Age-Specific Auditory Event-Related Potential Abnormalities in Children with Attention Deficit Hyperactivity Disorder: A Cross-Sectional Study

BackgroundAttention deficit hyperactivity disorder (ADHD) is generally characterized as a neurodevelopmental disorder with age-specific cognitive deficits. Despite progressive symptoms, neurophysiological correlates of ADHD developmental trajectories remain underexplored. Event-related potentials (ERPs), previously showing ADHD-related abnormalities, offer a promising but underutilized method to investigate the dynamic changes of neurophysiology during ADHD development. This study aims to investigate age-specific abnormalities in auditory ERPs in children with ADHD and explore their implications for developmental cognitive deficits.MethodsA total of 631 medication-naive children with ADHD (4-15 years) and 109 age- and sex-matched typically developing controls were recruited. Participants were divided into five age groups (4-6, 7-8, 9-10, 11-13 and 14-15 years). Auditory ERPs (N100, P200, N200, P300) were recorded using the oddball paradigm at frontal (Fz), central (Cz), and parietal (Pz) midline electrodes. Group differences in component latencies and amplitudes were analyzed using corrected statistical tests.ResultsSignificant age-specific ERP abnormalities were observed: 4-6 years: Prolonged P200 latency at Fz (<i>t</i> = 2.98, df = 113, <i>p</i> = 0.003, Cohen's <i>d</i> = 0.47 [0.12-0.82]), Cz (<i>t</i> = 2.18, df = 113, <i>p</i> = 0.034, Cohen's <i>d</i> = 0.42 [0.05-0.79]), and Pz (<i>t</i> = 2.25, df = 113, <i>p</i> = 0.028, Cohen's <i>d</i> = 0.45 [0.08-0.82]) and P300 latency at Pz (<i>t</i> = 2.51, df = 113, <i>p</i> = 0.013, Cohen's <i>d</i> = 0.51 [0.14-0.88]) under target stimuli; reduced P200 amplitude at Cz (<i>t</i> = -2.53, df = 113, <i>p</i> = 0.013, Cohen's <i>d</i> = 0.63 [0.25-1.01]) and N100 amplitude at Pz (<i>t</i> = -2.12, df = 113, <i>p</i> = 0.039, Cohen's <i>d</i> = 0.59 [0.21-0.97]) under non-target stimuli. 7-8 years: Prolonged N100 latency at Fz (<i>t</i> = 2.75, df = 256, <i>p</i> = 0.006, Cohen's <i>d</i> = 0.56 [0.21-0.91]), Cz (<i>t</i> = 2.82, df = 256, <i>p</i> = 0.005, Cohen's <i>d</i> = 0.59 [0.24-0.94]), and Pz (<i>t</i> = 2.91, df = 256, <i>p</i> = 0.004, Cohen's <i>d</i> = 0.61 [0.26-0.96]) and N200 latency at Fz (<i>t</i> = 2.52, df = 256, <i>p</i> = 0.010, Cohen's <i>d</i> = 0.47 [0.12-0.82]), Cz (<i>t</i> = 2.09, df = 256, <i>p</i> = 0.037, Cohen's <i>d</i> = 0.42 [0.07-0.77]), and Pz (<i>t</i> = 2.15, df = 256, <i>p</i> = 0.030, Cohen's <i>d</i> = 0.44 [0.09-0.79]) under target stimuli. 9-10 years: Increased N100 amplitude at Pz (<i>t</i> = 2.28, df = 195, <i>p</i> = 0.030, Cohen's <i>d</i> = 0.53 [0.06-1.00]) under target stimuli; increased P200 amplitude at Fz (<i>t</i> = 2.89, df = 195, <i>p</i> = 0.002, Cohen's <i>d</i> = 0.67 [0.20-1.14]), Cz (<i>t</i> = 2.06, df = 195, <i>p</i> = 0.042, Cohen's <i>d</i> = 0.49 [0.02-0.96]), and Pz (<i>t</i> = 2.28, df = 195, <i>p</i> = 0.030, Cohen's <i>d</i> = 0.55 [0.08-1.02]) under non-target stimuli. 11-13 years: Prolonged P300 latency at Pz (<i>t</i> = 2.45, df = 129, <i>p</i> = 0.016, Cohen's <i>d</i> = 0.51 [0.13-0.89]) under target stimuli. 14-15 years: No significant differences in any ERP component (all <i>p</i> > 0.05).ConclusionsADHD children exhibit stage-specific ERP abnormalities, reflecting developmental deficits in inhibitory control (4-6 years), sensory attention allocation (7-8 years), irrelevant information filtering (9-10 years), and working memory maturation (11-13 years). These findings highlight the potential of ERPs as non-invasive biomarkers for age-tailored ADHD diagnosis and intervention.