Transdiagnostic EEG Signatures in ASD and ADHD: A Comparative Review of Computational Biomarkers and Neuromodulatory Interventions

Abstract

Background/Objectives: Autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) are frequently co-occurring neurodevelopmental conditions with partially overlapping neurophysiological profiles. Electroencephalography (EEG) provides non-invasive access to candidate biomarkers, yet the literature remains largely organized around single-diagnosis frameworks, limiting comparison across conditions and constraining translation into intervention selection. This review compares EEG signatures across ASD and ADHD from a transdiagnostic perspective and examines how such signatures might inform the selection of non-pharmacological interventions. Methods: A structured search of PubMed, Scopus, IEEE Xplore and Web of Science identified peer-reviewed studies published between 2010 and 2026 reporting EEG findings in ASD and/or ADHD, spanning resting-state, task-based, connectivity, event-related potential, machine learning and intervention studies. Sixty-eight sources were synthesized thematically. Given substantial heterogeneity in acquisition parameters and analytic pipelines, evidence was integrated interpretively rather than pooled quantitatively, and no formal risk-of-bias assessment was undertaken. Results: Shared features across both conditions frequently included low-frequency theta excess, reduced alpha modulation under cognitive load, and flattened aperiodic (1/f) slopes—a pattern compatible with, though not a direct measurement of, altered excitation/inhibition balance. While substantial heterogeneity exists, disorder-specific signatures often comprised the ASD “U-shaped” spectral profile alongside elevated epileptiform activity, and frontally pronounced theta/beta ratio elevation in subsets of individuals with ADHD. Machine-learning studies increasingly emphasize interpretable, multidomain feature sets over binary classification. Mindfulness-based and neurofeedback interventions converge on theta reduction and alpha enhancement, although reported effects are frequently conditional on responder status, task context, or outcome-rater blinding. Conclusions: Convergent EEG features support a transdiagnostic account of neurodevelopmental dysregulation. A biomarker-informed framework for intervention selection is proposed, which requires prospective validation before clinical application.