No behavioral or ERP evidence for a developmental lag in visual working memory capacity or filtering in adolescents and adults with ADHD

A negative emotional state impairs individuals' ability to filter distractors from working memory: an ERP study

Capacity-limited visual working memory (VWM) requires that individuals have sufficient memory space and the ability to filter distractors. Negative emotional states are known to impact VWM storage, yet their influence on distractor filtering within VWM remains underexplored. We conducted direct neural measurement of participants (n = 56) who conducted a lateralized change detection task with distractors, while manipulating the emotional state by presenting neutral or negative images before each trial. We found a detrimental effect of distractors on memory accuracy under both neutral and negative emotional states. Using the event-related potential (ERP) component, contralateral delay activity (CDA; sensitive to VWM load), to observe the VWM load in each condition, we found that in the neutral state, the participants showed significantly higher late CDA amplitudes when remembering 4 targets compared with 2 targets and 2 targets with 2 distractors but no significant difference when remembering 2 targets compared with 2 targets with 2 distractors. In the negative state, no significant CDA amplitude differences were evident when remembering 4 targets and 2 targets, but CDA was significantly higher when remembering 2 targets with 2 distractors compared with 2 targets. These results suggest that the maximum number of items participants could store in VWM was lower under negative emotional states than under neutral emotional states. Importantly, the participants could filter out distractors when in a neutral emotional state but not in a negative emotional state, indicating that negative emotional states impair their ability to filter out distractors in VWM.

Neurophysiological measures and correlates of cognitive load in attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD) and dyslexia: A scoping review and research recommendations

Working memory is integral to a range of critical cognitive functions such as reasoning and decision-making. Although alterations in working memory have been observed in neurodivergent populations, there has been no review mapping how cognitive load is measured in common neurodevelopmental conditions such as attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD) and dyslexia. This scoping review explores the neurophysiological measures used to study cognitive load in these specific populations. Our findings highlight that electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) are the most frequently used methods, with a limited number of studies employing functional near-infrared spectroscopy (fNIRs), magnetoencephalography (MEG) or eye-tracking. Notably, eye-related measures are less commonly used, despite their prominence in cognitive load research among neurotypical individuals. The review also highlights potential correlates of cognitive load, such as neural oscillations in the theta and alpha ranges for EEG studies, blood oxygenation level-dependent (BOLD) responses in lateral and medial frontal brain regions for fMRI and fNIRS studies and eye-related measures such as pupil dilation and blink rate. Finally, critical issues for future studies are discussed, including the technical challenges associated with multimodal approaches, the possible impact of atypical features on cognitive load measures and balancing data richness with participant well-being. These insights contribute to a more nuanced understanding of cognitive load measurement in neurodivergent populations and point to important methodological considerations for future neuroscientific research in this area.

Attentional Orienting in Working Memory in Children with ADHD

Children with attentional-deficit/hyperactivity disorder (ADHD) have impairments in working memory (WM) functioning. Impaired orienting of visual attention during encoding and/or maintenance is hypothesized as the cause of poor performance in visuospatial WM in 10-to-16-year-olds. We used a color-recognition task with valid location cues before encoding (pre-cues) and during maintenance (retro-cues). If ADHD children have an orienting deficit during these processing stages, they should not benefit from the cues. We observed strong pre- and retro-cueing benefits both for ADHD and typically developing controls, with no differences between the groups. This strengthens findings showing that ADHD is not characterized by deficits in orienting attention and provides evidence of retro-cue benefits in this population.

Effects of forward and backward span trainings on working memory: Evidence from a randomized controlled trial

Both forward and backward working memory span tasks have been used in cognitive training, but no study has been conducted to test whether the two types of trainings are equally effective. Based on data from a randomized controlled trial, this study (N = 60 healthy college students) tested the effects of backward span training, forward span training, and no intervention. Event-related potential (ERP) signals were recorded at the pre-, mid-, and post-tests while the subjects were performing a distractor version of the change detection task, which included three conditions (2 targets and 0 distractor [2T0D]; 4 targets and 0 distractor [4T0D]; and 2 targets and 2 distractors [2T2D]). Behavioral data were collected from two additional tasks: a multi-object version of the change detection task, and a suppress task. Compared to no intervention, both forward and backward span trainings led to significantly greater improvement in working memory maintenance, based on indices from both behavioral (Kmax) and ERP data (CDA_2T0D and CDA_4T0D). Backward span training also improved interference control based on the ERP data (CDA_filtering efficiency) to a greater extent than did forward span training and no intervention, but the three groups did not differ in terms of behavioral indices of interference control. These results have potential implications for optimizing the current cognitive training on working memory.

Visuo-spatial working memory for objects and configurations in natural scenes in university students with ADHD

Adults with ADHD typically show reduced performance in visuo-spatial working memory (VSWM) tasks. These limitations have been observed mainly in tasks probing VSWM for low-level visual information. The current study investigated whether these limitations extended to memory for real-world objects, and memory for the spatial context in which they were presented. Sixty-four university students with and without ADHD memorised the form of real-world objects embedded in natural scenes. Following a short delay, participants were probed on a single object in the scene that could change in token or orientation, and that could appear within the original scene or in isolation. Consistent with previous studies, memory for the individual objects was impaired in the ADHD group relative to the control group, demonstrating that this deficit extends to complex real-world objects. Nevertheless, participants in the ADHD group benefited from the reinstatement of the scene during retrieval to the same extent as participants in the control group. This finding suggests that participants in the ADHD group formed and maintained a representation of the spatial context of the scene that aided memory retrieval. Overall, the results support an emerging view that VSWM operates on multiple, possibly independent, representations at different hierarchal levels.

Intermittent theta burst stimulation over the parietal cortex has a significant neural effect on working memory

The crucial role of the parietal cortex in working memory (WM) storage has been identified by fMRI studies. However, it remains unknown whether repeated parietal intermittent theta‐burst stimulation (iTBS) can improve WM. In this within‐subject randomized controlled study, under the guidance of fMRI‐identified parietal activation in the left hemisphere, 22 healthy adults received real and sham iTBS sessions (five consecutive days, 600 pulses per day for each session) with an interval of 9 months between the two sessions. Electroencephalography signals of each subject before and after both iTBS sessions were collected during a change detection task. Changes in contralateral delay activity (CDA) and K‐score were then calculated to reflect neural and behavioral WM improvement. Repeated‐measures ANOVA suggested that real iTBS increased CDA more than the sham one (p = .011 for iTBS effect). Further analysis showed that this effect was more significant in the left hemisphere than in the right hemisphere (p = .029 for the hemisphere‐by‐iTBS interaction effect). Pearson correlation analyses showed significant correlations for two conditions between CDA changes in the left hemisphere and K score changes (ps <.05). In terms of the behavioral results, significant K score changes after real iTBS were observed for two conditions, but a repeated‐measures ANOVA showed a nonsignificant main effect of iTBS (p = .826). These results indicate that the current iTBS protocol is a promising way to improve WM capability based on the neural indicator (CDA) but further optimization is needed to produce a behavioral effect.

Estimating the statistical power to detect set-size effects in contralateral delay activity

The contralateral delay activity (CDA) is an event-related potential component commonly used to examine the online processes of visual working memory. Here, we provide a robust analysis of the statistical power that is needed to achieve reliable and reproducible results with the CDA. Using two very large EEG datasets that examined the contrast between CDA amplitude with set sizes 2 and 6 items and set sizes 2 and 4 items, we present a subsampling analysis that estimates the statistical power achieved with varying numbers of subjects and trials based on the proportion of significant tests in 10,000 iterations. We also generated simulated data using Bayesian multilevel modeling to estimate power beyond the bounds of the original datasets. The number of trials and subjects required depends critically on the effect size. Detecting the presence of the CDA-a reliable difference between contralateral and ipsilateral electrodes during the memory period-required only 30-50 clean trials with a sample of 25 subjects to achieve approximately 80% statistical power. However, for detecting a difference in CDA amplitude between two set sizes, a substantially larger number of trials and subjects were required; approximately 400 clean trials with 25 subjects to achieve 80% power. Thus, to achieve robust tests of how CDA activity differs across conditions, it is essential to be mindful of the estimated effect size. We recommend researchers designing experiments to detect set-size differences in the CDA collect substantially more trials per subject.

Neurocognitive mechanisms underlying working memory encoding and retrieval in Attention-Deficit/Hyperactivity Disorder

Working memory (WM) impairments in ADHD have been consistently reported along with deficits in attentional control. Yet, it is not clear which specific WM processes are affected in this condition. A deficient coupling between attention and WM has been reported. Nevertheless, most studies focus on the capacity to retain information rather than on the attention-dependent stages of encoding and retrieval. The current study uses a visual short-term memory binding task, measuring both behavioral and electrophysiological responses to characterize WM encoding, binding and retrieval comparing ADHD and non-ADHD matched adolescents. ADHD exhibited poorer accuracy and larger reaction times than non-ADHD on all conditions but especially when a change across encoding and test displays occurred. Binding manipulation affected equally both groups. Encoding P3 was larger in the non-ADHD group. Retrieval P3 discriminated change only in the non-ADHD group. Binding-dependent ERP modulations did not reveal group differences. Encoding and retrieval P3 were significantly correlated only in non-ADHD. These results suggest that while binding processes seem to be intact in ADHD, attention-related encoding and retrieval processes are compromised, resulting in a failure in the prioritization of relevant information. This new evidence can also inform recent theories of binding in visual WM.

ERP evidence for the effect of working memory span training on working memory maintenance: A randomized controlled trial

There is a lot of debate in the literature with regards to whether the effects of working memory span training generalize to working memory tasks that are different from the trained task, however, there is little evidence to date supporting this idea. The present randomized controlled trial included 80 undergraduate students who were randomly assigned to either the experimental group (N = 40) or the control group (N = 40) in order to receive a working memory span intervention for 20 sessions over the course of 4 weeks. Brain electrophysiological signals during a dot pattern expectancy (DPX) task and a change detection task were recorded both before and after the intervention. The amplitudes of characteristic event-related potential (ERP) components reflecting working memory maintenance capability during the delay period of both tasks (i.e., the contingent negative variation or CNV, derived from the DPX task, and the contralateral delay activity or CDA, derived from the change detection task) were used as the primary outcome measures. Our data indicated that the intervention resulted in specific changes in both, the CNV and the CDA, suggesting that working memory span training generalized to working memory maintenance processes as observed in working memory tasks that were different from the trained task. We conclude that working memory span training might serve as a useful tool to improve working memory maintenance capability. Trial Registration: Chinese Clinical Trial Registry (chiCTR-INR-17011728).

A meta-analysis on verbal working memory in children and adolescents with ADHD

Objective: Previous meta-analyses have demonstrated verbal working memory (WM) dysfunction in children and adolescents with attention deficit/hyperactivity disorder (ADHD); however, the findings are inconsistent. The main objective of this meta-analysis was to investigate the performance of children and adolescents with ADHD in the Digit Span Backwards (DSB) subtest from the Wechsler Intelligence Scale for Children or Wechsler Adult Intelligence Scale. We also sought to provide an updated meta-analysis on WM in children and adolescents with ADHD.Method: PubMed, PsyINFO, Scopus, and Web of Science were searched to locate studies published between 1990 and 2016 that report DSB scores both of children and adolescents with ADHD and matched controls. Potential moderator variables were also analyzed.Results: Forty-nine studies comparing children and adolescents with ADHD (n = 4956) against healthy controls (n = 3249) generated a medium-sized effect (Hedges' g) of 0.56 (95% CI [0.49, 0.64]), indicating poorer verbal WM performance in those with ADHD. A subgroup meta-analysis of studies with participants aged 8-16 years only demonstrated low heterogeneity (I² = 17.06, cf. 55.50 for the main analysis). Moreover, the meta-regression showed a negative association (β = -.05, p = .02) between DSB performance differences and increasing age, indicating that for every one year increase in age the effect size decreased by .05.Conclusion: These results, which emanated from the largest meta-analysis concerning verbal WM in ADHD reported to date, reinforce WM as a key domain of cognitive dysfunction in ADHD, and point to age as the main variable influencing DSB performance difficulties.

The neural correlations of spatial attention and working memory deficits in adults with ADHD

Working memory impairment is a typical cognitive abnormality in patients with attention-deficit/hyperactivity disorder (ADHD) and is closely related to attention. Exploring the interaction between working memory and attention in patients with ADHD is of great significance for studying the pathological mechanism of this disease. In this study, electrophysiological markers of attention, posterior contralateral N2 (N2pc), and working memory, contralateral delay activity (CDA), were used to explore the relationship between these two cognitive abilities in patients with ADHD. EEG data were collected from adults with ADHD and age-, sex-, and IQ-matched normal controls while performing a classical visuospatial working memory task that consisted of low-load and high-load memory conditions. In different memory load conditions, the memory array elicited a smaller N2pc (220–260 ms) and a smaller CDA (400–800 ms) in adults with ADHD than in normal controls. Further analysis revealed that the reduced CDA amplitude could be significantly predicted by the earlier and reduced N2pc amplitude in adults with ADHD. Moreover, when the number of memory items increased, the increase in N2pc highly predicted the increases in CDA. Our findings illustrate the relationship between spatial working memory and attention ability in ADHD adults from the neurophysiological aspect that reduced working memory is closely related to insufficient attention ability and provide a potential physiological basis for the pathological mechanism of ADHD.

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We investigate the relationship between attention and working memory in ADHD adults.

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Both the N2pc and CDA are reduced in ADHD adults compared with normal controls.

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The reduced N2pc is correlated with the reduced CDA in ADHD adults.

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Working memory deficits in adults with ADHD may be related to attention deficits.

Production Effect in Adults With ADHD With and Without Methylphenidate (MPH): Vocalization Improves Verbal Learning

OBJECTIVES

Reading aloud (vocal production) enhances memory relative to reading silently, the Production Effect (PE) in memory. Thus, vocalization has been suggested as a mnemonic device. The current study tested the PE in a sample of adults with ADHD and in a control sample, evaluating verbal learning.

METHODS

Twenty adults with ADHD and 21 controls learned a list of words, half by reading aloud and half by reading silently. Free recall test followed. The participants with ADHD performed the task twice (in two different sessions in a counterbalanced order), before self-administration of a single dose of methylphenidate (MPH) and 60-min after dosage.

RESULTS

PEs were found for all groups. Memory was better for the controls than for the ADHD group (with or without MPH). In the ADHD group, recall rates and the PE were higher with than without MPH.

CONCLUSIONS

These results suggest that vocalization yields a larger memory gain with MPH. Possibly, MPH enables the ADHD participants to better shift their attention to the aloud words, enhancing their retrieval rates. Theoretically, these findings stress the role of attention in the PE. (JINS, 2019, 25, 230-235).

A Pilot Study of Behavioral, Physiological, and Subjective Responses to Varying Mental Effort Requirements in Attention-Deficit/Hyperactivity Disorder

Background: Attention-deficit/hyperactivity disorder (ADHD) is presumed to involve mental effort application difficulties. To test this assumption, we manipulated task difficulty and measured behavioral, as well as subjective and psychophysiological indices of effort.

Methods: Fifteen adolescent ADHD boys and 16 controls performed two tasks. First, subjective estimates and behavioral and pupillary measures of effort were recorded across five levels of N-back task difficulties. Second, effort discounting was assessed. In the latter, participants made repeated choices between performing a difficult N-back task for a high reward versus an easier N-back task for a smaller reward.

Results: Increasing task difficulty led to similar deteriorations in performance for both groups – although ADHD participants performed more poorly at all difficulty levels than controls. While ADHD and control participants rated the tasks equally difficult and discounted effort similarly, those with ADHD displayed slightly different pupil dilation patterns with increasing task difficulty.

Conclusion: The behavioral results did not provide evidence for mental effort problems in adolescent boys with ADHD. The subtle physiological effects, however, suggest that adolescents with ADHD may allocate effort in a different way than controls.

Neural processing of working memory in adults with ADHD in a visuospatial change detection task with distractors

Individuals with Attention-Deficit Hyperactivity Disorder (ADHD) are often characterized by deficits in working memory (WM), which manifest in academic, professional, and mental health difficulties. To better understand the underlying mechanisms of these presumed WM deficits, we compared adults with ADHD to their peers on behavioral and neural indices of WM. We used a visuospatial change detection task with distractors which was designed to assess the brain’s ability to effectively filter out distractors from WM, in addition to testing for effects of WM load. Twenty-seven unmedicated adults with ADHD were compared to 27 matched peers on event-related potential (ERP) measures of WM, i.e., the contralateral delay activity (CDA). Despite severe impairments in everyday life functioning, findings showed no difference in deficits in behavioral tests of working memory for adults with ADHD compared to their peers. Interestingly, there were differences in neural activity between individuals with ADHD and their peers showing that the CDA of individuals with ADHD did not distinguish between high, distractor, and low memory load conditions. These data suggest, in the face of comparable behavioral performance, a difference in neural processing efficiency, wherein the brains of individuals with ADHD may not be as selective in the allocation of neural resources to perform a WM task.

The neurophysiology of working memory development: from childhood to adolescence and young adulthood

Working memory (WM) is an important cognitive function that is necessary to perform our daily activities. The present review briefly describes the most accepted models underlying WM and the neural networks involved in its processing. The review focuses on how the neurophysiological mechanisms develop with age in the periods from childhood to adolescence and young adulthood. Studies using behavioral, neuroimaging, and electrophysiological techniques showed the progress of WM throughout the development. The present review focuses on the neurophysiology of the basic processes underlying WM operations, as indicated by electroencephalogram-derived signals, in order to take advantage of the excellent time resolution of this technique. Children and adults use similar cerebral mechanisms and areas to encode, recognize, and keep the stimuli in memory and update the WM contents, although adults rely more on anterior sites. The possibility that a functional reorganization of WM brain processing occurs around the adolescent period is suggested, and would partly justify the high prevalence of the emergence of mental pathology in the adolescent period.

Event-Related Potentials during a Gambling Task in Young Adults with Attention-Deficit/Hyperactivity Disorder

Attention-deficit hyperactivity disorder (ADHD) is characterized by deficits in executive functions and decision making during childhood and adolescence. Contradictory results exist whether altered event-related potentials (ERPs) in adults are associated with the tendency of ADHD patients toward risky behavior. Clinically diagnosed ADHD patients (n = 18) and healthy controls (n = 18), aged between 18 and 29 (median 22 Yo), were screened with the Conners' Adult ADHD Rating Scales and assessed by the Mini-International Neuropsychiatric Interview, adult ADHD Self-Report Scale, and by the 60-item HEXACO Personality Inventory. The characteristic personality traits of ADHD patients were the high level of impulsiveness associated with lower values of agreeableness. All participants performed a probability gambling task (PGT) with two frequencies of the feedback information of the outcome. For each trial, ERPs were triggered by the self-paced trial onset and by the gamble selection. After trial onset, N2-P3a ERP component associated with the attentional load peaked earlier in the ADHD group than in controls. An N500 component related to the feedback frequency condition after trial onset and an N400-like component after gamble selection suggest a large affective stake of the decision making and an emphasized post-decisional evaluation of the choice made by the ADHD participants. By combining ERPs, related to the emotions associated with the feedback frequency condition, and behavioral analyses during completion of PGT, this study provides new findings on the neural dynamics that differentiate controls and young ADHD adults. In the patients' group, we raise the hypothesis that the activity of frontocentral and centroparietal neural circuits drive the decision-making processes dictated by an impaired cognitive workload followed by the build-up of large emotional feelings generated by the conflict toward the outcome of the gambling choice. Our results can be used for new investigations aimed at studying the fine spatiotemporal distribution of cortical activity, and the neural circuits that underly the generation of that activity, associated with the behavioral deficits characteristic of ADHD.

Event-related potential measures of executive functioning from preschool to adolescence

Executive functions are a collection of cognitive abilities necessary for behavioural control and regulation, and are important for school success. Executive deficits are common across acquired and developmental disorders in childhood and beyond. This review aims to summarize how studies using event-related potential (ERP) can provide insight into mechanisms underpinning how executive functions develop in children from preschool to adolescence. We specifically focus on ERP components that are considered to be well-established markers of executive functioning, including the ability to resist distraction (inhibition, N200), hold scenes in mind (visuospatial working memory, contralateral delay activity), attend to specific stimuli (information processing, P300), follow rules (response monitoring, error-related negativity [ERN], and error-related positivity [Pe]), and adjust to feedback (outcome monitoring, feedback-related negativity). All of these components show developmental changes from preschool to adolescence, in line with behavioural and neuroimaging findings. These ERP markers also show altered developmental trajectories in the context of atypical executive functions. As an example, deficits in executive function are prominently implicated in attention-deficit-hyperactivity disorder. Therefore, this review highlights ERP studies that have investigated the above ERP components in this population. Overall, ERPs provide a useful marker for the development and dysfunction of executive skills, and provide insight into their neurophysiological basis.

Does Contralateral Delay Activity Reflect Working Memory Storage or the Current Focus of Spatial Attention within Visual Working Memory?

During the retention of visual information in working memory, event-related brain potentials show a sustained negativity over posterior visual regions contralateral to the side where memorized stimuli were presented. This contralateral delay activity (CDA) is generally believed to be a neural marker of working memory storage. In two experiments, we contrasted this storage account of the CDA with the alternative hypothesis that the CDA reflects the current focus of spatial attention on a subset of memorized items set up during the most recent encoding episode. We employed a sequential loading procedure where participants memorized four task-relevant items that were presented in two successive memory displays (M1 and M2). In both experiments, CDA components were initially elicited contralateral to task-relevant items in M1. Critically, the CDA switched polarity when M2 displays appeared on the opposite side. In line with the attentional activation account, these reversed CDA components exclusively reflected the number of items that were encoded from M2 displays, irrespective of how many M1 items were already held in working memory. On trials where M1 and M2 displays were presented on the same side and on trials where M2 displays appeared nonlaterally, CDA components elicited in the interval after M2 remained sensitive to a residual trace of M1 items, indicating that some activation of previously stored items was maintained across encoding episodes. These results challenge the hypothesis that CDA amplitudes directly reflect the total number of stored objects and suggest that the CDA is primarily sensitive to the activation of a subset of working memory representations within the current focus of spatial attention.

Distinct neural mechanisms for spatially lateralized and spatially global visual working memory representations

Visual working memory (VWM) allows humans to actively maintain a limited amount of information. Whereas previous electrophysiological studies have found that lateralized event-related potentials (ERPs) track the maintenance of information in VWM, recent imaging experiments have shown that spatially global representations can be read out using the activity across the visual cortex. The goal of the present study was to determine whether both lateralized and spatially global electrophysiological signatures coexist. We first show that it is possible to simultaneously measure lateralized ERPs that track the number of items held in VWM from one visual hemfield and parietooccipital α (8-12 Hz) power over both hemispheres indexing spatially global VWM representations. Next, we replicated our findings and went on to show that this bilateral parietooccipital α power as well as the contralaterally biased ERP correlate of VWM carries a signal that can be used to decode the identity of the representations stored in VWM. Our findings not only unify observations across electrophysiology and imaging techniques but also suggest that ERPs and α-band oscillations index different neural mechanisms that map on to lateralized and spatially global representations, respectively.

EEG correlates of visual short-term memory as neuro-cognitive endophenotypes of ADHD

Attention deficit hyperactivity disorder (ADHD) frequently persists into adulthood. A reduction in visual short-term memory (vSTM) storage capacity was recently suggested as a potential neuro-cognitive endophenotype, i.e., a testable marker of an individual's liability for developing ADHD. This study aimed at identifying markers of the brain abnormalities underlying vSTM reductions in adult ADHD. We combined behavioral parameter-based assessment with electrophysiology in groups of adult ADHD patients and healthy age-matched controls. Amplitudes of ERP markers of vSTM storage capacity, the contralateral delay activity (CDA) and the P3b, were analyzed according to (i) differences between individuals with higher vs. lower storage capacity K and (ii) differences between ADHD patients and control participants. We replicated the finding of reduced storage capacity in adult ADHD. Across groups, individuals with higher relative to lower storage capacity showed a larger CDA and P3b. We further found differences between the patient and control groups in the ERPs: The CDA amplitude was attenuated in an early time window for ADHD patients compared to control participants, and was negatively correlated with ADHD patients' symptom severity ratings. Furthermore, the P3b was larger in ADHD patients relative to control participants. These electrophysiological findings indicate altered brain mechanisms underlying visual storage capacity in ADHD, which are characterized by deficient encoding and maintenance, and increased recruitment of control processes. Accordingly, (quantifiable) ERP markers of vSTM in adult ADHD bear candidacy as neuro-cognitive endophenotypes of the disease.