Volume 62, Issue 1 e14762
REVIEW

EEG Microstates in the Study of Attention-Deficit Hyperactivity Disorder: A Review of Preliminary Evidence

Cristina Berchio

Corresponding Author

Cristina Berchio

Department of Translational Biomedicine and Neuroscience, University of Bari Aldo Moro, Bari, Italy

Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland

Correspondence:

Cristina Berchio ([email protected])

Contribution: Conceptualization, Data curation, Formal analysis, Funding acquisition, ​Investigation, Methodology, Project administration, Resources, Software, Supervision, Validation, Visualization, Writing - original draft, Writing - review & editing

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Samika S. Kumar

Samika S. Kumar

Department of Psychology, University of Cambridge, Cambridge, UK

Section on Functional Imaging Methods, Laboratory of Brain and Cognition, National Institute of Mental Health, Bethesda, Maryland, USA

Contribution: Conceptualization, ​Investigation, Writing - review & editing

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Antonio Narzisi

Antonio Narzisi

Department of Child Psychiatry and Psychopharmacology, IRCCS Stella Maris Foundation, Pisa, Italy

Contribution: Conceptualization, ​Investigation, Writing - review & editing

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Maddalena Fabbri-Destro

Maddalena Fabbri-Destro

Consiglio Nazionale delle Ricerche, Istituto di Neuroscienze, Parma, Italy

Contribution: Conceptualization, Data curation, Formal analysis, ​Investigation, Methodology, Project administration, Resources, Supervision, Validation, Visualization, Writing - original draft, Writing - review & editing

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First published: 08 January 2025

Funding: The authors received no specific funding for this work.

ABSTRACT

Attention-deficit hyperactivity disorder (ADHD) is a neurobiological condition that affects both children and adults. Microstate (MS) analyses, a data-driven approach that identifies stable patterns in EEG signals, offer valuable insights into the neurophysiological characteristics of ADHD. This review summarizes findings from 13 studies that applied MS analyses to resting-state and task-based brain activity in individuals with ADHD. Relevant research articles were retrieved from electronic databases, including PubMed, Google Scholar, Web of Science, PsychInfo, and Scopus. The reviewed studies applied MS analyses to explore brain activity differences in ADHD populations. Resting-state studies consistently reported alterations in MS organization, with increased duration (MS-D) and changes in temporal dynamics (MS-C), potentially reflecting executive dysfunctions and delayed maturation of the default mode network. Additionally, MS B demonstrated promise in distinguishing between ADHD subtypes based on differences in visual network function. Task-based and event-related potential (ERP) studies, using paradigms like the continuous performance task (CPT) or Go–NoGo Task, identified MS abnormalities (i.e., N2, P2, P3, CNV) linked to inhibition and attentional resource allocation. Preliminary evidence suggests that MS analyses hold potential for distinguishing individuals with ADHD from control groups. The integration of machine learning techniques holds promise for improving diagnostic accuracy and identifying ADHD subtypes, while MS analyses may also help monitor the effects of stimulant medications like methylphenidate by tracking neurophysiological changes. However, this review highlights the need for more standardized methodologies to enhance the generalizability and replicability of findings. These efforts will ultimately contribute to a deeper understanding of the neurobiological mechanisms that underlie ADHD.

Conflicts of Interest

The authors declare no conflicts of interest.

Data Availability Statement

Data derived from public domain resources.

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