Abstract
OBJECTIVE: Attention-deficit/hyperactivity disorder (ADHD) includes three subtypes: inattentive type (ADHD-I), hyperactive/impulsive type (ADHD-HI), and combined type (ADHD-C). Diagnosis mainly relies on subjective behavioral rating scales, lacking objective biomarkers. Electroencephalography (EEG) and serum neurotrophic factors-brain-derived neurotrophic factor (BDNF), nerve growth factor (NGF), glial cell line-derived neurotrophic factor (GDNF), and neurotrophin-3 (NTF3)-may aid subtype differentiation. This study evaluates their combined diagnostic value in children with ADHD. METHODS: A retrospective cohort of 322 children aged 6-12 years diagnosed with ADHD based on DSM-5 criteria was analyzed. EEG recordings were processed using Fast Fourier Transform to extract frequency band powers and P300 wave features. Serum levels of BDNF, NGF, GDNF, and NTF3 were measured via ELISA. Analysis of variance (ANOVA), multivariate regression, and ROC curve analyses were performed to assess diagnostic performance. RESULTS: ADHD-I patients exhibited elevated frontal θ power, higher θ/β ratios, prolonged P300 latency, and reduced P300 amplitude. ADHD-HI patients demonstrated increased β power in parietal regions and elevated NGF and NTF3 levels. Multivariate analysis identified θ power, θ/β ratio, NGF, NTF3, and P300 amplitude area as independent predictors for subtype differentiation. Combined EEG and serum markers yielded an area under the curve (AUC) (0.90) in distinguishing ADHD-I from ADHD-HI. CONCLUSION: The integration of EEG features and neurotrophic factor profiles offers high diagnostic accuracy in differentiating ADHDI from ADHD-HI and moderate accuracy for the other subtype comparisons. These findings support the development of objective biomarker- based diagnostic tools for precision psychiatry in ADHD.