Effects of d-Methylphenidate, Guanfacine, and Their Combination on Electroencephalogram Resting State Spectral Power in Attention-Deficit/Hyperactivity Disorder

Abstract

Objective Psychostimulant medications are the gold standard of treatment for attention-deficit/hyperactivity disorder (ADHD); however, a significant minority (~30%) of individuals with ADHD fail to respond favorably. Noradrenergic agents are increasingly used as ADHD monotherapies or adjuncts for suboptimal stimulant response, yet knowledge of their cortical effects is limited. This study is the first to examine comparative effects of guanfacine (an alpha adrenergic 2A agonist), psychostimulant, and their combination on resting state cortical activity in ADHD. Method The sample comprised 179 participants aged 7 to 14 years old with ADHD (113 boys, 55 girls). Participants were randomized to one of three blinded conditions: guanfacine (GUAN), d-methylphenidate (DMPH), or a combination (COMB). Electroencephalography (EEG) was performed pre-, mid-, and post-medication titration, with concomitant assessment of behavioral and cognitive functioning. Results Analyses of spectral power measures during resting EEG suggested that each medication condition displayed a distinct profile of effects on cortical activity. Significant time effects suggested that GUAN decreased global alpha-band (8–12 hertz [Hz]) power, DMPH and COMB increased centro-parietal beta-band (13–21 Hz) power, and COMB resulted in decreased theta-band (4–7 Hz) power. Relative to other medication groups, COMB was associated with significantly lower theta power and DMPH with higher beta-band power compared to the GUAN group. Medication-related changes in theta power were correlated with improvements in behavioral and cognitive functioning. Conclusion These data revealed distinct underlying medication-related effects on neural mechanisms. The COMB condition uniquely exhibited an EEG profile that was associated with improved behavioral and cognitive functioning. Clinical trial registration information Single Versus Combination Medication Treatment for Children With Attention Deficit Hyperactivity Disorder; http://clinicaltrials.gov/; NCT00429273.

Comparison of QEEG Findings between Adolescents with Attention Deficit Hyperactivity Disorder (ADHD) without Comorbidity and ADHD Comorbid with Internet Gaming Disorder

“…Beta activity increase tends to reflect brain cortical activity enhancement ( 29 ). In a previous QEEG study, methylphenidate treatment resulted in an increase in beta power in centro-parietal regions, which was correlated with behavioral and cognitive symptom improvement ( 30 ). It has been suggested that video game playing might stimulate synaptic dopaminergic transmission similar to methylphenidate stimulation in ADHD, which could result in attentional capacity enhancement ( 31 ).…”

Alpha modulation during working memory encoding predicts neurocognitive impairment in ADHD

“…This study examines the baseline data of a subset of 246 children recruited from the UCLA community to participate in a clinical trial (Bilder et al., ; Loo et al., ; McCracken et al., ) (clinicaltrials.gov ID: NCT00429273). In a prior publication, we reported results based on 102 individuals from this dataset.…”

“…Of the 144 in the independent sample, five were excluded during our independent component analysis protocol (c.f., Appendix S2) and another 20 were excluded because task performance was less than our criterion of 60%. Full diagnostic details are provided in Supplemental Materials (c.f., Appendix S1) as well as in prior publications Loo et al, 2016;McCracken et al, 2016).…”

Double-Blind, Sham-Controlled, Pilot Study of Trigeminal Nerve Stimulation for Attention-Deficit/Hyperactivity Disorder

“…qEEG acquisition followed previously used procedures. 26 Participants underwent qEEG recording, including a five minute, eyes-open resting condition. Recordings were carried out using an Electrical Geodesics (EGI; Eugene, Oregon) GES300 system with 128-electrode high-impedance Hydrocel Geodesic Sensor Nets.…”