Sex differences between the combined and inattentive types of attention-deficit/hyperactivity disorder: An EEG perspective

This study investigated sex differences between the EEGs of Combined and Inattentive types of attention-deficit/hyperactivity disorder (AD/HD) within boys and girls aged 8–12 years. Subject groups included 80 AD/HD Combined type (40 boys and 40 girls), 80 AD/HD Inattentive type (40 boys and 40 girls) and 80 controls (40 boys and 40 girls). An eyes-closed resting EEG was recorded and Fourier transformed to provide estimates for absolute and relative power in the delta, theta, alpha and beta frequency bands, as well as total power and the theta/beta ratio. The boy AD/HD groups, compared with boy controls, had greater absolute and relative theta, greater theta/beta ratio, reduced absolute and relative alpha, and reduced absolute and relative beta. The girl AD/HD groups, compared with girl controls, had greater absolute delta, greater absolute and relative theta, greater theta/beta ratio, greater total power, and reduced relative delta and relative beta. Between AD/HD types, Combined type boys had globally greater absolute and relative theta, greater theta/beta ratio, and less relative alpha than Inattentive type boys. While topographical differences emerged, there were no significant global differences between AD/HD types in girls. That is, EEG differences between AD/HD types are dissimilar in boys and girls. Different EEG maturational patterns between boys and girls also obscure AD/HD-related EEG abnormalities. These results have important implications for our understanding of AD/HD in girls. Ignoring such sex differences may have compromised the value of previous AD/HD investigations, and these sex differences should be recognised in future research.