# Measuring Accuracy (Classification Probabilities, Positive, and Negative Predictive Values) of Executive Function Electroencephalogram Metrics in Attention-Deficit/Hyperactivity Disorder Diagnosis: Protocol for and Perspectives From the SINCRONIA Study

## TL;DR

The SINCRONIA study aims to develop an EEG-based diagnostic tool for ADHD to improve diagnosis accuracy in children.

## Contribution

The study introduces a novel EEG-based classification algorithm for ADHD diagnosis with potential biomarkers.

## Key findings

- The study will evaluate EEG biomarkers for ADHD diagnosis in children aged 7-12.
- EEG-based diagnosis is expected to outperform traditional neuropsychological tests like the Conners test.

## Abstract

Attention deficit/hyperactivity disorder (ADHD) is the most prevalent neurodevelopmental disorder worldwide, affecting approximately 5%‐7% of school-aged children and 2%‐5% of adults worldwide. However, there is still no reliable diagnostic tool for it. The lack of specific biomarkers further complicates the accurate diagnosis of ADHD.

The SINCRONIA study seeks to develop and optimize an electroencephalogram (EEG)-based ADHD diagnostic classification algorithm by identifying biomarkers that provide optimal diagnostic performance.

This protocol introduces a single-center, case-control study involving at least 165 participants, aged between 7 and 12 years, that is being conducted at the Puerta de Hierro University Hospital in Madrid, Spain. Participants will be allocated to 3 groups, including ADHD predominantly inattentive, ADHD predominantly combined or hyperactive/impulsive, and a control group, according to the best estimated diagnosis based on clinical interviews and a neuropsychological assessment that includes the Conners Continuous Performance Test. In addition, an EEG recording will be conducted separately, and functional connectivity metrics will be used to characterize brain networks associated with inhibitory control. The index test is expected to match or improve the clinical diagnosis of ADHD in children aged between 7 and 12 years and provide a set of eventual biomarkers that maximize diagnostic performance and provide pathophysiological clues.

The SINCRONIA study began screening and recruitment in March 2023. Recruitment ended on December 11, 2024. A total of 165 eligible participants were enrolled.

The SINCRONIA project is a high-quality, large-scale, unicenter study devoted to improving the objective diagnosis of ADHD by using EEG biomarkers. The EEG-based ADHD diagnosis is expected to have greater sensitivity and specificity than the Conners Continuous Performance Test.