Abstract:In the field of psychiatry diagnoses are primarily based on the report ofsymptoms from either the patient, parents, or both, and a psychiatrist’sobservations. A psychiatric diagnosis is currently the most widely used basisfor medication selection and the brain is seldom investigated directly as asource of those symptoms. This study addresses the request from the NationalInstitute of Mental Health (NIMH) Research Domain Criteria Project (RDoC) forscientific research into neurological abnormalities that can be linked topsychiatric symptoms for the purpose of predicting medication response. Onesuch neurological abnormality that has been the focus of many studies over thelast three decades is isolated epileptiform discharges (IEDs) in children andadolescents without seizures. We conducted a systematic review of theliterature to determine prevalence rates of IEDs within diagnostic categories.We then compared the prevalence of IEDs in the selected literature to our IRB approveddata archive. Our study found a consistent high prevalence of IEDs specificallyfor ADHD (majority>25%) and ASD (majority>59%), and consistent lowprevalence rates were found for Depression (3%). If children and adolescentshave failed multiple medication attempts, and more than one-third of them haveIEDs, then an EEG would be justified within the RDoC paradigm.
