Research Article 2026-04-21 under-review v1

Back to the Future of Quantitative EEG: Normative Biomarkers from Spectral Ratios and Functional Indices for Diagnosis and Therapeutic Monitoring

J
Jorge F. Bosch-Bayard Carl von Ossietzky University of Oldenburg
J
Judith Guerrero-Sauzameda Centro Integrador del Movimiento, Mente y Conducta (CIMMCO), Querétaro, México
R
Rodolfo Bosch-Bayard State University of Zanzibar
R
Ruben Pérez-Elvira Pontifical University of Salamanca
A
Ayelen Bosch-Castro Centro Integrador del Movimiento, Mente y Conducta (CIMMCO), Querétaro, México
J
Jamin Sánchez-Rodríguez Centro Integrador del Movimiento, Mente y Conducta (CIMMCO), Querétaro, México
A
Alethia Flores Centro Integrador del Movimiento, Mente y Conducta (CIMMCO), Querétaro, México
E
Edgar Resendiz-Flores Centro Integrador del Movimiento, Mente y Conducta (CIMMCO), Querétaro, México
K
Karyme Flores Centro Integrador del Movimiento, Mente y Conducta (CIMMCO), Querétaro, México
A
Arnaldo Ferrando Neuropulse, Neurocare Center, Paraguay
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Patricia Ferrando Neuropulse, Neurocare Center, Paraguay
L
Lidice Galán-García Cuban Neuroscience Center
P
Pedro Valdes-Sosa University of Electronic Science and Technology of China
G
Giuseppe A. Chiarenza Centro Internazionale Disturbi di Apprendimento, Attenzione, Iperattività, CIDAAI
R
Rolando J. Biscay Centro de Investigaciones en Matemática (CIMAT)
L
Lilia Morales-Chacón Universidad Internacional De La Rioja

Abstract

Background Quantitative EEG (qEEG) provides objective, millisecond-resolution measures of brain dynamics. Despite decades of methodological advances, clinically relevant derived indices—spectral power ratios, cognitive-emotional state markers, and physiological parameters—are typically reported as raw values without the normative context required for individualized clinical inference.Objective To develop the first systematic age-dependent normative models for this family of derived qEEG indices using a multinational database, enabling probabilistic Z-score interpretation at the individual level and objective therapeutic monitoring.Methods Normative modeling was applied to the HarMNqEEG database (n = 1,564 neurologically healthy participants, ages 5–97, 9 countries, eyes-closed resting state). Electrode-level Spectral Normalization (ESN) removed inter-individual and inter-device amplitude variability while preserving the neurophysiological interpretability of each index. Age-dependent normative trajectories were estimated using Generalized Additive Models for Location, Scale, and Shape (GAMLSS) with P-splines on log(age), allowing conditional mean and variance to vary non-linearly across the lifespan.Results GAMLSS modeling revealed significant non-linear age-dependent trajectories for all indices. Slow-wave-dominated ratios showed steep decreases from childhood to early adulthood, consistent with cortical maturation; alpha-dominated indices increased during adolescence before stabilizing. ESN normalization yielded well-calibrated normative residuals across the full age range and across all nine recording devices.Conclusions These normative models enable principled, age-adjusted probabilistic inference at the individual level, bridging the historical gap between advanced qEEG methodology and routine clinical practice. The ESN strategy requires no knowledge of recording equipment, ensuring broad applicability. The framework provides an objective tool for monitoring neurophysiological change during therapeutic interventions.

Citation Information

@article{jorgefboschbayard2026,
  title={Back to the Future of Quantitative EEG: Normative Biomarkers from Spectral Ratios and Functional Indices for Diagnosis and Therapeutic Monitoring},
  author={Jorge F. Bosch-Bayard and Judith Guerrero-Sauzameda and Rodolfo Bosch-Bayard and Ruben Pérez-Elvira and Ayelen Bosch-Castro and Jamin Sánchez-Rodríguez and Alethia Flores and Edgar Resendiz-Flores and Karyme Flores and Arnaldo Ferrando and Patricia Ferrando and Lidice Galán-García and Pedro Valdes-Sosa and Giuseppe A. Chiarenza and Rolando J. Biscay and Lilia Morales-Chacón},
  journal={Brain Topography},
  year={2026},
  doi={https://doi.org/10.21203/rs.3.rs-9333312/v1}
}
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