Abstract
Individuals with attention-deficit hyperactivity disorder (ADHD) often display over-response to stimuli that are irrelevant to the ongoing task, and their attentional abilities disproportionately worsen in the presence of competing stimuli. Auditory event-related potentials (ERPs) such as mismatch negativity (MMN) and P3a using the passive oddball paradigm have been studied in children and adolescents with ADHD. Still, there is no such data for adults with ADHD. This study aimed to compare the MMN and P3a and their clinical and neurocognitive correlations between drug-naive adults with ADHD and control adults. We recruited 52 adults with ADHD (26.5 ± 6.2 years), and 62 age-matched controls (25.6 ± 5.6 years). They received the psychiatric interviews, auditory ERP, the Conners' continuous performance test (CCPT), and the Cambridge gambling test (CGT). They also completed the questionnaires about ADHD symptoms and real-world executive functions. MMN and P3a were assessed during a passive duration-deviant auditory oddball paradigm from the midline electrodes Cz. Adults with ADHD demonstrated smaller Cz MMN amplitude, more severe ADHD symptoms, poorer attention profiles (CCPT), and a wide range of executive dysfunctions than controls. As for the correlates, Cz peak amplitude of MMN correlated with inattention symptoms, executive dysfunctions, attentional vigilance (CCPT), and decision-making (CGT) in ADHD adults but only with decision-making in controls. Our findings that smaller amplitude of MMN and its differential associated pattern with inattention, real-world executive dysfunction, and decision-making, in drug-naive adults with ADHD from adult controls, provide evidence to support the potential electrophysiological biomarker for adult ADHD.
Highlights
Attention-deficit hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder that affects 11% of children in the USA (Centers for Disease Control and Prevention, 2016) and 7–9% in Taiwan (Chen, Chen, Lin, Shen, & Gau, 2019; Gau, Chong, Chen, & Cheng, 2005)
With regard to the real-world executive functions (BRIEF), attention performance (CCPT), and decision making (CGT), we found that compared to controls, attention-deficit hyperactivity disorder (ADHD) adults demonstrated poorer real-world executive functions on all domains assessed by Behavior Rating Inventory of Executive Function (BRIEF) (Table 2), and poorer performance in focused attention, impulsivity, and vigilance but no significant differences on decision-making assessed by Cambridge gambling test (CGT)
We found that the results of backward selection in the ADHD group were supported by the least absolute shrinkage and selection operator (Lasso) method with five-fold cross-validation, showing that metacognition index (MCI) of BRIEF, and Hit reaction time (RT) inter-stimulus interval (ISI) of Conners’ continuous performance test (CCPT) were predictive of Cz MMN amplitude in the ADHD group
Summary
Attention-deficit hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder that affects 11% of children in the USA (Centers for Disease Control and Prevention, 2016) and 7–9% in Taiwan (Chen, Chen, Lin, Shen, & Gau, 2019; Gau, Chong, Chen, & Cheng, 2005). We recruited 52 adults with ADHD (26.5 ± 6.2 years), and 62 age-matched controls (25.6 ± 5.6 years) They received the psychiatric interviews, auditory ERP, the Conners’ continuous performance test (CCPT), and the Cambridge gambling test (CGT). They completed the questionnaires about ADHD symptoms and real-world executive functions. Adults with ADHD demonstrated smaller Cz MMN amplitude, more severe ADHD symptoms, poorer attention profiles (CCPT), and a wide range of executive dysfunctions than controls. As for the correlates, Cz peak amplitude of MMN correlated with inattention symptoms, executive dysfunctions, attentional vigilance (CCPT), and decision-making (CGT) in ADHD adults but only with decision-making in controls. Our findings that smaller amplitude of MMN and its differential associated pattern with inattention, real-world executive dysfunction, and decision-making, in drug-naive adults with ADHD from adult controls, provide evidence to support the potential electrophysiological biomarker for adult ADHD
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