Performance monitoring and post-error adjustments in adults with attention-deficit/hyperactivity disorder: an EEG analysis

Monitoring and control processes within executive functions: Is post-error slowing related to pre-error speeding in children?

Both pre-error speeding and post-error slowing reflect monitoring and control strategies. Post-error slowing is relatively well-established in children, whereas pre-error speeding is much less studied. Here we investigated (a) whether kindergarten and first-grade children show pre-error speeding in a cognitive control task (Hearts and Flowers) and, if so, (b) whether post-error slowing is associated with pre-error speeding. We analyzed the data from 153 kindergartners and 468 first-graders. Both kindergartners and first-graders showed significant pre-error speeding and post-error slowing, with no differences between the two samples in the magnitude of each. The magnitude of pre-error speeding and post-error slowing was correlated within individuals in both samples and to a similar extent. That is, children who sped up more extremely toward an error also slowed down more extremely after an error. These findings provide evidence that pre-error speeding and post-error slowing are related in children as early as kindergarten age and may in concert reflect how optimal children's monitoring and control of their performance is in a cognitive control task.

Longitudinal Stability of Neural Correlates of Pediatric Attention Deficit Hyperactivity Disorder: A Pilot Study of Event Related Potentials and Electroencephalography

OBJECTIVE

Stability and developmental effects of electroencephalography (EEG) and event related potential (ERP) correlates of ADHD are understudied. This pilot study examined stability and developmental changes in ERP and EEG metrics of interest.

METHODS

Thirty-seven 7 to 11-year-old children with ADHD and 15 typically developing (TD) children completed EEG twice, 11 to 36 months apart. A series of mixed effects linear models were run to examine stability and developmental effects of EEG and ERP metrics.

RESULTS

Stability and developmental effects of EEG and ERP correlates of ADHD varied considerably across metrics. P3 amplitude was stable over time and showed diverging developmental trajectories across groups. Developmental differences were apparent in error related ERPs and resting aperiodic exponent. Theta-beta ratio was stable over time among all children.

CONCLUSIONS

Developmental trajectories of EEG and ERP correlates of ADHD are candidate diagnostic markers. Replication with larger samples is needed.

Prefrontal-cerebellar dynamics during post-success and post-error cognitive controls in major psychiatric disorders

BACKGROUND

Difficulty in cognitive adjustment after a conflict or error is a hallmark for many psychiatric disorders, yet the underlying neural correlates are not fully understood. We have previously shown that post-success and post-error cognitive controls are associated with distinct mechanisms particularly related to the prefrontal-cerebellar circuit, raising the possibility that altered dynamic interactions in this circuit may underlie mental illness.

METHODS

This study included 136 patients with three diagnosed disorders [48 schizophrenia (SZ), 49 bipolar disorder (BD), 39 attention deficit hyperactivity disorder (ADHD)] and 89 healthy controls who completed a stop-signal task during fMRI scans. Brain activations for concurrent, post-success, and post-error cognitive controls were analyzed and compared between groups. Dynamic causal modeling was applied to investigate prefrontal-cerebellar effective connectivity patterns during post-success and post-error processing.

RESULTS

No significant group differences were observed for brain activations and overall effective connectivity structures during post-success and post-error conditions. However, significant group differences were shown for the modulational effect on top-down connectivity from the prefrontal cortex to the cerebellum during post-error trials (pFWE = 0.02), which was driven by reduced modulations in both SZ and ADHD. During post-success trials, there were significantly decreased modulational effect on bottom-up connectivity from the cerebellum to the prefrontal cortex in ADHD (pFWE = 0.04) and decreased driving input to the cerebellum in SZ (pFWE = 0.04).

CONCLUSIONS

These findings suggest that patients with SZ and ADHD are associated with insufficient neural modulation on the prefrontal-cerebellar circuit during post-success and post-error cognitive processing, a phenomenon that may underlie cognitive deficits in these disorders.

Mind-wandering does not always rhyme with proactive functioning! Changes in the temporal dynamics of the mPFC-mediated theta oscillations during moments of mind-wandering

The reduced engagement of the cognitive control network has been documented widely during mind-wandering (MW). However, it remains unknown how MW affects the neural dynamics of cognitive control processes. From this perspective, we explored neural dynamics mediated by the medial prefrontal cortex (mPFC). Their engagement can be both transient (or reactive) and anticipated (or proactive). A total of fortyseven healthy subjects (37 females) were engaged in a long-lasting sustained-attention Go/NoGo task. Subjective probes were used to detect MW episodes. Channel-based EEG time-frequency analysis was performed to measure the theta oscillations, an index of the mPFC activity. The theta oscillations were computed immediately after conflictual NoGo trials to explore the reactive engagement of the mPFC. Proactive control was measured on the Go trials preceded the NoGo. Behaviorally, periods of MW were associated with an increase in errors and in RT variability in comparison to on-task periods. The analysis of the frontal midline theta power (MFθ) revealed that MW periods were associated with lower anticipated/proactive engagement and similar transient/reactive engagement of mPFC-mediated processes. Moreover, the communication between the mPFC and the DLPFC, as revealed by the poorer theta synchronization between these two regions, was also impaired during MW periods. Our results provide new insights about performance impairment during MW. They could be an important step in improving the existing understanding of the altered performances that are reported for some disorders that are known to be associated with excessive MW.

Post-error adjustments depend causally on executive attention: Evidence from an intervention study

Detecting and correcting execution errors is crucial for safe and efficient goal-directed behavior. Despite intensive investigations on error processing, the cognitive foundations of this process remain unclear. Based on the presumed relation between executive attention (EA) and error processing, we implemented a seven-day EA intervention by adopting the Posner cueing paradigm to test the potential causal link from EA to error processing in healthy adults. The experimental group (high EA, HEA) was trained on the Posner cueing paradigm, with a ratio of invalid cue (IC) trials to valid cue (VC) trials of 5:1 and a corresponding ratio of 1:1 in the active control group (low EA, LEA). We found that the EA intervention improved EA across intervention sessions. Critically, after the EA intervention, the HEA group showed that post-error accuracy (PEA) was restored to the same level as the post-correct accuracy (in comparison with the LEA group). However, post-error slowing and the flanker effect were not modulated by the EA intervention. Furthermore, we observed that the changes in the accuracy of VC trials positively predicted the changes in PEA and that the two groups were classified according to the changes in PEA with a 61.3% accuracy. Based on these results, we propose that EA causally drives error processing. And the capabilities of the “actively catch” more attention resources and the automatic mismatch processing developed after EA intervention is transferable to error processing, thereby directly resulting in the gains in post-error adjustments. Our work informs the potential cognitive mechanisms underlying this causal link.

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.

A systematic review and meta-analysis of altered electrophysiological markers of performance monitoring in Obsessive-Compulsive Disorder (OCD), Gilles de la Tourette Syndrome (GTS), Attention-Deficit/Hyperactivity disorder (ADHD) and Autism

Altered performance monitoring is implicated in obsessive-compulsive disorder (OCD), Gilles de la Tourette syndrome (GTS), attention-deficit/hyperactivity disorder (ADHD) and autism. We conducted a systematic review and meta-analysis of electrophysiological correlates of performance monitoring (error-related negativity, ERN; error positivity, Pe; feedback-related negativity, FRN; feedback-P3) in individuals with OCD, GTS, ADHD or autism compared to control participants, or associations between correlates and symptoms/traits of these conditions. Meta-analyses on 97 studies (5890 participants) showed increased ERN in OCD (Hedge's g = 0.54[CIs:0.44,0.65]) and GTS (g = 0.99[CIs:0.05,1.93]). OCD also showed increased Pe (g = 0.51[CIs:0.21,0.81]) and FRN (g = 0.50[CIs:0.26,0.73]). ADHD and autism showed reduced ERN (ADHD: g=-0.47[CIs:-0.67,-0.26]; autism: g=-0.61[CIs:-1.10,-0.13]). ADHD also showed reduced Pe (g=-0.50[CIs:-0.69,-0.32]). These findings suggest overlap in electrophysiological markers of performance monitoring alterations in four common neurodevelopmental conditions, with increased amplitudes of the markers in OCD and GTS and decreased amplitudes in ADHD and autism. Implications of these findings in terms of shared and distinct performance monitoring alterations across these neurodevelopmental conditions are discussed. PROSPERO pre-registration code: CRD42019134612.

Conjoint fluctuations of PFC-mediated processes and behavior: An investigation of error-related neural mechanisms in relation to sustained attention

The ability to detect errors, which derives from the medial prefrontal cortex (mPFC), is crucial to maintain attention over a long period of time. While impairment of this ability has been reported in patients with sustained attention disruption, the role mPFC-mediated processes play in the intra-individual fluctuation of sustained attention remains an open question. In this context, we computed the variance time course of reaction time (RT) of 42 healthy individuals to distinguish intra-individual periods of low and high performance instability, assumed to represent optimal and suboptimal attentional states, when performing a sustained Go/NoGo task. Analysis of the neurophysiological mechanisms of response monitoring revealed a specific reduction in the error-related negativity (ERN) amplitude and frontal midline theta power during periods of high compared to low RT variability, but only in individuals with a higher standard deviation of reaction time (SD-RT). Concerning post-error adaptation, an increase in the correct-related negativity (CRN) amplitude as well as the frontal lateral theta power on trials following errors was observed in individuals with lower SD-RT but not in those with higher SD-RT. Our results thus show that individuals with poor sustained attention ability exhibit altered post-error adaptation and attentional state-dependent efficiency of error monitoring. Conversely, individuals with good sustained attention performances retained their post-error adaptation and response monitoring regardless of the attentional periods. These findings reveal the critical role of the action-monitoring system in intra-individual behavioral stability and highlight the importance of considering attentional states when studying mPFC-mediated processes, especially in subjects with low sustained attention ability.

Neural oscillatory responses to performance monitoring differ between high- and low-impulsive individuals, but are unaffected by TMS

Higher impulsivity may arise from neurophysiological deficits of cognitive control in the prefrontal cortex. Cognitive control can be assessed by time‐frequency decompositions of electrophysiological data. We aimed to clarify neuroelectric mechanisms of performance monitoring in connection with impulsiveness during a modified Eriksen flanker task in high‐ (n = 24) and low‐impulsive subjects (n = 21) and whether these are modulated by double‐blind, sham‐controlled intermittent theta burst stimulation (iTBS). We found a larger error‐specific peri‐response beta power decrease over fronto‐central sites in high‐impulsive compared to low‐impulsive participants, presumably indexing less effective motor execution processes. Lower parieto‐occipital theta intertrial phase coherence (ITPC) preceding correct responses predicted higher reaction time (RT) and higher RT variability, potentially reflecting efficacy of cognitive control or general attention. Single‐trial preresponse theta phase clustering was coupled to RT in correct trials (weighted ITPC), reflecting oscillatory dynamics that predict trial‐specific behavior. iTBS did not modulate behavior or EEG time‐frequency power. Performance monitoring was associated with time‐frequency patterns reflecting cognitive control (parieto‐occipital theta ITPC, theta weighted ITPC) as well as differential action planning/execution processes linked to trait impulsivity (frontal low beta power). Beyond that, results suggest no stimulation effect related to response‐locked time‐frequency dynamics with the current stimulation protocol. Neural oscillatory responses to performance monitoring differ between high‐ and low‐impulsive individuals, but are unaffected by iTBS.

Patients with mutations of the Thyroid hormone beta-receptor show an ADHD-like phenotype for performance monitoring: an electrophysiological study

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Mutations in the thyroid hormone receptor beta (THRB) lead to relative hyperthyroidism in the brain.

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Electrophysiological biomarkers of performance monitoring (ERN and Pe components) show a pattern similar to ADHD in carriers of THRB mutations.

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The phenotype of THRB mutation carriers is indistinguishable from ADHD with regard to performance monitoring.

Resistance to thyroid hormone beta (RTHβ) is a syndrome of reduced responsiveness of peripheral tissue to thyroid hormone, caused by mutations in the thyroid hormone receptor beta (THRB). Its cognitive phenotype has been reported to be similar to attention deficit hyperactivity disorder (ADHD). This study used electrophysiological biomarkers of performance monitoring in RTHβ to contribute further evidence on its phenotypical similarity to ADHD. Twenty-one participants with RTHβ aged 18–67 years and 21 matched healthy controls performed a modified flanker task during EEG recording. The RTHβ and control groups were compared on behavioural measures and components of event related potentials (ERPs), i.e. the error related negativity (ERN), the error positivity (Pe) and P3 component. There were no significant group differences with regard to behaviour. RTHβ subjects displayed significantly reduced ERN and Pe amplitudes compared to the controls in the response-locked ERPs. In addition, we observed reduced P3 amplitudes in both congruent and incongruent trials, as well as prolonged P3 latencies in RTHβ subjects in the stimulus-locked ERPs. Our findings reveal alterations in error detection and performance monitoring of RTHβ patients, likely indicating reduced error awareness. The electrophysiological phenotype of RTHß subjects with regard to action monitoring is indistinguishable from ADHD.

Behavioral and Electrophysiological Correlates of Performance Monitoring and Development in Children and Adolescents with Attention-Deficit/Hyperactivity Disorder

The pathophysiology of attention-deficit/hyperactivity disorder (ADHD) involves deficits in performance monitoring and adaptive adjustments. Yet, the developmental trajectory and underlying neural correlates of performance monitoring deficits in youth with ADHD remain poorly understood. To address the gap, this study recruited 77 children and adolescents with ADHD and 77 age- and gender-matched healthy controls (HC), ages 8–18 years, who performed an arrow flanker task during electroencephalogram recording. Compared to HC, participants with ADHD responded more slowly and showed larger reaction time variability (RTV) and reduced post-error slowing; they also exhibited reduced error-related negativity (ERN) and error positivity effects, and reduced N2 and P3 congruency effects. Age effects were observed across groups: with increasing age, participants responded faster, with less variability, and with increased post-error slowing. They also exhibited increased ERN effects and increased N2 and P3 congruency effects. Increased RTV and reduced P3 amplitude in incongruent trials were associated with increased ADHD Problems Scale scores on the Child Behavior Checklist across groups. The altered behavioral and ERP responses in ADHD are consistent with the pattern associated with younger age across groups. Further research with a longitudinal design may determine specific aspects of developmental alteration and deficits in ADHD during performance monitoring.

A tradeoff relationship between internal monitoring and external feedback during the dynamic process of reinforcement learning

Effective behavior monitoring, including internal monitoring/error detection and external monitoring/feedback, is very pivotal for reinforcement learning. However, less attention has been paid to internal monitoring and the dynamic learning performance in reinforcement learning, and there is still a heated debate on which kind of external feedback is relied on in the reinforcement learning. In order to address these questions, an adaption probabilistic selection task was used to examine the effect of the internal monitoring, external feedback and the relationship between them for approach learners and avoidance learners during dynamic learning process of reinforcement learning and behavior adaption. Error-related negativity (ERN), feedback-related negativity (FRN) and feedback-related P300 are three ERPs components, which can be used as the indexes of internal monitoring, external feedback and behavior adaption. For our results, the ERN effect of avoidance learners become large in block 3, which is earlier than approach learners (block 4). This phenomenon suggests that avoidance learners learned faster than approach learners. In addition, the FRN amplitude of avoidance learners in block 4 was significantly smaller than the other three blocks. The aforementioned results demonstrated a tradeoff relationship between the ERN and FRN effects.

Bereitschaftspotential and lateralized readiness potential in children with attention deficit hyperactivity disorder: altered motor system activation and effects of methylphenidate

Attention deficit hyperactivity disorder (ADHD) has been linked to abnormal functioning of cortical motor areas such as the supplementary motor area, the premotor cortex and primary motor cortex (MI). The Bereitschaftspotential (BP) and lateralized readiness potential (LRP) are movement-related potentials generated by cortical motor areas. We hypothesized that the BP and LRP would be altered in children with ADHD. A group of 17 children with ADHD (mean age: 11.5 ± 1.9 years) and a control group of 16 typically developing children (mean age: 12.2 ± 2.0 years) performed movements at self-chosen irregular intervals while a 64-channel DC-EEG was registered. BP and LRP were calculated from the EEG. The ADHD group had significantly lower and on average positive BP amplitudes at Cz. In agreement with age-dependent maturation effects the LRP had a positive polarity in both groups, but lower amplitudes were found in the ADHD group without medication. The control group showed a mid-central negativity and a positivity over motor areas contra-lateral to the side of movement, whereas no negativity over Cz and a more diffuse positivity was found in the ADHD group. LRP group differences diminished after MPH administration as indicated by an interaction between group and time of measurement/medication. The cortical motor system shows altered functioning during movement preparation and initiation in children affected by ADHD. Positive Bereitschaftspotential polarities may represent delayed cortical maturation. Group differences of LRP were pharmacologically modulated by the catecholaminergic agent MPH.