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dc.contributor.authorDuffy, Frank H.en_US
dc.contributor.authorShankardass, Aditien_US
dc.contributor.authorMcAnulty, Gloria B.en_US
dc.contributor.authorAls, Heideliseen_US
dc.date.accessioned2017-04-06T03:19:27Z
dc.date.issued2017en_US
dc.identifier.citationDuffy, Frank H., Aditi Shankardass, Gloria B. McAnulty, and Heidelise Als. 2017. “A unique pattern of cortical connectivity characterizes patients with attention deficit disorders: a large electroencephalographic coherence study.” BMC Medicine 15 (1): 51. doi:10.1186/s12916-017-0805-9. http://dx.doi.org/10.1186/s12916-017-0805-9.en
dc.identifier.issnen
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:32072085
dc.description.abstractBackground: Attentional disorders (ADD) feature decreased attention span, impulsivity, and over-activity interfering with successful lives. Childhood onset ADD frequently persists to adulthood. Etiology may be hereditary or disease associated. Prevalence is 5% but recognition may be ‘overshadowed’ by comorbidities (brain injury, mood disorder) thereby escaping formal recognition. Blinded diagnosis by MRI has failed. ADD may not itself manifest a single anatomical pattern of brain abnormality but may reflect multiple, unique responses to numerous and diverse etiologies. Alternatively, a stable ADD-specific brain pattern may be better detected by brain physiology. EEG coherence, measuring cortical connectivity, is used to explore this possibility. Methods: Participants: Ages 2 to 22 years; 347 ADD and 619 neurotypical controls (CON). Following artifact reduction, principal components analysis (PCA) identifies coherence factors with unique loading patterns. Discriminant function analysis (DFA) determines discrimination success differentiating ADD from CON. Split-half and jackknife analyses estimate prospective diagnostic success. Coherence factor loading constitutes an ADD-specific pattern or ‘connectome’. Results: PCA identified 40 factors explaining 50% of total variance. DFA on CON versus ADD groups utilizing all factors was highly significant (p≤0.0001). ADD subjects were separated into medication and comorbidity subgroups. DFA (stepping allowed) based on CON versus ADD without comorbidities or medication treatment successfully classified the correspondingly held out ADD subjects in every instance. Ten randomly generated split-half replications of the entire population demonstrated high-average classification success for each of the left out test-sets (overall: CON, 83.65%; ADD, 90.07%). Higher success was obtained with more restricted age sub-samples using jackknifing: 2-8 year olds (CON, 90.0%; ADD, 90.6%); 8-14 year olds (CON, 96.8%; ADD 95.9%); and 14-20 year-olds (CON, 100.0%; ADD, 97.1%). The connectome manifested decreased and increased coherence. Patterns were complex and bi-hemispheric; typically reported front-back and left-right loading patterns were not observed. Subtemporal electrodes (seldom utilized) were prominently involved. Conclusions: Results demonstrate a stable coherence connectome differentiating ADD from CON subjects including subgroups with and without comorbidities and/or medications. This functional ‘connectome’, constitutes a diagnostic ADD phenotype. Split-half replications support potential for EEG-based ADD diagnosis, with increased accuracy using limited age ranges. Repeated studies could assist recognition of physiological change from interventions (pharmacological, behavioral).en
dc.language.isoen_USen
dc.publisherBioMed Centralen
dc.relation.isversionofdoi:10.1186/s12916-017-0805-9en
dc.relation.hasversionhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC5343416/pdf/en
dash.licenseLAAen_US
dc.subjectAttention deficit disorderen
dc.subjectAttention deficit/hyperactivity disorderen
dc.subjectAutism spectrum disorderen
dc.subjectClassificationen
dc.subjectCoherenceen
dc.subjectConnectivityen
dc.subjectConnectomeen
dc.subjectDiagnosisen
dc.subjectDiscriminant analysisen
dc.subjectElectroencephalogramen
dc.subjectMedicationen
dc.subjectMRIen
dc.subjectPrincipal component analysisen
dc.subjectSpectral analysisen
dc.subjectSplit-half replicationen
dc.titleA unique pattern of cortical connectivity characterizes patients with attention deficit disorders: a large electroencephalographic coherence studyen
dc.typeJournal Articleen_US
dc.description.versionVersion of Recorden
dc.relation.journalBMC Medicineen
dash.depositing.authorDuffy, Frank H.en_US
dc.date.available2017-04-06T03:19:27Z
dc.identifier.doi10.1186/s12916-017-0805-9*
dash.contributor.affiliatedShankardass, Aditi
dash.contributor.affiliatedMcAnulty, Gloria
dash.contributor.affiliatedDuffy, Frank
dash.contributor.affiliatedAls, Heidelise


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