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Research Paper

Reduced error signalling in medication-naive children with ADHD: associations with behavioural variability and post-error adaptations

Kerstin J. Plessen, Elena A. Allen, Heike Eichele, Heidi van Wageningen, Marie Farstad Høvik, Lin Sørensen, Marius Kalsås Worren, Kenneth Hugdahl and Tom Eichele
J Psychiatry Neurosci March 01, 2016 41 (2) 77-87; DOI: https://doi.org/10.1503/jpn.140353
Kerstin J. Plessen
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)
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  • For correspondence: [email protected]
Elena A. Allen
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)
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Heike Eichele
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)
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Heidi van Wageningen
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)
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Marie Farstad Høvik
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)
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Lin Sørensen
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)
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Marius Kalsås Worren
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)
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Kenneth Hugdahl
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)
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Tom Eichele
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)
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  • Fig. 1
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    Fig. 1

    Behavioural data. (A) Behavioural variables as a function of Flanker compatibility and group (attention-deficit/hyperactivity disorder [ADHD] = red; control = blue). The distribution of each variable is summarized with a boxplot; the mean ± 1 standard error of the mean (SEM) are also displayed to show group differences. These plots display residualized variables (see Methods section), thus variables with only positive values may be transformed to (slightly) negative values after residualization. Repeated-measures analysis of variance (ANOVA) F1,52 stat-tistics for Flanker compatibility, diagnosis and their interaction are provided as FC, FD, and FC × D, respectively. (B) Examples of reaction time (RT) distributions over all trials in 4 control (left) and ADHD (right) participants. Histograms are overlayed with kernel density estimates. (C) Average RT distributions ± 1 SEM for each group. To fairly compare distributions between groups, RTs for each participant were divided into 10 quantiles and normalized to compute probability densities. Differences in the average RT distribution were determined using the Kolmogorov–Smirnov statistic, D, which considers the maximum absolute difference between the cumulative distribution functions (inset). Significance of D was determined by comparing the observed value to a null distribution of D′ values, which were created by permuting group labels (10 000 permutations). The distributions differed significantly across groups (D = 0.15, p = 0.014).

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    Fig. 2

    Component activation to different task conditions. (A) Component maps of cingulo-opercular networks (CONs; left), dorsal attention networks (DANs; middle) and the right-lateralized ventral attention network (VAN; right). Component t maps are thresholded at t > 8 (1-sample t test) and displayed at the most informative slices. See Table 1 for peak coordinates and cluster extents of each component. (B) Average hemodynamic response functions (HRFs) were estimated from incompatible trials, the condition that evoked the strongest response for these components (see Methods section). Error bands indicate ± 1 SEM. (C) Component amplitudes to compatible, incompatible and error trials as a function of group (attention-deficit/hyperactivity [ADHD] = red; control = blue). Repeated-measures analysis of variance F statistics for Flanker compatibility, diagnosis, and their interaction are provided as FC2,98, FD1,98 and FC × D2,98, respectively.

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    Fig. 3

    Association between error amplitudes and behavioural variability. Multiple regression model predicting reaction time (RT) from the cingulo-operculum network (CON1; left) and CON2 (right) error amplitudes. The model was determined with backward selection (see Methods). Each scatterplot displays the association between a single predictor and the response variable (sRT) adjusted for the remaining predictors (i.e., the remaining terms of the model are subtracted from the response vector). Grey contours indicate the 95% confidence interval for the regression line (dashed black line). ADHD = attention-deficit/hyperactivity disorder.

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    Fig. 4

    Post-error motor adaption (PEMA) and its association with the ventral attention network (VAN). (A) Component maps of lateralized left and right motor (MOT) systems. Component t maps are thresholded at t > 8 (1-sample t test) and displayed at the most informative slices. See Table 1 for peak coordinates and cluster extents of each component. (B) The MOT component activations on post-correct trials (divided by response laterality) and post-error trials as a function for each group. Only errors of commission are considered. (C) Post-error motor adaption for MOT components as a function of group. We calculated PEMA as the difference in activation between post-error trials and post-correct trials on the relevant side. Group differences in PEMA are indicated with t statistics and p values (1-tailed). (D) Scatterplot showing the association between VAN error amplitude and PEMA, averaged over right and left MOT networks. The simple regression model was determined with backward selection (see Methods section). Grey contours indicate the 95% confidence interval for the regression line (dashed black line).

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    Fig. 5

    Task-driven connectivity analysis between cingulo-opercular (CON) and ventral attention (VAN) networks. (A) Example of the cross-correlation analysis performed between trial × trial amplitudes of CON1 (solid line) and VAN for a single control participant. Positive lags denote the VAN lagging behind the CON1, while negative lags denote the VAN leading. (B) Average cross-correlations (± 1 SEM) between CON1 and VAN (left), and CON2 and VAN (right), as a function of group (attention-deficit/hyperactivity disorder [ADHD] = red; control = blue). †Significantly different from zero across the entire sample at p < 0.05, uncorrected; *significant difference between groups (p < 0.05, uncorrected). The CON1–VAN connectivity was significantly different from zero at lag 0 (t53 = 6.3, p < 0.001) and lag 1 (t53 = 2.11, p = 0.039). The CON2–VAN connectivity was significantly different from zero at lag 0 (t53 = 5.41, p < 0.001). Group differences were found only for CON1–VAN at positive lags 1 (t52 = 2.4, p = 0.022) and 2 (t = 2.1, p = 0.037). (C) Regression model predicting post-error motor adaption (PEMA) from CON1–VAN connectivity (left) and VAN (right) error amplitude. The model was determined with backward selection (see Methods section). Inclusion of CON1–VAN connectivity in the model significantly increases the fraction of accounted variance (see Fig. 4D). The CON1–VAN connectivity was averaged over 0 to 2 lags (shaded region in B). Grey contours indicate the 95% confidence interval for the regression line (dashed black line).

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    Table 1

    Anatomic regions and peak coordinates of selected components

    MNI coordinate
    ComponentVol, mm3Max t statisticxyzRegionBA
    CON1 (Component 21)
    2281544.8−3327−6L insulaL BA 47
    2427342.2536210R insulaR BA 47
    3801632.1102748L/R cingulate gyrusL/R BA 32
    62111.0939−60−33R cerebellum (Crus 1)—
    32410.5−39−57−33L cerebellum (Crus 1)—
    CON2 (Component 91)
    3709833.843066L/R SMAL/R BA 6
    1274428.3854051R precentral gyrusR BA 6
    758723.02−48−954L precentral gyrusL BA6
    588621.565490R insulaR BA 13
    926118.72−5490L insulaL BA 13
    283515.943−1812L/R thalamus—
    550815.41−21−5745L SPLL BA 7
    375313.4733−7254R SPLR BA 7
    78310.8415−621R caudate—
    29710.75−654−12L medial frontal gyrusL BA 11
    54010.11−304221L middle frontal gyrusL BA 10
    LDAN (Component 27)
    6110141.63−42−4548L IPLL BA 40
    456317.89−51−63−9L ITGL BA 19
    602114.8745−3951R IPLR BA 40
    302414.37−51333L precentral gyrusL BA 9
    256513.78−24−657L middle frontal gyrusL BA 6
    288913.1315−7254R SPLR BA 7
    RDAN (Component 36)
    6199246.6342−4548R IPLR BA 40
    1171821.5754−57−12R ITGR BA 19
    556219.854927R precentral gyrusR BA 9
    278111.7130−354R middle frontal gyrusR BA 6
    162011.45−36−4842L IPLL BA 40
    75610.35−21−7254L SPLL BA 7
    VAN (Component 33)
    6974146.1548−5115R MTGR BA 22, 39
    429312.8−54−6312L MTGL BA 22, 39
    51310.8145351R middle frontal gyrusR BA 6
    67510.5854270R IFG (p. triangularis)R BA 47
    RMOT (Component 1)
    4422649.6442−2466R precentral gyrusR BA 4
    864025.58−24−54−24L cerebellum (VI)—
    359121.1933−3−6R putamen—
    237617.6315−219R thalamus—
    326714.1148−2118R insulaR BA 13
    83712.47−24−63−54L cerebellum (VIII)—
    LMOT (Component 2)
    4722350.22−39−3069L precentral gyrusL BA 3
    658822.5621−57−21R cerebellum (VI)—
    232219.69−12−210L thalamus—
    332119.04−30−9−3L putamen—
    186312.27−48−2421L insulaL BA 13
    5409.7912−72−48R cerebellum (VIII)—
    • BA = Brodmann area; CON = cingulo-opercular network; IFG = inferior frontal gyrus; IPL = inferior parietal lobule; ITG = inferior temporal gyrus; L = left; LDAN/RDAN = left/right dorsal attention network; LMOT/RMOT = lateralized left/right motor systems; MNI = Montreal Neurological Institute; MTG = middle temporal gyrus; R = right; SMA = supplementary motor area; SPL = superior parietal lobule; VAN = ventral attention network.

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Journal of Psychiatry and Neuroscience: 41 (2)
J Psychiatry Neurosci
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1 Mar 2016
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Reduced error signalling in medication-naive children with ADHD: associations with behavioural variability and post-error adaptations
Kerstin J. Plessen, Elena A. Allen, Heike Eichele, Heidi van Wageningen, Marie Farstad Høvik, Lin Sørensen, Marius Kalsås Worren, Kenneth Hugdahl, Tom Eichele
J Psychiatry Neurosci Mar 2016, 41 (2) 77-87; DOI: 10.1503/jpn.140353

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Reduced error signalling in medication-naive children with ADHD: associations with behavioural variability and post-error adaptations
Kerstin J. Plessen, Elena A. Allen, Heike Eichele, Heidi van Wageningen, Marie Farstad Høvik, Lin Sørensen, Marius Kalsås Worren, Kenneth Hugdahl, Tom Eichele
J Psychiatry Neurosci Mar 2016, 41 (2) 77-87; DOI: 10.1503/jpn.140353
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