Event-related potentials in attention-deficit/hyperactivity disorder of the predominantly inattentive type: an investigation of EEG-defined subtypes.

Research using resting EEG measures suggests that there is a large variability in EEG profiles within the common behaviourally defined DSM-IV subtypes of AD/HD. Within the predominantly inattentive type of AD/HD (AD/HDin), two distinct groups have been identified, based on underlying EEG activity that represents either cortical hypoarousal, or a maturational lag (with EEGs resembling those of younger children). This study investigated whether ERPs from an inter-modal oddball task could differentiate AD/HDin children from controls, and whether the ERPs of the two previously identified subgroups of AD/HDin children with different EEG profiles differ on this task. AD/HDin children (N=54), 27 identified as cortically hypoaroused and 27 as maturationally lagged, and 27 age-matched controls, were presented with an inter-modal oddball task in which the non-target stimulus was a counter-phasing checkerboard and the target was a 2000 Hz auditory tone. Stimuli (20% targets) were presented at a fixed ISI of 1.03 s and participants were required to count all targets. The task successfully differentiated the AD/HDin children from controls, with AD/HDin children having smaller N1, P2 and P3 amplitudes to both the auditory targets and the visual non-targets. These results were interpreted as indicating a generalised stimulus registration, facilitation and processing deficit in AD/HDin. The only difference between the EEG-defined subtypes was a relative increase in left-frontal N1 amplitude in the cortically hypoaroused group. This was interpreted as indicating reduced frontal lateralisation of N1 in the maturational lag group, supporting its labelling, and anomalous lateralisation in the cortical hypoarousal group.