ADHD Remission is Linked to Better Neurophysiological Error Detection and Attention-Vigilance Processes

Giorgia Michelini; Glenn L. Kitsune; Celeste H.M. Cheung; Daniel Brandeis; Tobias Banaschewski; Philip Asherson; Gráinne McLoughlin; Jonna Kuntsi

doi:10.1016/j.biopsych.2016.06.021

ADHD Remission is Linked to Better Neurophysiological Error Detection and Attention-Vigilance Processes

Giorgia Michelini, Glenn L. Kitsune, Celeste H.M. Cheung, Daniel Brandeis, Tobias Banaschewski, Philip Asherson, Gráinne McLoughlin, Jonna Kuntsi

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Abstract

Background

The processes underlying persistence and remission of attention-deficit/hyperactivity disorder (ADHD) are poorly understood. We aimed to examine whether cognitive and neurophysiological impairments on a performance monitoring task distinguish between ADHD persisters and remitters.

Methods

On average six years after initial assessment, 110 adolescents and young adults with childhood ADHD (87 persisters, 23 remitters) and 169 age-matched controls were compared on cognitive-performance measures and event-related potentials (ERPs) of conflict monitoring (N2) and error processing (ERN, Pe) from an arrow flanker task with low- and high-conflict conditions. ADHD outcome was examined with parent-reported symptoms and functional impairment measures using a categorical (DSM-IV) and a dimensional approach.

Results

ADHD persisters were impaired compared to controls on all cognitive-performance and ERP measures (all p<0.05). ADHD remitters differed from persisters, and were indistinguishable from controls, on the number of congruent (low-conflict) errors, reaction time variability (RTV), ERN and Pe (all p≤0.05). Remitters did not differ significantly from the other groups on incongruent (high-conflict) errors, mean reaction time and N2. In dimensional analyses on all participants with childhood ADHD, ADHD symptoms and functional impairment at follow up were significantly correlated with congruent errors, RTV and Pe (r=0.19-0.23, p≤0.05).

Conclusions

Cognitive and neurophysiological measures of attention-vigilance and error detection distinguished ADHD remitters from persisters. These results extend our previous findings with other tasks (Cheung et al. 2015), and indicate that such measures are markers of remission and candidates for the development of non-pharmacological interventions.

Original language	English
Pages (from-to)	923-932
Journal	Biological psychiatry
Volume	80
Issue number	12
Early online date	5 Jul 2016
DOIs	https://doi.org/10.1016/j.biopsych.2016.06.021
Publication status	Published - 15 Dec 2016

Keywords

ADHD
remission
persistence
event-related potentials
EEG
cognitive impairments

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ADHD Remission is Linked_MICHELENI _Accepted 21Jun2016_GOLD AAM (CC BY)Accepted author manuscript, 1.1 MBLicence: CC BY
ADHD Remission is Linked_MICHELENI _Accepted 21Jun2016_GOLD VoRFinal published version, 947 KBLicence: CC BY

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@article{272803de459d403da90648d54d9ac545,

title = "ADHD Remission is Linked to Better Neurophysiological Error Detection and Attention-Vigilance Processes",

abstract = "BackgroundThe processes underlying persistence and remission of attention-deficit/hyperactivity disorder (ADHD) are poorly understood. We aimed to examine whether cognitive and neurophysiological impairments on a performance monitoring task distinguish between ADHD persisters and remitters.MethodsOn average six years after initial assessment, 110 adolescents and young adults with childhood ADHD (87 persisters, 23 remitters) and 169 age-matched controls were compared on cognitive-performance measures and event-related potentials (ERPs) of conflict monitoring (N2) and error processing (ERN, Pe) from an arrow flanker task with low- and high-conflict conditions. ADHD outcome was examined with parent-reported symptoms and functional impairment measures using a categorical (DSM-IV) and a dimensional approach.ResultsADHD persisters were impaired compared to controls on all cognitive-performance and ERP measures (all p<0.05). ADHD remitters differed from persisters, and were indistinguishable from controls, on the number of congruent (low-conflict) errors, reaction time variability (RTV), ERN and Pe (all p≤0.05). Remitters did not differ significantly from the other groups on incongruent (high-conflict) errors, mean reaction time and N2. In dimensional analyses on all participants with childhood ADHD, ADHD symptoms and functional impairment at follow up were significantly correlated with congruent errors, RTV and Pe (r=0.19-0.23, p≤0.05).ConclusionsCognitive and neurophysiological measures of attention-vigilance and error detection distinguished ADHD remitters from persisters. These results extend our previous findings with other tasks (Cheung et al. 2015), and indicate that such measures are markers of remission and candidates for the development of non-pharmacological interventions.",

keywords = "ADHD, remission, persistence, event-related potentials, EEG, cognitive impairments",

author = "Giorgia Michelini and Kitsune, {Glenn L.} and Cheung, {Celeste H.M.} and Daniel Brandeis and Tobias Banaschewski and Philip Asherson and Gr{\'a}inne McLoughlin and Jonna Kuntsi",

year = "2016",

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day = "15",

doi = "10.1016/j.biopsych.2016.06.021",

language = "English",

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pages = "923--932",

journal = "Biological psychiatry",

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T1 - ADHD Remission is Linked to Better Neurophysiological Error Detection and Attention-Vigilance Processes

AU - Michelini, Giorgia

AU - Kitsune, Glenn L.

AU - Cheung, Celeste H.M.

AU - Brandeis, Daniel

AU - Banaschewski, Tobias

AU - Asherson, Philip

AU - McLoughlin, Gráinne

AU - Kuntsi, Jonna

PY - 2016/12/15

Y1 - 2016/12/15

N2 - BackgroundThe processes underlying persistence and remission of attention-deficit/hyperactivity disorder (ADHD) are poorly understood. We aimed to examine whether cognitive and neurophysiological impairments on a performance monitoring task distinguish between ADHD persisters and remitters.MethodsOn average six years after initial assessment, 110 adolescents and young adults with childhood ADHD (87 persisters, 23 remitters) and 169 age-matched controls were compared on cognitive-performance measures and event-related potentials (ERPs) of conflict monitoring (N2) and error processing (ERN, Pe) from an arrow flanker task with low- and high-conflict conditions. ADHD outcome was examined with parent-reported symptoms and functional impairment measures using a categorical (DSM-IV) and a dimensional approach.ResultsADHD persisters were impaired compared to controls on all cognitive-performance and ERP measures (all p<0.05). ADHD remitters differed from persisters, and were indistinguishable from controls, on the number of congruent (low-conflict) errors, reaction time variability (RTV), ERN and Pe (all p≤0.05). Remitters did not differ significantly from the other groups on incongruent (high-conflict) errors, mean reaction time and N2. In dimensional analyses on all participants with childhood ADHD, ADHD symptoms and functional impairment at follow up were significantly correlated with congruent errors, RTV and Pe (r=0.19-0.23, p≤0.05).ConclusionsCognitive and neurophysiological measures of attention-vigilance and error detection distinguished ADHD remitters from persisters. These results extend our previous findings with other tasks (Cheung et al. 2015), and indicate that such measures are markers of remission and candidates for the development of non-pharmacological interventions.

AB - BackgroundThe processes underlying persistence and remission of attention-deficit/hyperactivity disorder (ADHD) are poorly understood. We aimed to examine whether cognitive and neurophysiological impairments on a performance monitoring task distinguish between ADHD persisters and remitters.MethodsOn average six years after initial assessment, 110 adolescents and young adults with childhood ADHD (87 persisters, 23 remitters) and 169 age-matched controls were compared on cognitive-performance measures and event-related potentials (ERPs) of conflict monitoring (N2) and error processing (ERN, Pe) from an arrow flanker task with low- and high-conflict conditions. ADHD outcome was examined with parent-reported symptoms and functional impairment measures using a categorical (DSM-IV) and a dimensional approach.ResultsADHD persisters were impaired compared to controls on all cognitive-performance and ERP measures (all p<0.05). ADHD remitters differed from persisters, and were indistinguishable from controls, on the number of congruent (low-conflict) errors, reaction time variability (RTV), ERN and Pe (all p≤0.05). Remitters did not differ significantly from the other groups on incongruent (high-conflict) errors, mean reaction time and N2. In dimensional analyses on all participants with childhood ADHD, ADHD symptoms and functional impairment at follow up were significantly correlated with congruent errors, RTV and Pe (r=0.19-0.23, p≤0.05).ConclusionsCognitive and neurophysiological measures of attention-vigilance and error detection distinguished ADHD remitters from persisters. These results extend our previous findings with other tasks (Cheung et al. 2015), and indicate that such measures are markers of remission and candidates for the development of non-pharmacological interventions.

KW - ADHD

KW - remission

KW - persistence

KW - event-related potentials

KW - EEG

KW - cognitive impairments

U2 - 10.1016/j.biopsych.2016.06.021

DO - 10.1016/j.biopsych.2016.06.021

M3 - Article

C2 - 27591125

SN - 0006-3223

VL - 80

SP - 923

EP - 932

JO - Biological psychiatry

JF - Biological psychiatry

IS - 12

ER -

ADHD Remission is Linked to Better Neurophysiological Error Detection and Attention-Vigilance Processes

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Keywords

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