The impact of ADHD symptom severity on reinforcement and punishment learning among adults

Introduction: Aberrations in feedback learning are hypothesised to contribute to the behavioural disruptions and impairment of attention-deficit/hyperactivity disorder (ADHD). However, few studies have evaluated the relation of reward/punishment feedback and ADHD symptom severity on learning. The current study evaluates the differential effects of reward and punishment feedback on learning among adults with elevated ADHD. Methods: One hundred five participants self-reported their level of current ADHD symptoms and completed an innovative instrumental learning task. Results: Consistent with predictions, participants with low self-reported ADHD symptom severity benefitted equally from reward and punishment feedback during the learning task, whereas participants with high self-reported symptom severity performed better (indexed by accuracy on learning task) from reward than punishment feedback trials. Conclusions: Overall, adults with high self-reported symptom severity of ADHD learned more from reward-based feedback, which provides critical implications for motivational theories about ADHD, as well as for treatment protocols. Future work should examine the translatability of results within a treatment setting.

A single-trial estimation of the feedback-related negativity and its relation to BOLD responses in a time-estimation task

An event-related potential (ERP) component reliably associated with feedback processing and well studied in humans is the feedback-related negativity (FRN), which is assumed to indicate activation of midcingulate cortex (MCC) neurons. However, recent approaches have conceptualized this frontocentral ERP component as reflecting at least partially a reward positivity associated with activation in reward-related brain regions, in line with fMRI studies investigating feedback processing in the context of reward evaluation. To discover convergence of electrophysiological and BOLD responses elicited by performance feedback, we concurrently recorded EEG and fMRI during a time-estimation task. The ERP showed relatively more negative amplitudes to negative than to positive feedback. Conventional analyses of fMRI data revealed activation of a number of areas, including ventral striatum, anterior cingulate cortex, and medial prefrontal cortex to positive versus negative feedback. Most importantly, when using single-trial amplitudes of electrophysiological feedback signals to estimate hemodynamic responses, we found feedback-related BOLD-responses in ventral striatum, midcingulate, and midfrontal cortices to positive but not to negative feedback associated with feedback signals in the time range of the FRN. Specifically, activation in these areas increased as amplitudes became more positive. These findings suggest that, in the time-estimation task, a positivity elicited by reward is associated with brain activation in several reward-related brain regions and is driving differential ERP responses in the time range of the FRN.