BlueCross BlueShield of Tennessee Medical Policy Manual

Quantitative Electroencephalography as a Diagnostic Aid for Attention-Deficit/Hyperactivity Disorder (ADHD)

DESCRIPTION

Individuals with attention-deficit/hyperactivity disorder (ADHD) may have alterations in their brain wave patterns that can be measured by quantitative electroencephalography. A commercially available system, the Neuropsychiatric EEG-based ADHD Assessment Aid (NEBA®) measures the resting theta/beta ratio of the electroencephalogram. This technology is being evaluated to aid in the diagnosis of adolescents and children for whom there is a clinical suspicion of ADHD. The system is not intended to evaluate individuals for whom the clinician’s diagnosis of ADHD is negative, and the system does not generate an interpretive report in this situation. It is also proposed that the clinician’s diagnostic impression plus the results generated by the NEBA system may reduce the potential for over diagnosis of ADHD and thereby reduce the risks of administering unnecessary pharmacologic therapy in the intended-use population.

POLICY

IMPORTANT REMINDERS

ADDITIONAL INFORMATION  

Published peer-reviewed studies that evaluate the accuracy of commercially available devices (e.g., NEBA®) in the diagnosis of ADHD are scant. The effect/impact of this technology on health outcomes is not known.

SOURCES

American Academy of Neurology. (2016, November). Practice advisory: The utility of EEG theta/beta power ratio in ADHD diagnosis. Retrieved April 23, 2018 from https://www.aan.com.

BlueCross BlueShield Association. Evidence Positioning System. (11:2020). Quantitative electroencephalography as a diagnostic aid for attention-deficit/hyperactivity disorder (3.01.03). Retrieved January 8, 2021 from http://www.evidencepositioningsystem.com. (7 articles and/or guidelines reviewed)

Kim, J. W., Lee, J., Kim, H. J., Lee Y. S., & Min, K. J. (2015). Relationship between theta-phase gamma-amplitude coupling and attention-deficit/hyperactivity behavior in children. Neuroscience Letters, 590, 12-17. Abstract retrieved July 24, 2015 from PubMed database.

Kim, J., Lee, Y., Han, D., Min, K., Kim, D., & Lee, C. (2015). The utility of quantitative electroencephalography and integrated visual and auditory continuous performance test as auxiliary tools for the Attention Deficit Hyperactivity Disorder diagnosis. Clinical Neurophysiology, 126 (3), 532-40. Abstract retrieved April 20, 2017 from PubMed database.

Snyder, S. M., Rugino, T. A., Hornig, M., & Stein, M. A. (2015). Integration of an EEG biomarker with a clinician’s ADHD evaluation. Brain and Behavior, 5 (4). (Level 3 evidence)

U.S. Food and Drug Administration. (2013, July). Center for Devices and Radiological Health. De novo classification request for Neuropsychiatric EEG-Based Assessment Aid for ADHD (NEBA) System. Retrieved November 18, 2013 from http://www.accessdata.fda.gov.

ORIGINAL EFFECTIVE DATE:  4/10/2014

MOST RECENT REVIEW DATE:  3/11/2021

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