Error detection in patients with lesions to the medial prefrontal cortex: an ERP study

Obsessive-compulsive disorder (OCD) is associated with increased engagement of frontal brain regions across multiple event-related potentials

BACKGROUND

Obsessive-compulsive disorder (OCD) is a psychiatric condition leading to significant distress and poor quality of life. Successful treatment of OCD is restricted by the limited knowledge about its pathophysiology. This study aimed to investigate the pathophysiology of OCD using electroencephalographic (EEG) event-related potentials (ERPs), elicited from multiple tasks to characterise disorder-related differences in underlying brain activity across multiple neural processes.

METHODS

ERP data were obtained from 25 OCD patients and 27 age- and sex-matched healthy controls (HCs) by recording EEG during flanker and go/nogo tasks. Error-related negativity (ERN) was elicited by the flanker task, while N200 and P300 were generated using the go/nogo task. Primary comparisons of the neural response amplitudes and the topographical distribution of neural activity were conducted using scalp field differences across all time points and electrodes.

RESULTS

Compared to HCs, the OCD group showed altered ERP distributions. Contrasting with the previous literature on ERN and N200 topographies in OCD where fronto-central negative voltages were reported, we detected positive voltages. Additionally, the P300 was found to be less negative in the frontal regions. None of these ERP findings were associated with OCD symptom severity.

CONCLUSIONS

These results indicate that individuals with OCD show altered frontal neural activity across multiple executive function-related processes, supporting the frontal dysfunction theory of OCD. Furthermore, due to the lack of association between altered ERPs and OCD symptom severity, they may be considered potential candidate endophenotypes for OCD.

Neurophysiological mechanisms of error monitoring in human and non-human primates

Performance monitoring is an important executive function that allows us to gain insight into our own behaviour. This remarkable ability relies on the frontal cortex, and its impairment is an aspect of many psychiatric diseases. In recent years, recordings from the macaque and human medial frontal cortex have offered a detailed understanding of the neurophysiological substrate that underlies performance monitoring. Here we review the discovery of single-neuron correlates of error monitoring, a key aspect of performance monitoring, in both species. These neurons are the generators of the error-related negativity, which is a non-invasive biomarker that indexes error detection. We evaluate a set of tasks that allows the synergistic elucidation of the mechanisms of cognitive control across the two species, consider differences in brain anatomy and testing conditions across species, and describe the clinical relevance of these findings for understanding psychopathology. Last, we integrate the body of experimental facts into a theoretical framework that offers a new perspective on how error signals are computed in both species and makes novel, testable predictions.

Associations between lifetime stress exposure and the error-related negativity (ERN) differ based on stressor characteristics and exposure timing in young adults

Life stress increases risk for multiple forms of psychopathology, in part by altering neural processes involved in performance monitoring. However, the ways in which these stress-cognition effects are influenced by the specific timing and types of life stressors experienced remains poorly understood. To address this gap, we examined how different social-psychological characteristics and developmental timing of stressors are related to the error-related negativity (ERN), a negative-going deflection in the event-related potential (ERP) waveform that is observed from 0 to 100 ms following error commission. A sample of 203 emerging adults performed an ERN-eliciting arrow flanker task and completed an interview-based measure of lifetime stress exposure. Adjusting for stress severity during other developmental periods, there was a small-to-medium effect of stress on performance monitoring, such that more severe total stress exposure, as well as more severe social-evaluative stress in particular, experienced during early adolescence significantly predicted an enhanced ERN. These results suggest that early adolescence may be a sensitive developmental period during which stress exposure may result in lasting adaptations to neural networks implicated in performance monitoring.

Electrophysiological correlates of action monitoring in brain-damaged patients: A systematic review

Action monitoring is crucial to the successful execution of an action and understanding the actions of others. It is often impaired due to brain lesions, in particular after stroke. This systematic review aims to map the literature on the neurophysiological correlates of action monitoring in patients with brain lesions. Eighteen studies were identified and divided into two groups: studies on monitoring of one's own actions and studies on monitoring of the actions of others. The first group included EEG studies on monitoring of self-performed erroneous and correct actions. Impaired error detection (decreased error-related negativity) was observed in patients with lesions in the performance-monitoring network, as compared to healthy controls. Less consistent results were shown for error positivity and behavioral error monitoring performance. The second group of studies on monitoring of others' actions reported decreased mu frequency suppression, impaired readiness potential in the affected hemisphere and decreased EEG indices of error observation (observed error positivity and theta power) in stroke patients. As a whole, these results indicate distinct patterns of impaired neurophysiological activity related to monitoring one's own versus others' actions in patients with brain lesions. EEG recordings of this dissociation in the same patients might be a useful index of motor recovery, and therefore, potentially also beneficial in rehabilitation protocols.

Neural Correlates of Executive Functioning in Anorexia Nervosa and Obsessive-Compulsive Disorder

Anorexia nervosa (AN) and obsessive-compulsive disorder (OCD) are commonly reported to co-occur and present with overlapping symptomatology. Executive functioning difficulties have been implicated in both mental health conditions. However, studies directly comparing these functions in AN and OCD are extremely limited. This review provides a synthesis of behavioral and neuroimaging research examining executive functioning in AN and OCD to bridge this gap in knowledge. We outline the similarities and differences in behavioral and neuroimaging findings between AN and OCD, focusing on set shifting, working memory, response inhibition, and response monitoring. This review aims to facilitate understanding of transdiagnostic correlates of executive functioning and highlights important considerations for future research. We also discuss the importance of examining both behavioral and neural markers when studying transdiagnostic correlates of executive functions.

Error Processing and Pain: A New Perspective

Errors put organisms in danger. Upon error commission, error processing allows for the updating of behavior that proved ineffective in light of the current context and goals, and for the activation of behavioral defensive systems. Pain, on the other hand, signals actual or potential danger to one's physical integrity and, likewise, motivates protective behavior. These parallels suggest the existence of cross-links between pain and error processing but so far their relationship remains elusive. In this review, we tie together findings from the field of pain research with those from electroencephalography studies on error processing [specifically the Error Related Negativity (ERN) and Positivity (Pe)]. More precisely, we discuss three plausible associations: Firstly, pain may enhance error processing as it increases error salience. Secondly, persons fearful of pain may be particularly vigilant towards painful errors and thus show a stronger neural response to them. Thirdly, the ERN as a component of the neural response to error commission is considered an endophenotype of threat sensitivity. As high sensitivity to pain threats is known to incite avoidance behavior, this raises the intriguing possibility that neural signatures of error processing predict pain-related protective behaviors, such as avoidance. We propose an integration of these findings into a common framework to inspire future research. Perspectives Inspired by research in anxiety disorders, we discuss the potential bi-directional relationships between error processing and pain, and identify future directions to examine the neural and psychological processes involved in acute and chronic pain and respective avoidance behavior.

Structural disconnection of the posterior medial frontal cortex reduces speech error monitoring

Optimal performance in any task relies on the ability to detect and correct errors. The anterior cingulate cortex and the broader posterior medial frontal cortex (pMFC) are active during error processing. However, it is unclear whether damage to the pMFC impairs error monitoring. We hypothesized that successful error monitoring critically relies on connections between the pMFC and broader cortical networks involved in executive functions and the task being monitored. We tested this hypothesis in the context of speech error monitoring in people with post-stroke aphasia. Diffusion weighted images were collected in 51 adults with chronic left-hemisphere stroke and 37 age-matched control participants. Whole-brain connectomes were derived using constrained spherical deconvolution and anatomically-constrained probabilistic tractography. Support vector regressions identified white matter connections in which lost integrity in stroke survivors related to reduced error detection during confrontation naming. Lesioned connections to the bilateral pMFC were related to reduce error monitoring, including many connections to regions associated with speech production and executive function. We conclude that connections to the pMFC support error monitoring. Error monitoring in speech production is supported by the structural connectivity between the pMFC and regions involved in speech production, comprehension, and executive function. Interactions between pMFC and other task-relevant processors may similarly be critical for error monitoring in other task contexts.

Detection of Error-Related Potentials in Stroke Patients from EEG Using an Artificial Neural Network

Error-related potentials (ErrPs) have been proposed as a means for improving brain-computer interface (BCI) performance by either correcting an incorrect action performed by the BCI or label data for continuous adaptation of the BCI to improve the performance. The latter approach could be relevant within stroke rehabilitation where BCI calibration time could be minimized by using a generalized classifier that is continuously being individualized throughout the rehabilitation session. This may be achieved if data are correctly labelled. Therefore, the aims of this study were: (1) classify single-trial ErrPs produced by individuals with stroke, (2) investigate test-retest reliability, and (3) compare different classifier calibration schemes with different classification methods (artificial neural network, ANN, and linear discriminant analysis, LDA) with waveform features as input for meaningful physiological interpretability. Twenty-five individuals with stroke operated a sham BCI on two separate days where they attempted to perform a movement after which they received feedback (error/correct) while continuous EEG was recorded. The EEG was divided into epochs: ErrPs and NonErrPs. The epochs were classified with a multi-layer perceptron ANN based on temporal features or the entire epoch. Additionally, the features were classified with shrinkage LDA. The features were waveforms of the ErrPs and NonErrPs from the sensorimotor cortex to improve the explainability and interpretation of the output of the classifiers. Three calibration schemes were tested: within-day, between-day, and across-participant. Using within-day calibration, 90% of the data were correctly classified with the entire epoch as input to the ANN; it decreased to 86% and 69% when using temporal features as input to ANN and LDA, respectively. There was poor test-retest reliability between the two days, and the other calibration schemes led to accuracies in the range of 63-72% with LDA performing the best. There was no association between the individuals' impairment level and classification accuracies. The results show that ErrPs can be classified in individuals with stroke, but that user- and session-specific calibration is needed for optimal ErrP decoding with this approach. The use of ErrP/NonErrP waveform features makes it possible to have a physiological meaningful interpretation of the output of the classifiers. The results may have implications for labelling data continuously in BCIs for stroke rehabilitation and thus potentially improve the BCI performance.

Motor adaptation and internal model formation in a robot-mediated forcefield

Background

Motor adaptation relies on error-based learning for accurate movements in changing environments. However, the neurophysiological mechanisms driving individual differences in performance are unclear. Transcranial magnetic stimulation (TMS)-evoked potential can provide a direct measure of cortical excitability.

Objective

To investigate cortical excitability as a predictor of motor learning and motor adaptation in a robot-mediated forcefield.

Methods

A group of 15 right-handed healthy participants (mean age 23 years) performed a robot-mediated forcefield perturbation task. There were two conditions: unperturbed non-adaptation and perturbed adaptation. TMS was applied in the resting state at baseline and following motor adaptation over the contralateral primary motor cortex (left M1). Electroencephalographic (EEG) activity was continuously recorded, and cortical excitability was measured by TMS-evoked potential (TEP). Motor learning was quantified by the motor learning index.

Results

Larger error-related negativity (ERN) in fronto-central regions was associated with improved motor performance as measured by a reduction in trajectory errors. Baseline TEP N100 peak amplitude predicted motor learning (P = 0.005), which was significantly attenuated relative to baseline (P = 0.0018) following motor adaptation.

Conclusions

ERN reflected the formation of a predictive internal model adapted to the forcefield perturbation. Attenuation in TEP N100 amplitude reflected an increase in cortical excitability with motor adaptation reflecting neuroplastic changes in the sensorimotor cortex. TEP N100 is a potential biomarker for predicting the outcome in robot-mediated therapy and a mechanism to investigate psychomotor abnormalities in depression.

Doing it Wrong: A Systematic Review on Electrocortical and Behavioral Correlates of Error Monitoring in Patients with Neurological Disorders

Detecting errors in one's own and other's actions is a crucial ability for learning and adapting behavior to everchanging, highly volatile environments. Studies in healthy people demonstrate that monitoring errors in one's own and others' actions are underpinned by specific neural systems that are dysfunctional in a variety of neurological disorders. In this review, we first briefly discuss the main findings concerning error detection and error awareness in healthy subjects, the current theoretical models, and the tasks usually applied to investigate these processes. Then, we report a systematic search for evidence of dysfunctional error monitoring among neurological populations (basal ganglia, neurodegenerative, white-matter diseases and acquired brain injury). In particular, we examine electrophysiological and behavioral evidence for specific alterations of error processing in neurological disorders. Error-related negativity (ERN) amplitude were reduced in most (although not all) neurological patient groups, whereas Positivity Error (Pe) amplitude appeared not to be affected in most patient groups. Also theta activity was reduced in some neurological groups, but consistent evidence on the oscillatory activity has not been provided thus far. Behaviorally, we did not observe relevant patterns of pronounced dysfunctional (post-) error processing. Finally, we discuss limitations of the existing literature, conclusive points, open questions and new possible methodological approaches for clinical studies.

Response-locked component of error monitoring in psychopathy: A systematic review and meta-analysis of error-related negativity/positivity

Evidence suggests that psychopathic individuals display difficulties to adapt their behavior in accordance with the demands of the environment and show altered performance monitoring. Studies investigating the error-related negativity (ERN) and the error-positivity (Pe) as electrophysiological markers of error monitoring reported contradictory results for this population. To explain these discrepancies, we hypothesized that psychopathy dimensions influence electrophysiological outcomes. We predicted that individuals with impulsive-antisocial features would display abnormal ERN compared to individuals with interpersonal-affective features. A systematic review and meta-analysis of studies investigating ERN and Pe components were conducted. A factorial analysis was undertaken to investigate the role of psychopathy dimensions on ERN and Pe. Compared to controls, psychopathic individuals (n = 940) showed a reduced ERN and Pe amplitude. The factorial analysis indicates a dissociation regarding the construct of psychopathy. The models reported that psychopathic individuals related specifically to the interpersonal-affective dimension displayed normal ERN component and efficient error-monitoring, while psychopathic individuals with a marked impulsive-antisocial dimension display a decreased ERN component and altered performance monitoring.

The error-related negativity (ERN) moderates the association between interpersonal stress and anxiety symptoms six months later

Anxiety disorders are often preceded by interpersonal stress; however, most individuals who experience stress do not develop anxiety, making it difficult to predict who is most susceptible to stress. One proposed trans-diagnostic neural risk marker for anxiety is the error-related negativity (ERN), a negative deflection in the event-related potential waveform occurring within 100 ms of error commission. The present study sought to investigate whether interpersonal stress experienced over the course of a year interacts with ERN magnitude to prospectively predict anxiety symptoms. A sample of 57 emerging adults performed an arrow flanker task to elicit the ERN at the start of the academic school year (time one). Toward the end of the academic year (time two), participants reported on past-year interpersonal stress and anxiety symptoms. Stress interacted with ERN magnitude to predict anxiety symptoms, whereby, for individuals with an enhanced ERN at time one, greater interpersonal stress over the course of a year was significantly associated with increased anxiety symptoms at time two, even controlling for anxiety symptoms at time one. These findings suggest that enhanced performance monitoring may render individuals more susceptible to the adverse effects of interpersonal stress, thereby increasing risk for heightened anxiety.

Preserved performance monitoring and error detection in left hemisphere stroke

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Our patients suffered from severe cognitive deficits and executive dysfunction.

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On the Go/Nogo task, stroke patients expressed no behavioral impairments.

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Patients showed no neural abnormalities in performance monitoring (Ne/ERN and Pe)

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However, patients had neural abnormalities during stimulus processing (N2 and P3)

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Preserved cognitive control function might be useful tool for rehabilitation.

Depending on the lesion site, a stroke typically affects various aspects of cognitive control. While executing a task, the performance monitoring system constantly compares an intended action plan with the executed action and thereby registers inaccurate actions in case of any mismatch. When errors occur, the performance monitoring system signals the need for more cognitive control, which is most efficient when the subject notices errors rather than processing them subconsciously. The current study aimed to investigate performance monitoring and error detection in a large sample of patients with left hemisphere (LH) stroke.

In addition to clinical and neuropsychological tests, 24 LH stroke patients and 32 healthy age-matched controls performed a Go/Nogo task with simultaneous electroencephalography (EEG) measurements. This set-up enabled us to compare performance monitoring at the behavioral and the neural level. EEG data were analyzed using event-related potentials [ERPs; e.g., the error-related negativity (Ne/ERN) and error positivity (Pe)] and additionally more sensitive whole-brain multivariate pattern classification analyses (MVPA). We hypothesized that LH stroke patients would show behavioural deficits in error detection when compared to healthy controls, mirrored by differences in neural signals, in particular reflected in the Pe component.

Interestingly, despite clinically relevant cognitive deficits (e.g., aphasia and apraxia) including executive dysfunction (trail making test), we did not observe any behavioral impairments related to performance monitoring and error processing in the current LH stroke patients. Patients also showed similar results for Ne/ERN and Pe components, compared to the control group, and a highly similar prediction of errors from multivariate signals. ERP abnormalities during stimulus processing (i.e., N2 and P3) demonstrated the specificity of these findings in the current LH stroke patients. In contrast to previous studies, by employing a relatively large patient sample, a well-controlled experimental paradigm with a standardized error signaling procedure, and advanced data analysis, we were able to show that performance monitoring (of simple actions) is a preserved cognitive control function in LH stroke patients that might constitute a useful resource in rehabilitative therapies for re-learning impeded functions.

Performance Monitoring during Visual Priming

Repetitive performance of single-feature (efficient or pop-out) visual search improves RTs and accuracy. This phenomenon, known as priming of pop-out, has been demonstrated in both humans and macaque monkeys. We investigated the relationship between performance monitoring and priming of pop-out. Neuronal activity in the supplementary eye field (SEF) contributes to performance monitoring and to the generation of performance monitoring signals in the EEG. To determine whether priming depends on performance monitoring, we investigated spiking activity in SEF as well as the concurrent EEG of two monkeys performing a priming of pop-out task. We found that SEF spiking did not modulate with priming. Surprisingly, concurrent EEG did covary with priming. Together, these results suggest that performance monitoring contributes to priming of pop-out. However, this performance monitoring seems not mediated by SEF. This dissociation suggests that EEG indices of performance monitoring arise from multiple, functionally distinct neural generators.

Differentiating electrophysiological indices of internal and external performance monitoring: Relationship with perfectionism and locus of control

The impact of individual differences on performance monitoring and psychopathology is a question of active debate. Personality traits associated with psychopathology may be related to poor internal performance monitoring (as measured by the error-related negativity [ERN]) but intact external performance monitoring (as measured by the reward positivity [RewP]), suggesting that there are underlying neural differences between internal and external performance monitoring processes. We tested the relationships between individual difference measures of perfectionism, locus of control, and ERN, error-positivity (Pe), and RewP component difference amplitude in a healthy undergraduate sample. A total of 128 participants (69 female, M(SD)age = 20.6(2.0) years) completed two tasks: a modified version of the Eriksen Flanker and a doors gambling task along with the Frost Multidimensional Perfectionism scale, the Rotter Locus of Control scale, and the Levenson Multidimensional Locus of Control scale to quantify perfectionism and locus of control traits, respectively. Linear regressions adjusting for age and gender showed that neither ΔERN nor ΔRewP amplitude were significantly moderated by perfectionism or locus of control scores. Findings suggest that, in psychiatrically-healthy individuals, there is not a strong link between perfectionism, locus of control, and ERN or RewP amplitude. Future research on individual difference measures in people with psychopathology may provide further insight into how these personality traits affect performance monitoring.

Developmental trends of performance monitoring measures in 7- to 25-year-olds: Unraveling the complex nature of brain measures

This study explores how trial-to-trial latency variability contributes to the developmental trends observed in ERN amplitude found in the incorrect trials of a performance monitoring task, the visual flanker task. An Adaptive Woody filter was used to measure and correct for the trial-to-trial latency variability of the ERN in 240 participants aged 7-25 years. Using three measures of latency variability, the degree of trial-to-trial latency variability was shown to decrease as the age of the participants increased from 7 to 25 years. The success of the Adaptive Woody filter technique to remove the trial-to-trial latency variability was demonstrated in a straightforward manner by the significant changes in the measures of fit and intraindividual variability obtained before and after applying the filter. After the latency variability effects were removed and adjusted averaged ERPs were obtained, a more subtle but significant nonlinear developmental trend was still found in the amplitude of the ERN component.

Error processing in the adolescent brain: Age-related differences in electrophysiology, behavioral adaptation, and brain morphology

Detecting errors and adjusting behaviour appropriately are fundamental cognitive abilities that are known to improve through adolescence. The cognitive and neural processes underlying this development, however, are still poorly understood. To address this knowledge gap, we performed a thorough investigation of error processing in a Flanker task in a cross-sectional sample of participants 8 to 19 years of age (n = 98). We examined age-related differences in event-related potentials known to be associated with error processing, namely the error-related negativity (ERN) and the error positivity (Pe), as well as their relationships with task performance, post-error adjustments and regional cingulate cortex thickness and surface area. We found that ERN amplitude increased with age, while Pe amplitude remained constant. A more negative ERN was associated with higher task accuracy and faster reaction times, while a more positive Pe was associated with higher accuracy, independently of age. When estimating post-error adjustments from trials following both incongruent and congruent trials, post-error slowing and post-error improvement in accuracy both increased with age, but this was only found for post-error slowing when analysing trials following incongruent trials. There were no age-independent associations between either ERN or Pe amplitude and cingulate cortex thickness or area measures.

Theta-Band Functional Connectivity and Single-Trial Cognitive Control in Sports-Related Concussion: Demonstration of Proof-of-Concept for a Potential Biomarker of Concussion

OBJECTIVES

This report examined theta-band neurodynamics for potential biomarkers of brain health in athletes with concussion.

METHODS

Participants included college-age contact/collision athletes with (N=24) and without a history of concussion (N=16) in Study 1. Study 2 (N=10) examined changes over time in contact/collision athletes. There were two primary dependent variables: (1) theta-band phase-synchronization (e.g., functional connectivity) between medial and right-lateral electrodes; and (2) the within-subject correlation between synchronization strength on error trials and post-error reaction time (i.e., operationalization of cognitive control).

RESULTS

Head injury history was inversely related with medial-lateral connectivity. Head injury was also related to declines in a neurobehavioral measure of cognitive control (i.e., the single-trial relationship between connectivity and post-error slowing).

CONCLUSIONS

Results align with a theory of connectivity-mediated cognitive control. Mild injuries undetectable by behavioral measures may still be apparent on direct measures of neural functioning. This report demonstrates that connectivity and cognitive control measures may be useful for tracking recovery from concussion. Theoretically relevant neuroscientific findings in healthy adults may have applications in patient populations, especially with regard to monitoring brain health. (JINS 2019, 25, 314-323).

An Event-related Potential Study of Error-monitoring Deficits in Female College Students Who Participate in Binge Drinking

Objective

This study investigated error-monitoring deficits in female college students with binge drinking (BD) using event-related potentials (ERPs) and the modified Flanker task.

Methods

Participants were categorized into BD (n=25) and non-BD (n=25) groups based on the scores of the Korean-version of the Alcohol Use Disorder Identification Test (AUDIT-K) and the Alcohol Use Questionnaire (AUQ). The modified Flanker task, consisting of congruent (target and flanker stimuli are the same) and incongruent (target and flanker stimuli are different) conditions, was used to evaluate error-monitoring abilities.

Results

The BD group exhibited significantly shorter response times and more error rates on the Flanker task, as well as reduced error-related negativity (ERN) amplitudes compared with the non-BD group. Additionally, ERN amplitudes measured at FCz and Cz were significantly correlated with scores on the AUDIT-K and AUQ in the whole participants. The BD and non-BD groups did not show any significant differences in error positivity amplitudes.

Conclusion

The present results indicate that college students with BD have deficits in error-monitoring, and that reduced ERN amplitudes may serve as a biological marker or risk factor of alcohol use disorder.

Differences in Characteristics of Error-Related Potentials Between Individuals With Spinal Cord Injury and Age- and Sex-Matched Able-Bodied Controls

Background: Non-invasive brain-computer interfaces (BCI) represent an emerging technology for enabling persons with impaired or lost grasping and reaching functions due to high spinal cord injury (SCI) to control assistive devices. A major drawback of BCIs is a high rate of false classifications. The robustness and performance of BCIs might be improved using cerebral electrophysiological correlates of error recognition (error-related potentials, ErrPs). As ErrPs have never been systematically examined in subjects with SCI, this study compares the characteristics of ErrPs in individuals with SCI with those of able-bodied control subjects. Methods: ErrPs at FCz and Cz were analyzed in 11 subjects with SCI (9 male, median age 28 y) and in 11 sex- and age-matched controls. Moving a shoulder joystick according to a visual cue, subjects received feedback about the match/mismatch of the performed movement. ErrPs occurring after "error"-feedback were evaluated by comparing means of voltage values within three consecutive time windows after feedback (wP1, wN1, wP2 containing peak voltages P1, N1, P2) using repeated-measurement analysis of variance. Results: In the control group, mean voltage values for the "error" and "correct" feedback condition differed significantly around N1 (FCz: 254 ms, Cz: 252 ms) and P2 (FCz: 347 ms, Cz: 345 ms), but not around P1 (FCz: 181 ms, Cz: 179 ms). ErrPs of the control and the SCI group showed similar morphology, however mean amplitudes of ErrPs were significantly smaller in individuals with SCI compared to controls for wN1 (FCz: control = -1.55 μV, SCI = -0.27 μV, p = 0.02; Cz: control = -1.03 μV, SCI = 0.11 μV, p = 0.04) and wP2 (FCz: control = 2.79 μV, SCI = 1.29 μV, p = 0.011; Cz: control = 2.12 μV, SCI = 0.81 μV, p = 0.003). Mean voltage values in wP1, wN1, and wP2 did not correlate significantly with either chronicity after or level of injury. Conclusion: The morphology of ErrPs in subjects with and without SCI is comparable, however, with reduced mean amplitude in wN1 and wP2 in the SCI group. Further studies should evaluate whether ErrP-classification can be used for online correction of false BCI-commands in individuals with SCI.

Overprotective/authoritarian maternal parenting is associated with an enhanced error-related negativity (ERN) in emerging adult females

Error monitoring is crucial for survival and adaptation, and can be indexed by the error-related negativity (ERN), a fronto-centrally located negative deflection in the event-related potential (ERP) waveform that differentiates erroneous from correct responses within 100 ms of a response. The ERN is seen as an early neural signal indicating the need to adjust performance and increase executive control. Previous findings indicate that punishing errors increases ERN magnitude, and that punitive parenting predicts an enhanced ERN in children. If punitive parenting can in fact sensitize children to error commission over the long term, an enhanced ERN should be seen in adults who experienced harsh parenting as children. The present study thus sought to establish whether punitive parenting is associated with an enhanced ERN in emerging adulthood. A sample of 70 emerging adult females reported on their mothers' and fathers' parenting styles separately and performed a flanker task to elicit the ERN. Higher reported overprotective/authoritarian maternal behavior was associated with an enhanced ERN. These results provide further support for the hypothesis that punitive parenting may lead to long-term sensitization of neural networks involved in performance monitoring.

When Neutral is Not Neutral: Neurophysiological Evidence for Reduced Discrimination between Aversive and Non-Aversive Information in Generalized Anxiety Disorder

Generalized anxiety disorder (GAD) is characterized by a range of cognitive and affective disruptions, such as pathological worry. There is debate, however, about whether such disruptions are specifically linked to heightened responses to aversive stimuli, or due to overgeneralized threat monitoring leading to deficits in the ability to discriminate between aversive and non-aversive affective information. The present study capitalized on the temporal and functional specificity of scalp-recorded event-related potentials (ERPs) to examine this question by exploring two targeted neurocognitive responses in a group of adults diagnosed with GAD: 1) visual processing of angry (aversive) versus neutral (non-aversive) faces; and 2) response monitoring of incorrect (aversive) versus correct (non-aversive) responses. Electroencephalography was recorded while 15 adults with GAD and 15 age-matched controls viewed angry and neutral faces prior to individual trials of a flanker task. ERPs to faces were the P1, reflecting attention allocation, the early posterior negativity (EPN), reflecting early affective discrimination, and the N170, reflecting face-sensitive visual discrimination. The error-related negativity (ERN) and positivity (Pe) were generated to incorrect and correct responses. Results showed reduced discrimination between aversive and non-aversive faces and responses in the GAD relative to the control group during visual discrimination (N170) and later-emerging error monitoring (Pe). These effects were driven by exaggerated processing of non-aversive faces and responses, suggesting over-generalized threat monitoring. Implications for cognitive-affective models of GAD are discussed.

Performance monitoring in lung cancer patients pre- and post-chemotherapy using fine-grained electrophysiological measures

No previous event-related potentials (ERPs) study has explored the error-related negativity (ERN) - an ERP component indexing performance monitoring - associated to cancer and chemotherapy-induced cognitive impairment in a lung cancer population. The aim of this study was to examine differences in performance monitoring in a small-cell lung cancer group (SCLC, C +) 1-month following chemotherapy and two control groups: a non-small cell lung cancer patient group (NSCLC, C −) prior to chemotherapy and a healthy control group (HC).

Seventeen SCLC (C +) underwent a neuropsychological assessment and an ERP study using a flanker and a stop-signal paradigm. This group was compared to fifteen age-, gender- and education-matched NSCLC (C −) and eighteen HC.

Between 20 and 30% of patients in both lung cancer groups (C + and C −) met criteria for cognitive impairment. Concerning ERPs, lung cancer patients showed lower overall hit rate and a severe ERN amplitude reduction compared to HC.

Lung cancer patients exhibited an abnormal pattern of performance monitoring thus suggesting that chemotherapy and especially cancer itself, may contribute to cognitive deterioration. ERN appeared as an objective laboratory tool sensitive to cognitive dysfunction in cancer population.

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This is the first study to explore error-related negativity in lung cancer patients.

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Lung cancer patients showed a severe ERN amplitude reduction.

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ERN resulted a potential biomarker of cognitive impairment in lung cancer population.

Brodmann area 10: Collating, integrating and high level processing of nociception and pain

Multiple frontal cortical brain regions have emerged as being important in pain processing, whether it be integrative, sensory, cognitive, or emotional. One such region, Brodmann Area 10 (BA 10), is the largest frontal brain region that has been shown to be involved in a wide variety of functions including risk and decision making, odor evaluation, reward and conflict, pain, and working memory. BA 10, also known as the anterior prefrontal cortex, frontopolar prefrontal cortex or rostral prefrontal cortex, is comprised of at least two cytoarchitectonic sub-regions, medial and lateral. To date, the explicit role of BA 10 in the processing of pain hasn't been fully elucidated. In this paper, we first review the anatomical pathways and functional connectivity of BA 10. Numerous functional imaging studies of experimental or clinical pain have also reported brain activations and/or deactivations in BA 10 in response to painful events. The evidence suggests that BA 10 may play a critical role in the collation, integration and high-level processing of nociception and pain, but also reveals possible functional distinctions between the subregions of BA 10 in this process.

Error-related brain activity and internalizing disorder symptom dimensions in depression and anxiety

BACKGROUND

Research suggests that enhanced neural reactivity to errors, measured via the error-related negativity (ERN), is relatively unique to internalizing psychopathologies (IPs) and symptom clusters characterized by excessive worry and apprehension. However, no prior study has tested the association between the ERN and IP symptom dimensions in a heterogeneous, clinically representative patient population. The current study was designed to address this gap in the literature and clarify the role of the ERN in an adult IP treatment-seeking patient sample.

METHOD

Eighty-five participants completed a well-validated flanker task known to robustly elicit the ERN and a battery of questionnaires assessing a range of IP symptoms. All participants had at least one IP diagnosis and over 75% had co-occurring IPs. A principal components analysis (PCA) was performed on the questionnaire data indicating two distinct factors that characterized the IP sample: affective distress/misery and fear-based anxiety.

RESULTS

Analyses indicated that within this sample, an enhanced ERN, but not CRN, was associated with greater fear-based anxiety symptoms but had no relation with distress/misery symptoms.

CONCLUSIONS

Together, these findings indicate that an enhanced ERN may not be specific to worry/apprehension and may extend to the IP fear dimension. The results also converge with a broader literature suggesting that fear-based psychopathology is characterized by an exaggerated reactivity to threat and this objective, psychophysiological response tendency may distinguish fear disorders from distress.

Cognitive Deficits Underlying Error Behavior on a Naturalistic Task after Severe Traumatic Brain Injury

People with severe traumatic brain injury (TBI) often make errors on everyday tasks that compromise their safety and independence. Such errors potentially arise from the breakdown or failure of multiple cognitive processes. This study aimed to investigate cognitive deficits underlying error behavior on a home-based version of the Cooking Task (HBCT) following TBI. Participants included 45 adults (9 females, 36 males) with severe TBI aged 18–64 years (M = 37.91, SD = 13.43). Participants were administered the HBCT in their home kitchens, with audiovisual recordings taken to enable scoring of total errors and error subtypes (Omissions, Additions, Estimations, Substitutions, Commentary/Questions, Dangerous Behavior, Goal Achievement). Participants also completed a battery of neuropsychological tests, including the Trail Making Test, Hopkins Verbal Learning Test-Revised, Digit Span, Zoo Map test, Modified Stroop Test, and Hayling Sentence Completion Test. After controlling for cooking experience, greater Omissions and Estimation errors, lack of goal achievement, and longer completion time were significantly associated with poorer attention, memory, and executive functioning. These findings indicate that errors on naturalistic tasks arise from deficits in multiple cognitive domains. Assessment of error behavior in a real life setting provides insight into individuals' functional abilities which can guide rehabilitation planning and lifestyle support.

Single-session attention bias modification and error-related brain activity

An attentional bias to threat has been implicated in the etiology and maintenance of anxiety disorders. Recently, attention bias modification (ABM) has been shown to reduce threat biases and decrease anxiety. However, it is unclear whether ABM modifies neural activity linked to anxiety and risk. The current study examined the relationship between ABM and the error-related negativity (ERN), a putative biomarker of risk for anxiety disorders, and the relationship between the ERN and ABM-based changes in attention to threat. Fifty-nine participants completed a single-session of ABM and a flanker task to elicit the ERN--in counterbalanced order (i.e., ABM-before vs. ABM-after the ERN was measured). Results indicated that the ERN was smaller (i.e., less negative) among individuals who completed ABM-before relative to those who completed ABM-after. Furthermore, greater attentional disengagement from negative stimuli during ABM was associated with a smaller ERN among ABM-before and ABM-after participants. The present study suggests a direct relationship between the malleability of negative attention bias and the ERN. Explanations are provided for how ABM may contribute to reductions in the ERN. Overall, the present study indicates that a single-session of ABM may be related to a decrease in neural activity linked to anxiety and risk.

Neural Systems for Error Monitoring

Complex behavior requires a flexible system that maintains task performance in the context of specific goals, evaluating behavioral progress, adjusting behavior as needed, and adapting to changing contingencies. Generically referred to as performance monitoring, a key component concerns the identification and correction of differences between an intended and an executed response (i.e., an error). Brain mapping experiments have now identified the temporal and spatial components of a putative error-processing system in the large-scale networks of the human brain. Most of this work has focused on the medial frontal cortex and an associated electrophysiological component known as the error-related negativity (or error negativity). Although the precise role, or roles, of this region still remain unknown, investigations of error processing have identified a cluster of modules in the medial frontal cortex involved in monitoring/maintaining ongoing behavior and motivating task sets. Other regions include bilateral anterior insula/inferior operculum and lateral prefrontal cortex. Recent work has begun to uncover how individual differences might affect the modules recruited for a task, in addition to the identification of associations between pathological states and aberrant error signals, leading to insights about possible mechanisms of neuropsychiatric illness. NEUROSCIENTIST 13(2):160—172, 2007.

The Representation of Objects in Apraxia: From Action Execution to Error Awareness

Apraxia is a well-known syndrome characterized by the sufferer's inability to perform routine gestures. In an attempt to understand the syndrome better, various different theories have been developed and a number of classifications of different subtypes have been proposed. In this article review, we will address these theories with a specific focus on how the use of objects helps us to better understand upper limb apraxia. With this aim, we will consider transitive vs. intransitive action dissociation as well as less frequent types of apraxia involving objects, i.e., constructive apraxia and magnetic apraxia. Pantomime and the imitation of objects in use are also considered with a view to dissociating the various different components involved in upper limb apraxia. Finally, we discuss the evidence relating to action recognition and awareness of errors in the execution of actions. Various different components concerning the use of objects emerge from our analysis and the results show that knowledge of an object and sensory-motor representations are supported by other functions such as spatial and body representations, executive functions and monitoring systems.

Intact error monitoring in combat Veterans with post-traumatic stress disorder

The error-related negativity (ERN) is a neuroelectric signature of performance monitoring during speeded response time tasks. Previous studies indicate that individuals with anxiety disorders show ERN enhancements that correlate with the degree of clinical symptomology. Less is known about the error monitoring system in post-traumatic stress disorder (PTSD). PTSD is characterized by impairments in the regulation of fear and other emotional responses, as well as deficits in maintaining cognitive control. Here, combat Veterans with PTSD were compared to control Veterans in two different versions of the flanker task (n=13 or 14 per group). Replicating and extending previous findings, PTSD patients showed an intact ERN in both experiments. In addition, task performance and error compensation behavior were intact. Finally, ERN amplitude showed no relationship with self-reported PTSD, depression, or post-concussive symptoms. These results suggest that error monitoring represents a relative strength in PTSD that can dissociate from cognitive control functions that are impaired, such as response inhibition and sustained attention. A healthy awareness of errors in external actions could be leveraged to improve interoceptive awareness of emotional state. The results could have positive implications for PTSD treatments that rely on self-monitoring abilities, such as neurofeedback and mindfulness training.

Blunted neural response to errors as a trait marker of melancholic depression

Identification of biomarkers of vulnerability for Major Depressive Disorder is a high priority, but heterogeneity of the diagnosis can hinder research. Biomarkers of vulnerability should also be present in the absence of the diagnosis. The present study examined the magnitude of the error-related negativity (ERN), an event-related potential component following errors in a sample with remitted melancholic depression (N=17), remitted non-melancholic depression (N=33), and healthy controls (N=55). Remitted melancholic depression was uniquely characterized by a blunted ERN relative to the other two groups. Individuals with remitted non-melancholic depression did not differ from controls in the magnitude of the ERN. This was the case despite the fact that the melancholic and non-melancholic groups did not differ in course or severity of their past illnesses, or in their current functioning. Results suggest that the blunted ERN may be a viable vulnerability marker for melancholia.

An event-related source localization study of response monitoring and social impairments in autism spectrum disorder

A number of studies suggest anterior cingulate cortex (ACC) abnormalities in autism spectrum disorder (ASD), which might underlie response monitoring and social impairments exhibited by children and adolescents with ASD. The goal of the present study was to extend this work by examining error and correct response monitoring using event-related potentials (ERN, Pe, CRN) and LORETA source localization in high functioning adults with ASD and controls. Adults with ASD showed reduced ERN and Pe amplitudes and reduced rostral ACC activation compared with controls. Adults with ASD also showed less differentiation between error and correct ERP components. Social impairments and higher overall autism symptoms were related to reduced rostral ACC activity at the time of the ERN, particularly in adults with ASD. These findings suggest that reduced ACC activity may reflect a putative brain mechanism involved in the origins and maintenance of social impairments and raise the possibility of the presence of stable brain-behavior relation impairment across development in some individuals with ASD.

Dose-dependent effects of cannabis on the neural correlates of error monitoring in frequent cannabis users

Cannabis has been suggested to impair the capacity to recognize discrepancies between expected and executed actions. However, there is a lack of conclusive evidence regarding the acute impact of cannabis on the neural correlates of error monitoring. In order to contribute to the available knowledge, we used a randomized, double-blind, between-groups design to investigate the impact of administration of a low (5.5 mg THC) or high (22 mg THC) dose of vaporized cannabis vs. placebo on the amplitudes of the error-related negativity (ERN) and error positivity (Pe) in the context of the Flanker task, in a group of frequent cannabis users (required to use cannabis minimally 4 times a week, for at least 2 years). Subjects in the high dose group (n=18) demonstrated a significantly diminished ERN in comparison to the placebo condition (n=19), whereas a reduced Pe amplitude was observed in both the high and low dose (n=18) conditions, as compared to placebo. The results suggest that a high dose of cannabis may affect the neural correlates of both the conscious (late), as well as the initial automatic processes involved in error monitoring, while a low dose of cannabis might impact only the conscious (late) processing of errors.

The Effects of Acute Dopamine Precursor Depletion on the Cognitive Control Functions of Performance Monitoring and Conflict Processing: An Event-Related Potential (ERP) Study

Studies using medications and psychiatric populations implicate dopamine in cognitive control and performance monitoring processes. However, side effects associated with medication or studying psychiatric groups may confound the relationship between dopamine and cognitive control. To circumvent such possibilities, we utilized a randomized, double-blind, placebo-controlled, within-subjects design wherein participants were administered a nutritionally-balanced amino acid mixture (BAL) and an amino acid mixture deficient in the dopamine precursors tyrosine (TYR) and phenylalanine (PHE) on two separate occasions. Order of sessions was randomly assigned. Cognitive control and performance monitoring were assessed using response times (RT), error rates, the N450, an event-related potential (ERP) index of conflict monitoring, the conflict slow potential (conflict SP), an ERP index of conflict resolution, and the error-related negativity (ERN) and error positivity (Pe), ERPs associated with performance monitoring. Participants were twelve males who completed a Stroop color-word task while ERPs were collected four hours following acute PHE and TYR depletion (APTD) or balanced (BAL) mixture ingestion in two separate sessions. N450 and conflict SP ERP amplitudes significantly differentiated congruent from incongruent trials, but did not differ as a function of APTD or BAL mixture ingestion. Similarly, ERN and Pe amplitudes showed significant differences between error and correct trials that were not different between APTD and BAL conditions. Findings indicate that acute dopamine precursor depletion does not significantly alter cognitive control and performance monitoring ERPs. Current results do not preclude the role of dopamine in these processes, but suggest that multiple methods for dopamine-related hypothesis testing are needed.

Impaired rapid error monitoring but intact error signaling following rostral anterior cingulate cortex lesions in humans

Detecting one's own errors and appropriately correcting behavior are crucial for efficient goal-directed performance. A correlate of rapid evaluation of behavioral outcomes is the error-related negativity (Ne/ERN) which emerges at the time of the erroneous response over frontal brain areas. However, whether the error monitoring system's ability to distinguish between errors and correct responses at this early time point is a necessary precondition for the subsequent emergence of error awareness remains unclear. The present study investigated this question using error-related brain activity and vocal error signaling responses in seven human patients with lesions in the rostral anterior cingulate cortex (rACC) and adjoining ventromedial prefrontal cortex, while they performed a flanker task. The difference between errors and correct responses was severely attenuated in these patients indicating impaired rapid error monitong, but they showed no impairment in error signaling. However, impaired rapid error monitoring coincided with a failure to increase response accuracy on trials following errors. These results demonstrate that the error monitoring system's ability to distinguish between errors and correct responses at the time of the response is crucial for adaptive post-error adjustments, but not a necessary precondition for error awareness.

Neural correlates of high-risk behavior tendencies and impulsivity in an emotional Go/NoGo fMRI task

Improved neuroscientific understanding of high-risk behaviors such as alcohol binging, drug use, and unsafe sex will lead to therapeutic advances for high-risk groups. High-risk behavior often occurs in an emotionally-charged context, and behavioral inhibition and emotion regulation play important roles in risk-related decision making. High impulsivity is an important potential contributor to high-risk behavior tendencies. We explored the relationships between high-risk behavior tendencies, impulsivity, and fMRI brain activations in an emotional Go/NoGo task. This task presented emotional distractor pictures (aversive vs. neutral) simultaneously with Go/NoGo stimuli (square vs. circle) that required a button press or withholding of the press, respectively. Participants' risk behavior tendencies were assessed with the Cognitive Appraisal of Risky Events (CARE) scale. The Barratt Impulsivity Scale 11 (BIS) was used to assess participant impulsivity. Individuals with higher CARE risk scores exhibited reduced activation related to response inhibition (NoGo-Go) in right orbital frontal cortex (OFC) and ventromedial prefrontal cortex. These regions did not show a significant relationship with impulsivity scores. Conversely, more impulsive individuals showed reduced emotion-related activity (aversive-neutral distractors) in dorsomedial prefrontal cortex, perigenual anterior cingulate cortex, and right posterior OFC. There were distinct neural correlates of high-risk behavior tendency and impulsivity in terms of brain activity in the emotional Go/NoGo task. This dissociation supports the conception of high-risk behavior tendency as a distinct construct from that of impulsivity. Our results suggest that treatment for high-risk behavior may be more effective with a nuanced approach that does not conflate high impulsivity necessarily with high-risk behavior tendencies.

Error-related brain activity in the age of RDoC: A review of the literature

The ability to detect and respond to errors is critical to successful adaptation to a changing environment. The error-related negativity (ERN), an event-related potential (ERP) component, is a well-validated neural response to errors and reflects the error monitoring activity of the anterior cingulate cortex (ACC). Additionally, the ERN is implicated in several processes key to adaptive functioning. Abnormalities in error-related brain activity have been linked to multiple forms of psychopathology and individual differences. As such, the component is likely to be useful in NIMH's Research Domain Criteria (RDoC) initiative to establish biologically-meaningful dimensions of psychological dysfunction, and currently appears as a unit of measurement in three RDoC domains: Positive Valence Systems, Negative Valence Systems, and Cognitive Systems. In this review paper, we introduce the ERN and discuss evidence related to its psychometric properties, as well as important task differences. Following this, we discuss evidence linking the ERN to clinically diverse forms of psychopathology, as well as the implications of one unit of measurement appearing in multiple RDoC dimensions. And finally, we discuss important future directions, as well as research pathways by which the ERN might be leveraged to track the ways in which dysfunctions in multiple neural systems interact to influence psychological well-being.

Correlational structure of 'frontal' tests and intelligence tests indicates two components with asymmetrical neurostructural correlates in old age

Both general fluid intelligence (gf) and performance on some 'frontal tests' of cognition decline with age. Both types of ability are at least partially dependent on the integrity of the frontal lobes, which also deteriorate with age. Overlap between these two methods of assessing complex cognition in older age remains unclear. Such overlap could be investigated using inter-test correlations alone, as in previous studies, but this would be enhanced by ascertaining whether frontal test performance and gf share neurobiological variance. To this end, we examined relationships between gf and 6 frontal tests (Tower, Self-Ordered Pointing, Simon, Moral Dilemmas, Reversal Learning and Faux Pas tests) in 90 healthy males, aged ~ 73 years. We interpreted their correlational structure using principal component analysis, and in relation to MRI-derived regional frontal lobe volumes (relative to maximal healthy brain size). gf correlated significantly and positively (.24 ≤ r ≤ .53) with the majority of frontal test scores. Some frontal test scores also exhibited shared variance after controlling for gf. Principal component analysis of test scores identified units of gf-common and gf-independent variance. The former was associated with variance in the left dorsolateral (DL) and anterior cingulate (AC) regions, and the latter with variance in the right DL and AC regions. Thus, we identify two biologically-meaningful components of variance in complex cognitive performance in older age and suggest that age-related changes to DL and AC have the greatest cognitive impact.

Localizing evoked cortical activity associated with balance reactions: does the anterior cingulate play a role?

The ability to correct balance disturbances is essential for the maintenance of upright stability. Although information about how the central nervous system controls balance reactions in humans remains limited, recent literature highlights a potentially important role for the cerebral cortex. The objective of this study was to determine the neural source of the well-reported balance-evoked N1 response. It was hypothesized that the N1 is associated with an "error-detection" event in response to the induced perturbation and therefore may be associated with activity within the anterior cingulate cortex (ACC). The localized source of the N1 evoked by perturbations to standing balance was compared, within each participant, to the location of an error-related negativity (ERN) known to occur within the ACC while performing a flanker task. In contrast to the main hypotheses, the results revealed that the location of the N1 was not within the ACC. The mean Talairach coordinates for the ERN were (6.47, -4.41, 41.17) mm, corresponding to the cingulate gyrus [Brodmann area (BA) 24], as expected. However, coordinates for the N1 dipole were (5.74, -11.81, 53.73) mm, corresponding to the medial frontal gyrus (BA 6), specifically the supplementary motor area. This may suggest the N1 is linked to the planning and execution of elements of the evoked balance reactions rather than being associated with error or event detection. Alternatively, it is possible that the N1 is associated with variation in the cortical representation due to task-specific differences in the activation of a distributed network of error-related processing. Subsequent work should focus on disentangling these two possible explanations as they relate to the cortical processing linked to reactive balance control.