Reduced error signalling in medication-naive children with ADHD: associations with behavioural variability and
Kerstin J Plessen1, Elena A Allen1, Heike Eichele1
1From the Child and Adolescent Mental Health Centre, Capital Region Psychiatry, Copenhagen, Denmark (Plessen); the Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark (Plessen); the Department of Clinical Medicine, Faculty of Medicine and Odontology, University of Bergen, Bergen, Norway (Plessen, Høvik, Worren); the K.G. Jebsen Center for Research on Neuropsychiatric Disorders, University of Bergen, Bergen, Norway (Plessen, Allen, Sørensen, Hugdahl, Eichele); the Mind Research Network, Albuquerque, New Mexico (Allen, Eichele); the Department of Biological and Medical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway (Allen, Eichele, Hugdahl, Eichele); the Norwegian School of Economics, Bergen, Norway (van Wageningen); the Division of Psychiatry, Haukeland University Hospital, Bergen, Norway (Hugdahl); the Department of Radiology, Haukeland University Hospital, Bergen, Norway (Hugdahl); the Section for Clinical Neurophysiology, Haukeland University Hospital, Bergen, Norway (Eichele).
Background:
We examined the blood-oxygen level-dependent (BOLD) activation in brain regions that signal errors and their association with intraindividual behavioural variability and adaptation to errors in children with attention-deficit/hyperactivity disorder (ADHD).
Methods:
We acquired functional MRI data during a Flanker task in medication-naive children with ADHD and healthy controls aged 8-12 years and analyzed the data using independent component analysis. For components corresponding to performance monitoring networks, we compared activations across groups and conditions and correlated them with reaction times (RT). Additionally, we analyzed post-error adaptations in behaviour and motor component activations.
Results:
We included 25 children with ADHD and 29 controls in our analysis. Children with ADHD displayed reduced activation to errors in cingulo-opercular regions and higher RT variability, but no differences of interference control. Larger BOLD amplitude to error trials significantly predicted reduced RT variability across all participants. Neither group showed evidence of post-error response slowing; however, post-error adaptation in motor networks was significantly reduced in children with ADHD. This adaptation was inversely related to activation of the right-lateralized ventral attention network (VAN) on error trials and to task-driven connectivity between the cingulo-opercular system and the VAN.
Limitations:
Our study was limited by the modest sample size and imperfect matching across groups.
Conclusion:
Our findings show a deficit in cingulo-opercular activation in children with ADHD that could relate to reduced signalling for errors. Moreover, the reduced orienting of the VAN signal may mediate deficient post-error motor adaptions. Pinpointing general performance monitoring problems to specific brain regions and operations in error processing may help to guide the targets of future treatments for ADHD.
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