The Significance of Impulsive Error in Children With ADHD

Abstract

A deficit of inhibition ability is a neuropsychological problem in children with attention deficit hyperactivity disorder (ADHD). We investigated whether in children who made impulsive error (IE), less error-related negativity (ERN) would correlate with poorer executive attention functions (EAFs). Ninety children (49 with ADHD and 41 without ADHD) were investigated by a 4-minute simple reaction time task and simultaneous electroencephalogram. When they made IE, the ERN in response-locked event-related potential (ERP) was defined as error awareness. The average area under curve of ERN in the control group with IEs was used as the proper criterion for regrouping the children with ADHD into 2 groups: ADHD children with enough ERN (ADHD-enough ERN) and those with less ERN (ADHD-less ERN). EAFs from Comprehensive Nonverbal Attention Test were used as objective indices, and behavioral questionnaires were used as subjective indices and statistically analyzed within ADHD groups. Forty-eight percent of the children made IEs. ADHD(n = 31, 63%) was significantly more than in the control group (n = 12, 29%; P < .001). The ADHD group had significantly less ERN than did the control group while making IE, especially at frontal and central electrodes ( P < .01). Both ADHD-less ERN and ADHD-enough ERN groups had poorer subjective EAFs on questionnaires. Only the ADHD-less ERN group had significant poorer objective EAFs on the Comprehensive Nonverbal Attention Test than did the ADHD without IE. We conclude that investigating the IE and ERN of IE in children with ADHD might help to differentiate subtypes of ADHD with different neuropsychological abilities, and the possibility that ADHD-less ERN children might be confirmed a meaningful subgroup that needs close follow-up, treatments different from standard, or both.

Can electroencephalography (EEG) identify ADHD subtypes? A systematic review

“…Two novel ADHD groups were created: one with reduced ERN amplitudes (n=26) and one with ERN amplitudes comparable to controls (n=5). Only the reduced-ERN subgroup had poorer performance on the Comprehensive Nonverbal Attention test, an objective measure of executive function, although both groups provided equivalent subjective ratings of executive function (Liao et al, 2018).…”

“…Five of the ten studies used previously-identified EEG markers to create ADHD subgroups, and then assessed differences in EEG or behavioral measures between the subgroups. Four studies used spectral analysis of resting state EEG and one study defined subgroups based on the error-related negativity (ERN) during a reaction time task (Liao et al, 2018). All five studies included children.…”

“…Liao et al (2018) grouped children with ADHD-I or ADHD-C based on their behavioral errors and corresponding error-related negativity (ERN) component during a simple 4-minute reaction time task. Two novel ADHD groups were created: one with reduced ERN amplitudes (n=26) and one with ERN amplitudes comparable to controls (n=5).…”

Effects of Twenty Hours of Neurofeedback-Based Neuropsychotherapy on the Executive Functions and Achievements among ADHD Children

“…16 Performance and monitoring abilities are also deficient in ADHD children and adolescents in executive attention and flanker tasks. 17,18 Their frontal beta-band activities cannot be enhanced when task complexity increases. 19…”

“…16 Performance and monitoring abilities are also deficient in ADHD children and adolescents in executive attention and flanker tasks. 17,18 Their frontal beta-band activities cannot be enhanced when task complexity increases. 19 Many meta-analysis studies that have reviewed neurofeedback treatment in ADHD have shown the short-term and follow-up effects in the symptoms of ADHD [20][21][22] Standard neurofeedback training protocols, including TBR, sensorimotor rhythm(SMR), and slow cortical potential(SCP), have been considered viable treatment alternatives for ADHD [21][22][23] Indications are that neurofeedback can find considerable utility as an intervention strategy in academic settings for individuals with ADHD.…”