2 years ago

Biomarker-based treatment stratification in ADHD: An out-of-sample validation

Helena Voetterl, Guido van Wingen, Giorgia Michelini, Kristi Griffiths, Evian Gordon, Roger deBeus, Mayuresh Korgaonkar, Sandra Loo, Donna Palmer, Rien Breteler, Damiaan Denys, Eugene Arnold, Paul du Jour, Rosalinde van Ruth, Jeanine Jansen, Hanneke van Dijk, Martijn Arns
Attention-deficit/hyperactivity disorder (ADHD) is characterized by neurobiological heterogeneity, possibly explaining why not all patients benefit from a given treatment. As a means to select the right treatment (stratification), biomarkers may aid in personalizing treatment prescription, thereby increasing remission rates.The present study introduces a clinically interpretable and actionable, age- and sex-standardized biomarker based on individual alpha peak frequency (iAPF) assessed during resting-state electroencephalography (EEG). The biomarker was developed in a heterogeneous sample (N=4249), and stratifies patients with a higher iAPF to Methylphenidate (MPH; N=336) and those with a lower iAPF to Neurofeedback (NFB; N=136), resulting in a predicted gain in normalized remission of 17-30%. Blinded out-of-sample validation studies for MPH (N=58) and NFB (N=96) corroborated these findings, yielding a predicted gain in stratified normalized remission of 36% and 29%, respectively.These findings suggest that acknowledging neurobiological heterogeneity can inform stratification of patients to their individual best treatment and enhance remission rates.
Open access
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