Predicting ADHD Symptoms in Adolescents Using Error-Related Brain Potentials

Portland State University

Attention-Deficit Hyperactivity Disorder (ADHD) is a common childhood disorder, but its clinical course varies widely. It is unclear why some individuals experience a remission of their ADHD symptoms across development while others have symptoms persist into adulthood. Performance monitoring, which involves the ability to recognize errors and make behavioral adjustments, is one aspect of self-regulation that may contribute to symptom change. Both early (e.g,. error-related negativity, ERN) and later (e.g., error-related positivity, Pe) stages of performance monitoring can be quantified via event-related potentials, which reflect electrical brain activity in response to errors. Better performance monitoring, as indicated by larger amplitude brain responses to errors, is hypothesized to be associated with symptom improvement in ADHD. Method: As part of a larger longitudinal study, 75 participants (control= 35, ADHD= 40) completed behavioral ratings (parents and teachers) and semi-structured clinical interviews (parents) to assess ADHD symptoms. At annual follow-up visits 3-5 years later, ADHD assessment was repeated. Children also completed a computerized emotional go/no-go task while electroencephalogram was recorded. ERN and Pe were quantified on failed inhibitory trials during positive, negative, and neutral conditions. Results: ERN amplitudes did not differ between groups. During positive emotion conditions, controls had higher Pe amplitudes (M=9.34, SD=6.49) than ADHD participants (M=5.57, SD=5.62), F(1,71)= 5.64, p=.02. Among the ADHD group, higher Pe amplitude in positive emotion conditions predicted a greater decrease in ADHD symptoms after controlling for baseline symptom severity, b=-.40, p=.005. Conclusions: Performance monitoring may be one cognitive skill associated with remission of ADHD symptoms.