Electroencephalographic assessment of the relationship between frontal alpha asymmetry and emotion dysregulation in children with attention deficit hyperactivity disorder

Lei CHEN; Li-Li ZHAO; Xiao-Chen WU; Hong-Yuan LI; Wei-Wei ZHANG

doi:10.7499/j.issn.1008-8830.2506048

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Chinese Journal of Contemporary Pediatrics ›› 2025, Vol. 27 ›› Issue (12) : 1493-1499. DOI: 10.7499/j.issn.1008-8830.2506048

CLINICAL RESEARCH

Electroencephalographic assessment of the relationship between frontal alpha asymmetry and emotion dysregulation in children with attention deficit hyperactivity disorder

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Abstract

Objective To explore the relationship between frontal alpha asymmetry (FAA) assessed by electroencephalogram (EEG) and emotion dysregulation (ED) in children with attention deficit hyperactivity disorder (ADHD). Methods Children with ADHD admitted to Fuyang Women and Children's Hospital from September 2021 to December 2024 were prospectively enrolled (n=104). Based on the Achenbach Child Behavior Checklist (CBCL), participants were classified into an ED group (sum of three subscales <180; n=41) and a non-ED group (sum ≥180; n=63). Clinical data were collected, and the Chinese ADHD SNAP-IV parent version and the Weiss Functional Impairment Rating Scale-Parent Report were used. FAA was measured by EEG. Correlations between FAA in different regions and CBCL score were analyzed, and the predictive value of FAA for ED was evaluated with multivariable logistic regression and receiver operating characteristic curves. Results Compared with the non-ED group, the ED group had a higher proportion of the predominantly inattentive ADHD subtype, higher SNAP-IV total score, higher Weiss Functional Impairment Rating Scale-Parent Report total score, and higher FP1/FP2-FAA and C3/C4-FAA (P<0.05). FP1/FP2-FAA and C3/C4-FAA were negatively correlated with CBCL score (P<0.05). The multivariable logistic regression analysis showed that FP1/FP2-FAA and C3/C4-FAA were closely associated with ED in children with ADHD (P<0.05). The areas under the curve for predicting ED using FP1/FP2-FAA, C3/C4-FAA, and their combination were 0.827, 0.685, and 0.917, respectively (P<0.05), and the combined prediction had a higher area under the curve than either single marker (P<0.05). The FP1/FP2 FAA value in hyperactive-impulsive ADHD was lower than in combined-type ADHD and predominantly inattentive ADHD (P<0.05). Conclusions FP1/FP2-FAA and C3/C4-FAA are reliable neural markers of emotion dysregulation in children with ADHD, and their combination shows superior predictive performance. ADHD subtypes show distinct patterns of FAA-functional impairment associations.

Key words

Attention deficit hyperactivity disorder / Electroencephalogram / Frontal alpha asymmetry / Emotion dysregulation / Child

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Lei CHEN , Li-Li ZHAO , Xiao-Chen WU , et al . Electroencephalographic assessment of the relationship between frontal alpha asymmetry and emotion dysregulation in children with attention deficit hyperactivity disorder[J]. Chinese Journal of Contemporary Pediatrics. 2025, 27(12): 1493-1499 https://doi.org/10.7499/j.issn.1008-8830.2506048

References

List( Publishing order | Descend order by publishing year | Descend order by cited within ) Chart analysis

[1]

Popit

, Serod

, Locatelli

, et al. Prevalence of attention-deficit hyperactivity disorder (ADHD): systematic review and meta-analysis[J]. Eur Psychiatry, 2024, 67(1): e68. PMCID: PMC11536208. DOI: 10.1192/j.eurpsy.2024.1786 .

https://www.ncbi.nlm.nih.gov/pubmed/39381949

Cited in this article [1]

[2]	Baweja R, Waxmonsky JG. Updates in pharmacologic strategies for emotional dysregulation in attention deficit hyperactivity disorder[J]. Child Adolesc Psychiatr Clin N Am, 2022, 31(3): 479-498. DOI: 10.1016/j.chc.2022.02.003 . https://www.ncbi.nlm.nih.gov/pubmed/35697397 Cited in this article [1]

[3]	Groves NB, Wells EL, Soto EF, et al. Executive functioning and emotion regulation in children with and without ADHD[J]. Res Child Adolesc Psychopathol, 2022, 50(6): 721-735. PMCID: PMC9091051. DOI: 10.1007/s10802-021-00883-0 . https://www.ncbi.nlm.nih.gov/pubmed/34762251 Cited in this article [1]

[4]	Feng M, Xu J. Electroencephalogram-based ConvMixer architecture for recognizing attention deficit hyperactivity disorder in children[J]. Brain Sci, 2024, 14(5): 469. PMCID: PMC11118831. DOI: 10.3390/brainsci14050469 . https://www.ncbi.nlm.nih.gov/pubmed/38790448 Cited in this article [1]

[5]	Bitsika V, Sharpley CF, Evans ID, et al. Neurological validation of ASD diagnostic criteria using frontal alpha and theta asymmetry[J]. J Clin Med, 2024, 13(16): 4876. PMCID: PMC11355183. DOI: 10.3390/jcm13164876 . https://www.ncbi.nlm.nih.gov/pubmed/39201017 Cited in this article [1]

[6]	Im S, Fitzpatrick S, Hien DA, et al. Frontal alpha asymmetry in children with trauma exposure[J]. Clin EEG Neurosci, 2022, 53(5): 418-425. DOI: 10.1177/15500594221076346 . https://www.ncbi.nlm.nih.gov/pubmed/35125036 Cited in this article [1]

[7]

Zsigo

, Greimel

, Primbs

, et al. Frontal alpha asymmetry during emotion regulation in adults with lifetime major depression[J]. Cogn Affect Behav Neurosci, 2024, 24(3): 552-566. PMCID: PMC11078823. DOI: 10.3758/s13415-024-01165-0 .

https://www.ncbi.nlm.nih.gov/pubmed/38302819

Cited in this article [1]

[8]	李功迎, 宋思佳, 曹龙飞. 精神障碍诊断与统计手册第5版解读[J]. 中华诊断学电子杂志, 2014, 2(4): 310-312. DOI: 10.3877/cma.j.issn.2095-655X.2014.04.017 . Cited in this article [1]

[9]	岳鑫鑫, 刘若楠, 刘倩溶, 等. 注意缺陷多动障碍儿童父母情绪调节困难和儿童情绪调节的关系[J]. 中国心理卫生杂志, 2024, 38(7): 553-558. DOI: 10.3969/j.issn.1000-6729.2024.07.001 . Cited in this article [1]

[10]	Luo N, Luo X, Zheng S, et al. Aberrant brain dynamics and spectral power in children with ADHD and its subtypes[J]. Eur Child Adolesc Psychiatry, 2023, 32(11): 2223-2234. PMCID: PMC10576687. DOI: 10.1007/s00787-022-02068-6 . https://www.ncbi.nlm.nih.gov/pubmed/35996018 Cited in this article [1]

[11]	周晋波, 郭兰婷, 陈颖. 中文版注意缺陷多动障碍SNAP-Ⅳ评定量表-父母版的信效度[J]. 中国心理卫生杂志, 2013, 27(6): 424-428. DOI: 10.3969/j.issn.1000-6729.2013.06.005 . Cited in this article [1]

[12]	钱英, 杜巧新, 曲姗, 等. Weiss功能缺陷量表父母版的信效度[J]. 中国心理卫生杂志, 2011, 25(10): 767-771. DOI: 10.3969/j.issn.1000-6729.2011.10.012 . Cited in this article [1]

[13]

Edmunds

, Fogler

, Braverman

, et al. Resting frontal alpha asymmetry as a predictor of executive and affective functioning in children with neurodevelopmental differences[J]. Front Psychol, 2023, 13: 1065598. PMCID: PMC9880425. DOI: 10.3389/fpsyg.2022.1065598 .

https://www.ncbi.nlm.nih.gov/pubmed/36710763

Cited in this article [1]

[14]	Allison MLH, Broomell APR. Associations between ADHD symptoms, executive function and frontal EEG in college students[J]. Appl Neuropsychol Adult, 2024. Epub ahead of print. DOI: 10.1080/23279095.2024.2426180 . https://www.ncbi.nlm.nih.gov/pubmed/39541278 Cited in this article [1]

[15]

Chueh

, Hsieh

, Tsai

, et al. The relationship between internalizing problems and acute exercise duration in children with attention-deficit/hyperactivity disorder: the role of frontal alpha asymmetry[J]. Res Dev Disabil, 2021, 118: 104063. DOI: 10.1016/j.ridd.2021.104063 .

https://www.ncbi.nlm.nih.gov/pubmed/34507050

Cited in this article [1]

[16]	杨燕平, 李思迅, 王美雯, 等. 伴情绪失调的注意缺陷多动障碍患儿执行功能与临床特征[J]. 四川精神卫生, 2024, 37(4): 307-311. DOI: 10.11886/scjsws20240423002 . Cited in this article [1]

[17]

Taskiran

, Karaismailoglu

, Cak Esen

, et al. Clinical features and subjective/physiological responses to emotional stimuli in the presence of emotion dysregulation in attention-deficit hyperactivity disorder[J]. J Clin Exp Neuropsychol, 2018, 40(4): 389-404. DOI: 10.1080/13803395.2017.1353952 .

https://www.ncbi.nlm.nih.gov/pubmed/28721740

Cited in this article [1]

[18]

Hernandez

, Garcia

, Spiegel

, et al. Multimodal assessment of emotion dysregulation in children with and without ADHD and disruptive behavior disorders[J]. J Clin Child Adolesc Psychol, 2024, 53(3): 444-459. PMCID: PMC11192619. DOI: 10.1080/15374416.2024.2303706 .

https://www.ncbi.nlm.nih.gov/pubmed/38270592

Cited in this article [1]

[19]

Alperin

, Smith

, Gustafsson

, et al. The relationship between alpha asymmetry and ADHD depends on negative affect level and parenting practices[J]. J Psychiatr Res, 2019, 116: 138-146. PMCID: PMC6625668. DOI: 10.1016/j.jpsychires.2019.06.016 .

https://www.ncbi.nlm.nih.gov/pubmed/31233897

Cited in this article [1]

[20]	Ölçüoğlu R. Neurofeedback for ADHD: exploring the role of quantitative EEG and brainwave modulation[J]. Brain Behav, 2025, 15(8): e70714. PMCID:PMC12321976.DOI: 10.1002/brb3.70714 . https://www.ncbi.nlm.nih.gov/pubmed/40760811 Cited in this article [1]

[21]

Kim

, Oh

, Jeon

, et al. Resting-state alpha and gamma activity in affective disorder with ADHD symptoms: comparison between bipolar disorder and major depressive disorder[J]. Int J Psychophysiol, 2019, 143: 57-63. DOI: 10.1016/j.ijpsycho.2019.06.009 .

https://www.ncbi.nlm.nih.gov/pubmed/31255738

Cited in this article [1]

[22]

Stead

, Schmidt

, Crowley

, et al. Frontal EEG asymmetry moderates the relation between borderline personality disorder features and feelings of social rejection in adolescents[J]. Dev Psychopathol, 2023, 35(2): 876-890. DOI: 10.1017/S0954579422000128 .

https://www.ncbi.nlm.nih.gov/pubmed/35440357

Cited in this article [1]

[23]

Postema

, Hoogman

, Ambrosino

, et al. Analysis of structural brain asymmetries in attention-deficit/hyperactivity disorder in 39 datasets[J]. J Child Psychol Psychiatry, 2021, 62(10): 1202-1219. PMCID: PMC8455726. DOI: 10.1111/jcpp.13396 .

https://www.ncbi.nlm.nih.gov/pubmed/33748971

Cited in this article [1]

[24]

Longarzo

, Cavaliere

, Alfano

, et al. Electroencephalographic and neuroimaging asymmetry correlation in patients with attention-deficit hyperactivity disorder[J]. Neural Plast, 2020, 2020: 4838291. PMCID: PMC7481992. DOI: 10.1155/2020/4838291 .

https://www.ncbi.nlm.nih.gov/pubmed/32952547

Cited in this article [1]

[25]

Berretz

, Packheiser

, Wolf

, et al. Acute stress increases left hemispheric activity measured via changes in frontal alpha asymmetries[J]. iScience, 2022, 25(2): 103841. PMCID: PMC8850739. DOI: 10.1016/j.isci.2022.103841 .

https://www.ncbi.nlm.nih.gov/pubmed/35198894

Cited in this article [1]

[26]	Chen R, Liu WJ, Wang JJ, et al. Aperiodic components and aperiodic-adjusted alpha-band oscillations in children with ADHD[J]. J Psychiatr Res, 2024, 173: 225-231. DOI: 10.1016/j.jpsychires.2024.03.042 . https://www.ncbi.nlm.nih.gov/pubmed/38552332 Cited in this article [1]

[27]

Grassini

, Sikka

, Revonsuo

, et al. Subjective ratings of fear are associated with frontal late positive potential asymmetry, but not with early brain activity over the occipital and centro-parietal cortices[J]. Psychophysiology, 2020, 57(12): e13665. DOI: 10.1111/psyp.13665 .

https://www.ncbi.nlm.nih.gov/pubmed/32790915

Cited in this article [1]

[28]	Luo Y, Tang M, Fan X. Meta analysis of resting frontal alpha asymmetry as a biomarker of depression[J]. Npj Ment Health Res, 2025, 4(1): 2. PMCID: PMC11739517. DOI: 10.1038/s44184-025-00117-x . https://www.ncbi.nlm.nih.gov/pubmed/39820155 Cited in this article [1]

[29]

Ahmadi

, Kazemi

, Kuc

, et al. Disrupted functional rich-club organization of the brain networks in children with attention-deficit/hyperactivity disorder, a resting-state EEG study[J]. Brain Sci, 2021, 11(7): 938. PMCID: PMC8305540. DOI: 10.3390/brainsci11070938 .

https://www.ncbi.nlm.nih.gov/pubmed/34356174

Cited in this article [1]