics.

METHODS: The TBR was extracted from eyes-open resting state EEG recordings of 363 ADHD patients, aged 5-21 years. The TBR distribution was estimated with three Bayesian Gaussian Mixture Models (BGMMs) with one, two, and three components, respectively. The pairwise comparison of BGMMs was carried out with deviance tests to identify the number of components that best represented the data.

RESULTS: The two-component BGMM modeled the TBR values significantly better than the one-component BGMM (p-value = 0.005). No significant difference was observed between the two-component and three-component BGMM (p-value = 0.850).

CONCLUSION: These results suggest that there exist indeed two TBR clusters within the ADHD population.

SIGNIFICANCE: This work offers a global framework to understanding values found in the literature and suggest guidelines on how to compute theta-beta ratio values. Moreover, using objective data-driven method we confirm the existence of a high theta-beta ratio cluster.

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