Automatic sensory change processing in adults with attention deficit and hyperactivity disorder: a visual mismatch negativity study.

In addition to higher-order executive functions, underlying sensory processing ability is also thought to play an important role in Attention-Deficit/Hyperactivity Disorder (AD/HD). An event-related potential feature, the mismatch negativity, reflects the ability of automatic sensory change processing and may be correlated with AD/HD symptoms and executive functions. This study aims to investigate the characteristics of visual mismatch negativity (vMMN) in adults with AD/HD. Twenty eight adults with AD/HD and 31 healthy controls were included in this study. These two groups were matched in age, IQ and sex. In addition, both groups completed psychiatric evaluations, a visual ERP task used to elicit vMMN, and psychological measures about AD/HD symptoms and day-to-day executive functions. Compared to trols, the late vMMN (230-330 ms) was significantly reduced in the AD/HD group. Correlation analyses showed that late vMMN was correlated with executive functions but not AD/HD symptoms. However, further mediation analyses showed that different executive functions had mediated the relationships between late vMMN and AD/HD symptoms. Our findings indicate that the late vMMN, reflecting automatic sensory change processing ability, was impaired in adults with AD/HD. This impairment could have negative impact on AD/HD symptoms via affecting day-to-day executive functions.

Test anxiety in primary school children: A 20-year systematic review and meta-analysis.

This study sought to systematically review the full body of research on test anxiety in primary (elementary) school children aged 5-12 years. A comprehensive electronic and manual literature search identified 76 studies (85 independent samples; N = 53,617 children) that satisfied inclusion criteria. Inverse-variance weighted random effects meta-analysis showed that test anxiety related negatively to academic achievement in Mathematics (r = 0.21) and Literacy (r = -0.20), academic self-concept (r = -0.41), and self-efficacy (r = -0.39), and related positively to general anxiety (r = 0.62), social anxiety (r = 0.57), and depression (r = 0.45). Test anxiety was higher among girls than boys (d = 0.21) and in Asian samples compared to European and North American samples. There was some evidence of publication bias and heterogeneity across meta-analyses. Random effects meta-regression models further showed that the association between test anxiety and mathematics achievement was stronger among older children compared to younger children, and that gender differences in test anxiety scores were more prevalent in North American samples compared to Asian samples. Intervention studies targeting anxiety reduction have been successful in reducing test anxiety and improving test anxiety-related outcomes. Overall, findings from this systematic review and meta-analysis provide evidence that test anxiety varies in magnitude across populations and relates to multiple educational and psychosocial outcomes. We recommend further experimental studies that target the reduction of test anxiety among primary school children.

Remote neurocognitive interventions for attention-deficit/hyperactivity disorder - Opportunities and challenges.

Improving neurocognitive functions through remote interventions has been a promising approach to developing new treatments for attention-deficit/hyperactivity disorder (AD/HD). Remote neurocognitive interventions may address the shortcomings of the current prevailing pharmacological therapies for AD/HD, e.g., side effects and access barriers. Here we review the current options for remote neurocognitive interventions to reduce AD/HD symptoms, including cognitive training, EEG neurofeedback training, transcranial electrical stimulation, and external cranial nerve stimulation. We begin with an overview of the neurocognitive deficits in AD/HD to identify the targets for developing interventions. The role of neuroplasticity in each intervention is then highlighted due to its essential role in facilitating neuropsychological adaptations. Following this, each intervention type is discussed in terms of the critical details of the intervention protocols, the role of neuroplasticity, and the available evidence. Finally, we offer suggestions for future directions in terms of optimizing the existing intervention protocols and developing novel protocols.

Use of portable devices to measure brain and heart activity during relaxation and comparative conditions: Electroencephalogram, heart rate variability, and correlations with self-report psychological measures.

Recent technological advancements have enabled the development of portable devices that facilitate psychophysiological measurement in ecologically valid settings. The aim of the present study was to establish normative heart rate (HR), heart rate variability (HRV), and electroencephalogram (EEG) power during relaxation and comparative conditions. Fifty healthy adult participants completed baseline psychological questionnaires and subjective ratings of relaxation while portable devices measured continuous EEG, HR, and HRV data during eyes-open (EO) and eyes-closed (EC) resting, relaxation induction, and patting a toy dog (TD). Subjective relaxation levels were higher after the relaxation and TD compared to EO and EC resting conditions. Psychophysiological indications of relaxation included higher HRV during relaxation, and higher delta, theta, and alpha power during the TD condition. EEG recorded using a portable wireless single-channel device showed frontal EC versus EO differences comparable with those reported using traditional laboratory-based EEG equipment. Additionally, alpha power was positively correlated with resilience and negatively correlated with depression, anxiety, and stress. Delta power correlated positively with subjective relaxation levels during relaxation. Overall, the results suggest that portable devices can provide valid measurements of psychophysiological activity during relaxation outside of laboratory settings. Changes in HRV and EEG waveforms reveal more information about physiological relaxation and show promise for real-world monitoring in fields of study that investigate human arousal, stress, and health.

Links between excessive daytime sleepiness and EEG power and activation in two subtypes of ADHD.

OBJECTIVES: This study aimed to replicate previously reported EEG characteristics between typically developing (TD) children and two subtypes of Attention Deficit Hyperactivity Disorder (ADHD) using a frontal, single-channel, dry-sensor portable EEG device, and explore whether differences are moderated by excessive daytime sleepiness (EDS). METHODS: Children with ADHD Inattentive (ADHD-I) and ADHD Combined presentation (ADHD-C) and typically-developing (TD) children (N = 34 in each group) had frontal EEG recorded during eyes-closed resting, eyes-open resting, and focus tasks. Participants also completed the Children's Self-Report Sleep Patterns - Sleepiness Scale as a measure of EDS. RESULTS: Consistent with previous literature, there were increases in frontal delta and theta power in the ADHD-C compared to ADHD-I and TD groups, in all conditions. Novel power and activation effects in ADHD subtypes, as well as significant group and EDS interactions for alpha and beta power were also found. CONCLUSIONS: These findings highlight the importance of considering ADHD subtypes and EDS when exploring EEG characteristics, and have important implications for the diagnosis and treatment of children with ADHD.

A randomized controlled study of remote computerized cognitive, neurofeedback, and combined training in the treatment of children with attention-deficit/hyperactivity disorder.

There is an increasing interest in non-pharmacological treatments for children with attention-deficit/hyperactivity disorder (AD/HD), especially digital techniques that can be remotely delivered, such as neurofeedback (NFT) and computerized cognitive training (CCT). In this study, a randomized controlled design was used to compare training outcomes between remotely delivered NFT, CCT, and combined NFT/CCT training approaches. A total of 121 children with AD/HD were randomly assigned to the NFT, CCT, or NFT/CCT training groups, with 80 children completing the training program. Pre- and post-training symptoms (primary outcome), executive and daily functions were measured using questionnaires as well as resting EEG during eyes-closed (EC) and eyes-open (EO) conditions. After 3 months of training, the inattentive and hyperactive/impulsive symptoms, inhibition, working memory, learning and life skills of the three groups of children were significantly improved. The objective EEG activity showed a consistent increase in the relative alpha power in the EO condition among the three training groups. Training differences were not observed between groups. There was a positive correlation between pre-training EO relative alpha power and symptom improvement scores of inattention and hyperactivity/impulsivity, as well as a negative correlation between pre-training inattention scores and change in EO relative alpha. This study verified the training effects of NFT, CCT, and combined NFT/CCT training in children with AD/HD and revealed an objective therapeutic role for individual relative alpha activity. The verified feasibility and effectiveness of home-based digital training support promotion and application of digital remote training.

Comparing the Efficacy of Two School-Based Approaches of Neurocognitive Training for Enhancing Executive Functions.

Neurocognitive training has been shown to improve a range of cognitive/executive functions and behavior in children. Delivering this training in a school context may enhance its ecological validity and improve training outcomes. The current study examined the efficacy of two school-based neurocognitive training approaches for enhancing executive functions (EF) in typically developing children: neurocognitive training with no teacher positive feedback (NCT), and neurocognitive training with teacher positive feedback (NCT-TPF). Using a randomized control design, 45 children were randomly allocated to the no-training control, NCT, or NCT-TPF group and completed pre- and post-training assessments on the core executive function (EF) domains of inhibitory control, working memory, and task switching. Teachers' subjective acceptance of the two training protocols was investigated to explore potential ecological validity. The two training groups completed six sessions of training in a kindergarten over a 3-week period. The results showed significant post-training improvements in an untrained inhibitory control task for both training groups when compared with the control group. Different effects were found for each group for the untrained task switching task. While reduced reaction time (RT) in correct Color and Shape trials at Time 2 were reported for the NCT-TPF group, there was no difference compared to the control group for the NCT group. The NCT group showed increased RT in Switch trials but reduced Shape errors compared to controls at Time 2, while these effects were not significant for the NCT-TPF group. An unexpected outcome was that children in both training conditions did not show a significant improvement in an untrained working memory task. Teachers' subjective acceptance consistently supported including positive feedback as part of NCT. While further research is needed, these results support use of neurocognitive training and/or neurocognitive training with teacher positive feedback for typically developing children in a school context.

Psychophysiological mechanisms underlying the potential health benefits of human-dog interactions: A systematic literature review.

While the symbiotic nature of human-dog relationships and perceived benefits to human health have attracted much scientific interest, the mechanisms through which human-dog interactions may confer health benefits to humans are still poorly understood. The aim of this systematic literature review was to synthesize evidence of physiological changes associated with human-dog interactions with relevance to human health. Electronic databases were systematically searched (PubMed, MEDLINE with full text, Scopus, PsycINFO, CINAHL Plus with Full Text, and Web of Science Core Collection) for relevant studies. Of the 13,072 studies identified, 129 met the inclusion criteria, with approximately half being randomized trials (Level 2) based on the Oxford Centre for Evidence Based Medicine level system. Measures employed to study human physiological changes associated with human-dog interactions most commonly involved cardiac parameters and hormones, with negligible research of brain activity. The main positive findings were increases in heart rate variability and oxytocin, and decreases in cortisol with human-dog interactions. These physiological indicators are consistent with activation of the parasympathetic nervous system (PNS) and oxytocinergic system (OTS), and down-regulation of hypothalamic-pituitary-adrenal (HPA) axis activity. These results provide evidence of specific pathways through which human-dog contact may confer health benefits, likely through relaxation, bonding, and stress reduction. However, these findings should be interpreted contextually due to limitations and methodological differences. Previous research using other biological variables was limited in quantity and quality, thus impeding firm conclusions on other possible mechanisms. Further research is needed in some psychophysiological domains, particularly electroencephalography, to better understand central nervous system (CNS) effects. The findings of this review have implications for human-dog interactions to positively affect several stress-sensitive physiological pathways and thus confer health benefits. This supports their incorporation in various clinical, non-clinical, and research settings to develop evidence-based interventions and practices for cost-effective and efficacious ways to improve human health.

Executive Function and Self-Regulation: Bi-Directional Longitudinal Associations and Prediction of Early Academic Skills.

Despite a tendency to study executive function (EF) and self-regulation (SR) separately, parallel lines of research suggest considerable overlap between the two abilities. Specifically, both show similar developmental trajectories (i.e., develop rapidly in the early years), predict a broad range of overlapping outcomes across the lifespan (e.g., academic success, mental and physical health, and social competence), and have overlapping neural substrates (e.g., prefrontal cortex). While theoretical frameworks diverge in how they reconcile EF and SR - ranging from treating the two as functionally synonymous, to viewing them as related yet distinct abilities - there is no consensus and limited empirical evidence on the nature of their relationship and how this extends developmentally. The current study examined bi-directional longitudinal associations between early EF and SR, and their longitudinal associations with subsequent early academic skills, in a sample of 199 3- to 5-year-old pre-school children. The adopted measures permitted EF and SR to be modelled as composite indices for these analyses, thereby decreasing task-specific components of these associations. Early academic skills were captured by a standardized direct assessment. Bi-directional associations between EF and SR were found, with both accounting for unique variance in early academic skills 7 and 19months later. The current results provide important evidence to distinguish between EF and SR abilities, yet also for their reciprocal influence in situ and across early development.

Effect of Omega-3 Supplementation on Self-Regulation in Typically Developing Preschool-Aged Children: Results of the Omega Kid Pilot Study-A Randomised, Double-Blind, Placebo-Controlled Trial.

Supplementation of omega-3 long chain polyunsaturated fatty acids (n-3 LCPUFA) may enhance self-regulation (SR) and executive functioning (EF) in children of preschool age. The aim of the Omega Kid Study was to investigate the effect of n-3 LCPUFA supplementation on SR and EF in typically developing preschool-aged children. A double-blind placebo-controlled pilot trial was undertaken, the intervention was 12 weeks and consisted of 1.6 g of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) per day compared to placebo. The HS-Omega-3 Index® was assessed by capillary blood samples at baseline and post-intervention. Seventy-eight children were enrolled and randomised to either the n-3 LCPUFA treatment (n = 39) or placebo (n = 39) group. Post intervention, there was a significant three-fold increase in the HS-Omega-3 Index® in the n-3 LCPUFA group (p < 0.001). There were no improvements in SR or EF outcome variables for the n-3 LCPUFA group post intervention compared to the placebo group determined by linear mixed models. At baseline, there were significant modest positive Spearman correlations found between the HS-Omega-3 index® and both behavioural self-regulation and cognitive self-regulation (r = 0.287, p = 0.015 and r = 0.242, p = 0.015 respectively). Although no treatment effects were found in typically developing children, further research is required to target children with sub-optimal self-regulation who may benefit most from n-3 LCPUFA supplementation.

Atypical Developmental Trajectories of Early Perception Among School-Age Children With Attention Deficit Hyperactivity Disorder During a Visual Search Task.

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by cognitive deficits associated with attention. Prior studies have revealed the potential impact of ADHD on basic perception and cognitive ability in patients with ADHD. In this study, bilateral posterior P1 and N1 were measured in 122 Chinese children aged 7-12 years (64 with ADHD) to investigate the developmental characteristics of early perception during visual processing in school-age children with ADHD. For children with ADHD, a larger P1 activity with an atypical developmental pattern was evoked and observed for the visual search performance. These findings offer new insights into the mechanisms of cognitive developmental deficits and intervention techniques in children with ADHD.

Aiding diagnosis of childhood attention-deficit/hyperactivity disorder of the inattentive presentation: Discriminant function analysis of multi-domain measures including EEG.

INTRODUCTION: We developed a neurocognitive assessment tool (NCAT) in consultation with mental health professionals working with children with AD/HD as a diagnostic aid and screening tool. This study examines the predictive utility of NCAT in the classification of children with AD/HD Inattentive presentation. METHOD: Fifty three children with AD/HD Inattentive presentation and 161 typically-developing children completed an NCAT assessment. Discriminant function analyses examined group membership prediction for separate components of NCAT and for the components combined. RESULTS: The combined model correctly classified 93.4 % of participants, with 91.4 % sensitivity and 93.9 % specificity. Contributions to classification were from SNAP-IV, psychological needs satisfaction, self-regulation, executive function performance, and EEG. The combined model resulted in a 9.3 % increase in specificity and 5.9 % increase in sensitivity compared to SNAP-IV alone. CONCLUSIONS: NCAT provides good discrimination between children with and without AD/HD of the Inattentive presentation, and further investigation including other subtypes and comorbidities is warranted.

The Feasibility of the "Omega Kid" Study Protocol: A Double-Blind, Randomised, Placebo-Controlled Trial Investigating the Effect of Omega-3 Supplementation on Self-Regulation in Preschool-Aged Children.

Self-regulation, the regulation of behaviour in early childhood, impacts children's success at school and is a predictor of health, wealth, and criminal outcomes in adulthood. Self-regulation may be optimised by dietary supplementation of omega-3 long-chain polyunsaturated fatty acids (n-3 LCPUFAs). The aim of the "Omega Kid" study is to investigate the feasibility of a protocol to investigate whether n-3 LCPUFA supplementation enhances self-regulation in preschool-aged children. The protocol assessed involved a double-blind, randomised, placebo-controlled trial of 12 weeks duration, with an intervention of 1.6 g of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) per day (0.3 g EPA and 1.3 g DHA) in a microencapsulated powder compared to placebo. Children (n = 78; 40 boys and 38 girls) aged 3-5 years old were recruited and randomly allocated to the treatment (n = 39) or placebo group (n = 39). The HS-Omega-3 Index® served as a manipulation check on the delivery of either active (n-3 LCPUFAs) or placebo powders. Fifty-eight children (76%) completed the intervention (28-30 per group). Compliance to the study protocol was high, with 92% of children providing a finger-prick blood sample at baseline and high reported-adherence to the study intervention (88%). Results indicate that the protocol is feasible and may be employed in an adequately powered clinical trial to test the hypothesis that n-3 LCPUFA supplementation will improve the self-regulation of preschool-aged children.

Effect of Neurocognitive Training for Children With ADHD at Improving Academic Engagement in Two Learning Settings.

Objective: This preliminary study investigated effectiveness of neurocognitive training on academic engagement (AET) for children with ADHD. The training approach targeted working memory, inhibitory control, and attention/relaxation (via brain electrical activity). Method: A reversal design with a 2-week follow-up was used to assess the effectiveness of the treatment on two children with diagnosed ADHD in two learning settings. Direct observation was used to collect academic-related behavior. Results: Improvements in on-task expected behavior (ONT-EX) and general AET, as well as reductions in off-task motor activity (OFF-MA) and off-task passive behavior (OFF-PB) were observed for both students over baselines and across the settings. Moreover, differences in behavioral change were found between participants and settings. Conclusion: These findings support using the treatment for improving academic performance of children with ADHD. Future studies may investigate influences of contextual differences, nontreatment variables, or adult's feedback during the training session on treatment effectiveness.

Development of Frontal EEG Differences Between Eyes-Closed and Eyes-Open Resting Conditions in Children: Data From a Single-Channel Dry-Sensor Portable Device.

Changes in EEG when moving from an eyes-closed to an eyes-open resting condition result from bottom-up sensory processing and have been referred to as activation. In children, activation is characterized by a global reduction in alpha, frontally present reductions for delta and theta, and a frontal increase for beta. The present study aimed to replicate frontal EEG activation effects using single-channel, dry-sensor EEG, and to extend current understanding by examining developmental change in children. Frontal EEG was recorded using a single-channel, dry-sensor EEG device while 182 children aged 7 to 12 years completed eyes-closed resting (EC), eyes-open resting (EO), and focus (FO) tasks. Results indicated that frontal delta, theta, and alpha power were reduced, and frontal beta power was increased, in the EO compared with the EC condition. Exploratory analysis of a form of top-down activation showed that frontal beta power was increased in the FO compared with to the EO condition, with no differences for other bands. The activation effects were robust at the individual level. The bottom-up activation effects reduced with age for frontal delta and theta, increased for frontal alpha, with no developmental change for top-down or bottom-up frontal beta activation. These findings contribute further to validation of the single-channel, dry-sensor, frontal EEG and provide support for use in a range of medical, therapeutic, and clinical domains.

EEG coherence during subjectively-rated psychological state variations.

BACKGROUND: Neurofeedback training aims to develop awareness and control of psychological states in order to self-regulate brain activity and while used widely therapeutically, important questions remain unanswered. Central to these aims is an assumed association between the live EEG-based feedback and the subjective experience of a psychological state. To date, there is little evidence to support this relationship. Previous studies examining the association between an EEG index and subjective experience have explored only the presence or absence of the state, or merely assumed state variations. The current study aims to examine this association by considering how different levels of a psychological state (i.e., attention) are reflected in EEG coherence. METHODS: Our approach aims to allow comparisons of EEG coherence between psychological states (attention vs. rest), and also within subjectively-rated levels of a psychological state (attention) through a purpose-designed questionnaire. Thirty healthy adult participants performed a resting eyes-open (REO) and attention modulation task, while 28 channels of EEG were recorded. Levels within the psychological state were subjectively-attested by participants on a trial-by-trial basis. RESULTS: The main analyses examined the effect of subjectively-rated attention levels (SRALs) on EEG coherence, with results suggesting that high and low SRALs may be represented by: 1) different levels of alpha and theta coherence at anterior and posterior electrodes of the frontal lobe bilaterally, and 2) different levels of alpha coherence between central and parietal lobes, also bilaterally. DISCUSSION: These findings provide partial, preliminary evidence for EEG correlates of SRALs. These findings may have implications for understanding underlying mechanisms of NFT, which is an underdeveloped area.

Neural Correlates of Working Memory Deficits in Different Adult Outcomes of ADHD: An Event-Related Potential Study.

BACKGROUND: We investigated working memory (WM) processing in a longitudinal sample of young adults with persistent and remittent childhood-onset ADHD to investigate the neural correlates of working memory with adult outcomes of ADHD. METHODS: Forty-seven young Chinese adults who had been diagnosed with ADHD during childhood underwent follow-up assessments for an average of 9 years. The ADHD sample consisted of 25 ADHD persisters (mean age =18.38 ± 0.5 years) and 22 remitters (mean age = 18.78 ± 1.10 years), who were compared with 25 sex ratio- and IQ-matched healthy adults (mean age = 19.60 ± 1.22 years) in a verbal n-back task. RESULTS: No differences in behavioral measures were observed across the three groups. Compared with the healthy controls, the ADHD persisters and remitters had larger N1 amplitudes and smaller P2 amplitudes, while no significant differences between the persistence and remission groups were observed. The P3 amplitudes of the remission and control groups were higher than that of the persistence group, but there was no significant difference between the remitters and healthy controls. CONCLUSION: The P3 amplitudes reflecting postdecisional processing and/or WM updating were sensitive to ADHD remission, as they might improve concurrently with ADHD symptoms. These results indicate that the N1, P2, and P3 components of WM processing might be potential biomarkers for different ADHD outcomes.

Resting state EEG power research in Attention-Deficit/Hyperactivity Disorder: A review update.

This article reviews the eyes-open and eyes-closed resting electroencephalogram (EEG) literature for Attention-Deficit/Hyperactivity Disorder (AD/HD) from 2002 to 2019. This time has seen substantial increase in interest in resting state EEG, with investigations moving from a comparison of an AD/HD sample to a control group, to research investigating a wide range of theoretical and clinical aspects of the disorder. This has included investigations of subgroups based on their EEG profile, sex differences in the EEG, increasing interest in the EEG of adults, and the effects of comorbid disorders on the EEG of people with AD/HD. Research has further investigated the hyper- and hypo- arousal models of AD/HD, as well as the developmental deviation model. From a clinical perspective, a growing body of literature is emerging trying to ascertain if the EEG can be used as a diagnostic test, particularly the theta/beta ratio. While these advances have been made, there is widespread use of both the eyes-open and eyes-closed resting paradigms as being interchangeable, despite the two paradigms differ on a number of important factors. There is also lack of independent replication within the literature, which is needed to consolidate many of the findings that have been published.

Shared and distinct resting functional connectivity in children and adults with attention-deficit/hyperactivity disorder.

Attention-deficit/hyperactivity disorder (ADHD) often persists into adulthood, with a shift of symptoms including less hyperactivity/impulsivity and more co-morbidity of affective disorders in ADHDadult. Many studies have questioned the stability in diagnosing of ADHD from childhood to adulthood, and the shared and distinct aberrant functional connectivities (FCs) between ADHDchild and ADHDadult remain unidentified. We aim to explore shared and distinct FC patterns in ADHDchild and ADHDadult, and further investigated the cross-cohort predictability using the identified FCs. After investigating the ADHD-discriminative FCs from healthy controls (HCs) in both child (34 ADHDchild, 28 HCs) and adult (112 ADHDadult,77 HCs) cohorts, we identified both shared and distinct aberrant FC patterns between cohorts and their association with clinical symptoms. Moreover, the cross-cohort predictability using the identified FCs were tested. The ADHD-HC classification accuracies were 84.4% and 81.0% for children and male adults, respectively. The ADHD-discriminative FCs shared in children and adults lie in the intra-network within default mode network (DMN) and the inter-network between DMN and ventral attention network, positively correlated with total scores of ADHD symptoms. Particularly, inter-network FC between somatomotor network and dorsal attention network was uniquely impaired in ADHDchild, positively correlated with hyperactivity index; whereas the aberrant inter-network FC between DMN and limbic network exhibited more adult-specific ADHD dysfunction. And their cross-cohort predictions were 70.4% and 75.6% between each other. This work provided imaging evidence for symptomatic changes and pathophysiological continuity in ADHD from childhood to adulthood, suggesting that FCs may serve as potential biomarkers for ADHD diagnosis.

Predicting functional outcomes after stroke: an observational study of acute single-channel EEG.

Background: Early and objective prediction of functional outcome after stroke is an important issue in rehabilitation. Electroencephalography (EEG) has long been utilized to describe and monitor brain function following neuro-trauma, and technological advances have improved usability in the acute setting. However, skepticism persists whether EEG can provide the same prognostic value as neurological examination.Objective: The current cohort study examined the relationship between acute single-channel EEG and functional outcomes after stroke.Methods: Resting-state EEG recorded at a single left pre-frontal EEG channel (FP1) was obtained from 16 adults within 72 h of first stroke. At 30 and 90 days, measures of disability (modified Rankin Scale; mRS) and involvement in daily activities (modified Barthel Index; mBI) were obtained. Acute EEG measures were correlated with functional outcomes and compared to an early neurological examination of stroke severity using the National Institute of Health Stroke Scale (NIHSS). Classification of good outcomes (mRS ≤1 or mBI ≥95) was also examined using Receiver Operator Curve analyses.Results: One-third to one-half of participants experienced incomplete post-stroke recovery, depending on the time point and measure. Functional outcomes correlated with acute theta values (rs 0.45-0.60), with the strength of associations equivalent to previously reported values obtained from conventional multi-channel systems. Acute theta values ≥0.25 were associated with good outcomes, with positive (67-83%) and negative predictive values (70-90%) comparable to those obtained using the NIHSS.Conclusions: Acute, single-channel EEG can provide unique, non-overlapping clinical information, which may facilitate objective prediction of functional outcome after stroke.