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ORIGINAL RESEARCH article

Front. Psychiatry

Sec. ADHD

Volume 16 - 2025 | doi: 10.3389/fpsyt.2025.1590850

P300 Event-Related Potentials as Diagnostic Biomarkers for Attention Deficit Hyperactivity Disorder in Children

Provisionally accepted
Chuanxue  TanChuanxue Tan1Huimin  ZhouHuimin Zhou1Anqi  ZhengAnqi Zheng1Miao  YangMiao Yang1Chunyang  LiChunyang Li1Ting  YangTing Yang2Jie  ChenJie Chen2Jie  ZhangJie Zhang1*Tingyu  LiTingyu Li2*
  • 1Xi’an Children’s Hospital, Xi'an, China
  • 2Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China

The final, formatted version of the article will be published soon.

Objectives: This study aimed to evaluate the utility of P300 event-related potentials (ERPs) as neurophysiological biomarkers for diagnosing attention deficit hyperactivity disorder (ADHD) and to establish preliminary diagnostic thresholds for their use.A total of 106 children diagnosed with ADHD and 66 healthy controls were enrolled. Using a visual Oddball paradigm, P300 parameters were recorded at Fz, Cz, and Pz zones. Key metrics analyzed included P300 amplitude and latency as well as reaction time and correct responses. Statistical tests and logistic regression analysis identified significant group differences, while receiver operating characteristic (ROC) analysis determined the diagnostic performance of these parameters.Results: Children with ADHD exhibited significantly lower P300 amplitudes and longer latencies across all electrode sites compared to controls. Logistic regression identified Cz amplitude (p = 0.001), Pz amplitude (p = 0.011), maximum reaction time (p = 0.037), and correct response count (p < 0.001) as significant predictors of ADHD. ROC analysis showed that Cz amplitude, Pz amplitude, maximum reaction time, and correct responses achieved AUCs of 0.81, 0.75, 0.72, and 0.86, respectively, with sensitivities ranging from 66% to 80% and specificities from 61% to 95%. These results underscore the diagnostic potential of both electrophysiological and behavioral markers in ADHD assessment.Conclusions: Cz and Pz amplitude, maximum reaction time, and correct responses each demonstrated strong diagnostic utility for distinguishing ADHD from typically developing children. The use of these neurophysiological and behavioral indicators as objective complements to traditional clinical assessments.

Keywords: ADHD, Event-related potentials, P300, ROC Curve, diagnostic biomarkers

Received: 10 Mar 2025; Accepted: 09 Jul 2025.

Copyright: © 2025 Tan, Zhou, Zheng, Yang, Li, Yang, Chen, Zhang and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Jie Zhang, Xi’an Children’s Hospital, Xi'an, China
Tingyu Li, Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China

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