ERPs and behavioral inhibition in a Go/No-go task in children with attention-deficit hyperactivity disorder

In order to study the behavioral responses and the brain inhibition process in children with attention-deficit hyperactivity disorder (ADHD), Event-Related Potentials (ERPs) were recorded from 30 scalp electrodes in 21 ADHD and 21 normal boys during performing a Go/No-go task. ADHD children made fewer correct responses to both Go and No-go stimuli than normal controls. The frontal N2 amplitude was larger for No-go stimuli than Go stimuli in both groups, reflecting inhibition of responding. Smaller N2 amplitudes to No-go stimuli were found in ADHD children, but only when the Go/No-go task was performed after a first stimulus-response compatibility (SRC) task. In addition, the controls exhibited a prolonged N2 only when the Go/No-go task was performed second. However, the ADHD subjects exhibited this prolonged N2 when the task was first, but not when it was second. These results suggest an inhibitory regulation problem rather an inhibition deficit in ADHD children.     

不同特征维度下ADHD儿童的任务切换特点

本研究采用双向刺激设置,通过操纵两实验的特征维度,以考察任务维度对ADHD儿童任务切换的影响。结果发现,在两个实验中,相对于正常组儿童,ADHD儿童在任务切换上都表现出缺损。当注意维度相同时,ADHD儿童在固定顺序上的切换损耗大于随机顺序,但在跨维度任务中,ADHD儿童在固定顺序上的切换损耗则小于随机顺序,这与正常儿童的表现模式不一致。该结果表明,工作记忆会对ADHD儿童产生影响,但这取决于任务的特征维度是否一致。     

Underlying processes in the poor response inhibition of children with Attention-Deficit/Hyperactivity Disorder

This study evaluated the effects of reward, punishment, and reward + punishment on the impulsive responses of ADHD children. The impulsive responses of ADHD and normal control boys (30 per group) were compared during performance of a go/no-go task, administered under reward-only, punishment-only, and reward + punishment conditions. When differences in aggression, anxiety, and IQ between these groups were controlled for, results indicated that the impulsivity levels of the ADHD group were higher than the control group in all three reinforcement conditions. Also, the ADHD group was more impulsive in the reward + punishment condition, compared to the reward-only and punishment-only conditions, and there was no difference between the reward-only and punishment-only conditions. The control groups showed no difference across the three reinforcement conditions. These findings raise the possibility that the poor response inhibition of ADHD children may be related to both a generalized inhibitory deficit and a response modulation deficit.     

Deficit in Response Inhibition in Children with Attention Deficit/Hyperactivity Disorder (ADHD): Impact of Motivation?

To date, neuropsychological and psycho-physiological studies have revealed inconsistent results regarding an executive or motivational deficit explaining the response inhibition deficit in children with attention deficit/hyperactivity disorder (ADHD). Research on differentiating neuropsychological processes in ADHD subtypes is still scarce. Therefore, the motivational impact on response inhibition among boys with ADHD was examined in this study. In the first study, 19 boys with ADHD-combined type (ADHD-C) and 19 age-matched healthy control subjects performed a modified Go/No-Go task with the following experimental conditions: neutral, auditory feedback, reward, response cost, and reward/response cost. Performance and physiological data (heart rate and skin conductance responses) were recorded. In a second study with the modified Go/No-Go task, data for six children with ADHD-C, six with ADHD-inattentive subtype (ADHD-I), and six healthy control subjects were compared. Neither of the two studies revealed group by condition interactions. In study 1, boys with ADHD-C generally made more commissions and omissions compared to the control group. However, feedback significantly improved the response inhibition in all children. The heart rate of all children was increased in the two conditions of reward and reward/response cost. Study 2 revealed that children with ADHD-I responded more slowly and showed increased reaction time variability compared to both other groups. The present study supports an executive rather than a motivational deficit in the response inhibition among children with ADHD-C, though further results also indicate the role of auditory feedback on response inhibition. Additionally, the findings support the differentiation of ADHD-C and ADHD-I, suggesting that ADHD-I children are characterized by a sluggish cognitive tempo.     

注意缺陷多动障碍(ADHD)儿童的工作记忆:基础加工缺陷还是执行功能问题

为探索注意缺陷多动障碍(ADHD)儿童言语工作记忆缺陷的机制,研究采用了言语n-back任务比较了正常儿童与注意缺陷多动障碍儿童的工作记忆成绩。结果表明:在更新水平为0次时,ADHD儿童与正常儿童的成绩没有显著差异,但在更新水平为1次和2次时,ADHD儿童的记忆成绩均显著低于正常儿童,效应量指标(Cohen′d)分别达到了1.31和1.63;另外,在更新难度对记忆成绩的影响上,ADHD儿童表现出了更大的更新代价,效应量指标(Cohen′d)达到了1.54,处在很高的水平。结论认为ADHD儿童在记忆的基础性加工上并不存在明显缺陷,其更大的更新代价表明ADHD儿童在言语工作记忆的执行加工(更新操作)上的缺陷。     

Time-Based Prospective Memory Performance and Time-Monitoring in Children with ADHD

The current study investigated prospective memory (PM) performance in children with attention deficit/hyperactivity disorder (ADHD) and controls and aimed at exploring possible underlying factors of PM performance. Twenty-two children with ADHD and 39 age- and ability-matched typically developing children performed a computerized time-based PM task. As predicted, children with ADHD had fewer correct PM responses than controls. Neither differences in overall ongoing task performance nor, remarkably, differences in overall frequency and accuracy of time monitoring were found. Exploratory analyses suggest that individual differences in time monitoring in the final interval before target times may be related to PM performance in ADHD.     

Emotional distraction in boys with ADHD: Neural and behavioral correlates

Although, in everyday life, patients with attention deficit hyperactivity disorder (ADHD) are frequently distracted by goal-irrelevant affective stimuli, little is known about the neural and behavioral substrates underlying this emotional distractibility. Because some of the most important brain responses associated with the sudden onset of an emotional distracter are characterized by their early latency onset and short duration, we addressed this issue by using a temporally agile neural signal capable of detecting and distinguishing them. Specifically, scalp event-related potentials (ERPs) were recorded while 20 boys with ADHD combined type and 20 healthy comparison subjects performed a digit categorization task during the presentation of three types of irrelevant, distracting stimuli: arousing negative (A−), neutral (N) and arousing positive (A+). Behavioral data showed that emotional distracters (both A− and A+) were associated with longer reaction times than neutral ones in the ADHD group, whereas no differences were found in the control group. ERP data revealed that, compared with control subjects, boys with ADHD showed larger anterior N2 amplitudes for emotional than for neutral distracters. Furthermore, regression analyses between ERP data and subjects’ emotional ratings of distracting stimuli showed that only in the ADHD group, emotional arousal (ranging from calming to arousing) was associated with anterior N2: its amplitude increased as the arousal content of the visual distracter increased. These results suggest that boys with ADHD are more vulnerable to the distracting effects of irrelevant emotional stimuli than control subjects. The present study provides first data on the neural substrates underlying emotional distractibility in ADHD.     

Modulation of Response Timing in ADHD,Effects of Reinforcement Valence and Magnitude

The present study investigated the impact of reinforcement valence and magnitude on response timing in children with ADHD. Children were required to estimate a 1-s interval, and both the median response time (response tendency) and the intrasubject-variability (response stability) were investigated. In addition, heart rate and skin conductance were measured to examine the autonomic responses to reinforcement. Feedback-only trials were compared to low response cost trials (response cost for incorrect responses), low reward trials (reward for correct responses), high response cost and high reward trials. In feedback-only trials, children with ADHD underestimated more severely the interval and responded more variably than controls. Children with ADHD, unlike controls, were unaffected by the reinforcement conditions in terms of time underestimations. The variability of responding, on the other hand, decreased under conditions of reinforcement to a larger extent in children with ADHD than controls. There were no indications that children with ADHD were abnormally affected by the valence or magnitude of reinforcement. Furthermore, skin conductance responses increased when feedback was coupled with reinforcement, an effect which was larger in children with ADHD than controls. This could be interpreted as demonstrating that children with ADHD suffer from a diminished awareness of the significance of feedback in the feedback-only condition. The current study suggests that children with ADHD suffer from motivation problems when reinforcement was not available, at least when variability in responding was measured. Underestimations of time may reflect more stable deficits in ADHD.     

Sensitivity to reward frequency in boys with attention deficit hyperactivity disorder.

Compared the sensitivity of boys with and without attention deficit hyperactivity disorder (ADHD) to differences in reward frequency. Fifteen boys with ADHD as diagnosed in the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev.; American Psychiatric Association, 1987) and a matched control group completed a signal-detection task in which correct identification of 1 stimulus was rewarded 3 times as often as correct identification of the other. Boys in the ADHD group completed the task twice, on and off medication. Group differences emerged in response bias toward the more frequently rewarded alternative. Boys in the control group showed a stable pattern of response bias, irrespective of which alternative they were last rewarded on. Boys in the ADHD group showed different patterns of response bias following rewards on the 2 alternatives. These results suggest children with ADHD were more sensitive to individual instances of reward compared with controls, whose response bias is governed more by their reinforcement history. Methylphenidate improved discriminability and reduced sensitivity to individual instances of reward in the boys with ADHD.     

Hot and Cool Aspects of Cognitive Control in Children with ADHD: Decision-Making and Inhibition

This study investigated hot and cool aspects of cognitive control in children with Attention Deficit Hyperactivity Disorder (ADHD). The study aimed to: (1) replicate the postulated response inhibition deficit of children with ADHD; (2) explore whether children with ADHD choose disadvantageously in a decision-making task and to explore the mechanisms underlying the expected response pattern; and (3) study whether performance on a combination of hot and cool executive control measures has predictive value for an ADHD diagnosis. The sample consisted of 20 children with ADHD and 22 normal developing children (NC, 8 to 12 years) matched on age, FSIQ, and gender. Two paradigms have been applied: (1) the stop signal paradigm, and (2) the adapted children's version of the IOWA Gambling task. There were no group differences for both paradigms. Both groups chose in a reward-oriented manner and seemed to develop the ability to take future consequences into account in making decisions. Moreover, feedback resulted in direct behavioral changes. Children with ADHD did not have a specific response inhibition deficit or a decision-making deficit.     

Selective inhibition in children with attention-deficit hyperactivity disorder off and on stimulant medication

Selective inhibition requires discrimination between auditory signals and is assessed using a modification of the stop-signal task. Selective inhibition was assessed in a group of 59 clinic-referred, DSM-IV-diagnosed children with attention-deficit hyperactivity disorder (ADHD) and compared to that of a community sample of 59 children. Methylphenidate (MPH) effects on selective inhibition were assessed in a subset of the ADHD sample that participated in an acute, randomized, placebo-controlled, crossover trial with 3 fixed doses of MPH. Children with ADHD performed more poorly than controls on the majority of selective stop-signal task parameters: they exhibited more anticipatory (invalid) responses, with less accurate and more variable responses on the response execution task, as well as a slower selective inhibition process. MPH improved speed of both inhibition and response execution processes; it also reduced variability of response execution and decreased nonselective inhibition. On the one hand, findings are consistent with purported inhibition deficit in ADHD, but on the other hand, suggest that neither the impairment itself, nor MPH effects, were restricted to inhibition.     

激活水平对两亚型ADHD儿童反应执行与抑制能力的影响

研究选取了混合型ADHD儿童14名,注意缺陷型ADHD儿童16名以及正常儿童18名,考察了在不同激活水平下,两亚型ADHD儿童之间,及其与正常儿童之间的反应执行能力与抑制能力的异同。采用传统的go/no-go任务,并将刺激间的时间间隔设置为1秒、4秒、8秒三种条件,分别对应高、中、低三种激活水平。结果发现,(1)与正常儿童相比,ADHD儿童的反应执行能力更容易受到激活水平的影响,且两亚型ADHD儿童受到的影响模式基本一致。具体而言:在高激活水平下,ADHD儿童与正常儿童差异最小;在中、低激活水平下,ADHD儿童与正常儿童差异增大,表明ADHD儿童状态调节能力落后。(2)两亚型ADHD儿童的功能缺损模式不同,混合型儿童在状态调节和反应抑制两方面都存在缺损,且其反应抑制缺陷不受激活水平影响;注意缺陷型儿童仅在状态调节方面受损。     

Lack of Inhibition: A Motivational Deficit in Children With Attention Deficit/Hyperactivity Disorder and Children With Traumatic Brain Injury*

Recent research has demonstrated that both brain-injured children and children with attention deficit/hyperactivity disorder (ADHD) suffer from response inhibition deficits. To investigate whether these deficits can be influenced by motivational factors, the stop-signal task was performed with and without reward contingencies for successful inhibition. Three groups of children between 8 and 12 years of age, participated in the study: 31 children with ADHD, 37 with traumatic brain injuries (TBI), and 26 normal controls. Results indicated that, although all groups showed comparable learning effects, reward contingencies had different effects on the groups. Whereas the performance of children with ADHD under reward contingencies were brought up to the performance level of normal controls, rewards were found less effective at improving response inhibition in children with TBI. The results further support a motivational/energetic explanation of the inhibitory deficit in children with ADHD, and of a primary response inhibition deficit due to structural brain damage in children with TBI.     

Lack of inhibition: a motivational deficit in children with attention deficit/hyperactivity disorder and children with traumatic brain injury.

Recent research has demonstrated that both brain-injured children and children with attention deficit/hyperactivity disorder (ADHD) suffer from response inhibition deficits. To investigate whether these deficits can be influenced by motivational factors, the stop-signal task was performed with and without reward contingencies for successful inhibition. Three groups of children between 8 and 12 years of age, participated in the study: 31 children with ADHD, 37 with traumatic brain injuries (TBI), and 26 normal controls. Results indicated that, although all groups showed comparable learning effects, reward contingencies had different effects on the groups. Whereas the performance of children with ADHD under reward contingencies were brought up to the performance level of normal controls, rewards were found less effective at improving response inhibition in children with TBI. The results further support a motivational/energetic explanation of the inhibitory deficit in children with ADHD, and of a primary response inhibition deficit due to structural brain damage in children with TBI.     

The N400 component in parents of children with specific language impairment

Children with specific language impairment (SLI) often have a family history of language disorder. In this study, ERPs in response to a visual semantic priming task were recorded in parents of children with SLI. Despite equal performance, the ERPs displayed differences in language processing: larger N400 amplitudes indicated that the parents, especially the fathers, were less primed by the preceding context. Difference waveforms showed that the fathers of SLI children, contrary to controls, had less differentiated responses to congruent versus incongruent sentences. We propose that the N400 observations may be residual markers of past language deficiencies in the fathers. No differences in the N400 effect were found in the mothers of SLI children.     

反馈对注意缺损多动障碍儿童错误监控能力的影响

研究选取了注意缺损多动障碍(ADHD)儿童39名,正常儿童40名,采用两项选择任务,考察在无反馈和有反馈的情况下,ADHD儿童的错误监控能力是否存在缺损。结果发现,(1)无论是否提供反馈,与正常儿童相比,ADHD儿童的错误察觉能力正常,但是错误更正能力落后,这可能是由于ADHD儿童动作调节控制能力落后导致的;(2)反馈提高了ADHD儿童和正常儿童的认知加工速度,但同时降低了他们的警醒水平,导致错误监控能力下降。     

Task Switching and Attention Deficit Hyperactivity Disorder

The main goal of the present set of studies was to examine the efficiency of executive control processes and, more specifically, the control processes involved in task set inhibition and preparation to perform a new task in attention deficit hyperactivity disorder (ADHD) and non-ADHD children. This was accomplished by having ADHD children, both on and off medication, and non-ADHD children perform the task-switching paradigm, which involves the performance of two simple tasks. In nonswitch trials, an individual task is performed repeatedly for a number of trials. In switch trials, subjects must rapidly and accurately switch from one task to the other, either in a predictable or unpredictable sequence. Switch costs are calculated by subtracting performance on the nonswitch trials from performance on the switch trials. These costs are assumed to reflect the executive control processes required for the coordination of multiple tasks. ADHD children showed substantially larger switch costs than non-ADHD children. However, when on medication, the ADHD children's switch performance was equivalent to control children. In addition, medication was observed to improve the ADHD children's ability to inhibit inappropriate responses. These data are discussed in terms of models of ADHD and cognition.     

The auditory-evoked N2 and P3 components in the stop-signal task: indices of inhibition, response-conflict or error-detection?

The N2 and P3 components have been separately associated with response inhibition in the stop-signal task, and more recently, the N2 has been implicated in the detection of response-conflict. To isolate response inhibition activity from early sensory processing, the present study compared processing of the stop-signal with that of a task-irrelevant tone, which subjects were instructed to ignore. Stop-signals elicited a larger N2 on failed-stop trials and a larger P3 on successful-stop trials, relative to ignore-signal trials, likely reflecting activity related to failed and successful stopping, respectively. ERPs between fast and slow reaction-time (RT) groups were also examined as it was hypothesised that greater inhibitory activation to stop faster responses would manifest in the component reflecting this process. Successful-stop P3 showed the anticipated effect (globally larger amplitude in the fast than slow RT group), supporting its association with the stopping of an ongoing response. In contrast, N2 was larger in the slow than fast RT group, and in contrast to the predictions of the response-conflict hypothesis, successful-stop N2 and the response-locked error-negativity (Ne) differed in scalp distribution. These findings indicate that the successful-stop N2 may be better explained as a deliberate form of response control or selection, which the slow RT group employed as a means of increasing the likelihood of a successful-stop. Finally, a comparison of stimulus and response-locked ERPs revealed that the failed-stop N2 and P3 appeared to reflect error-related activity, best observed in the response-locked Ne and error-positivity (Pe). Together these findings indicate that the successful-stop N2 and P3 reflect functionally distinct aspects of response control that are dependent upon performance strategies, while failed-stop N2 and P3 reflect error-related activity.     

Very Low Birth Weight and Attention Deficit/Hyperactivity Disorder

It is well recognized that reaction time performance of term-born children with a normal birth weight (NBW > 2500 g) who fulfill the DSM-IV criteria for attention deficit/hyperactivity disorder (ADHD) in the primary school age is sensitive for the presentation rate of stimuli. They have been found to perform more poorly in conditions of relatively slow event rates as compared with fast event rates. The purpose of the current study was to explore whether reaction time performance of children with very low birth weight (VLBW < 1500 g) with or without ADHD showed the same sensitivity for the factor presentation rate of stimuli compared to children with a normal birth weight plus ADHD. To this end, reaction time performance of four groups of children was compared on a Go/No-Go test with a fast presentation rate of 1 second and a slow presentation rate of 6 seconds. Groups were: children with VLBW plus ADHD, children with VLBW only, children born full term with normal birth weight (NBW >2500 g) plus ADHD, and children born full term without ADHD (the control group). Findings indicated that, compared to the non-ADHD groups, the groups with ADHD (NBW and VLBW) showed a more dramatic decline in their reaction time performance in the slow condition: a state regulation deficit. In addition, both groups showed a response inhibition deficit. No difference was found in reaction time performance between the groups of children with VLBW only and the control group.     

Methylphenidate influences on both early and late ERP waves of ADHD children in a continuous performance test

Although it has frequently been reported that hyperactive children have abnormally small P3 amplitudes of the event-related potential (ERP), which are normalized by the stimulant drug methylphenidate (MPH), the literature is inconsistent concerning earlier ERP waves. The aim of the present study was to investigate whether the normalizing effect of a 10-mg dose of MPH was also apparent on earlier waves, such as the N1, the P2, and the N2, besides the P3. Twelve attention deficit with hyperactivity disorder (ADHD) children performed a Continuous Performance Test involving a button-press response to the letter X (CPT-X) under the influence of MPH in a double-blind placebo controlled acute dosage design. ERPs were recorded at Oz, Pz, Cz, and Fz. The expected increase of the parietal P3, both to targets and nontargets, was apparent, as well as a significant increase in percentage of hits. There also was a significant increase of an earlier, negative going, wave, the N2, with a frontal maximum, under the influence of MPH. This wave was probably a manifestation of an increase in processing negativity for target stimuli only, after the intake of the stimulant drug. No effect of MPH was found on the N1 or the P2.