Overactive Performance Monitoring Research Articles

Neural indices of performance monitoring are associated with daily emotional functioning in youth with anxiety disorders: An ERP and EMA study

Excessive monitoring of one's performance is a characteristic of anxiety disorders that has been linked to alterations in implicit emotion regulation (ER), including elevations in neural measures of performance monitoring (i.e., error- and correct-related negativity; ERN and CRN). Elevations in ERN and CRN amplitudes have been reported consistently in anxiety disorders, suggesting that an overactive performance monitoring system is linked to ER difficulties in anxiety. Yet, the relevance of these lab-based neural measures for day-to-day emotional functioning remains poorly understood. This study examined the degree to which ERN and CRN amplitudes are associated with measures of daily ER difficulties in youth with anxiety disorders. Youth (N = 100, Mage = 11.14, SDage = 1.46) completed a computerized flanker task assessing the ERN and CRN. They then completed a 5-day ecological momentary assessment (EMA) protocol assessing their daily ER (i.e., intensity of momentary and peak negative affect, intensity of worry, reliance on maladaptive ER strategies). Results showed that more negative mean CRN amplitudes were associated with higher levels of negative emotional reactivity and more intense worries. There were no significant associations between ERN amplitude and EMA measures. Furthermore, elevations in CRN were linked to more frequent use of maladaptive ER strategies (i.e., rumination, physiological reactivity, avoidance). Together, results indicate that among youth with anxiety, individual differences in CRN, but not ERN, amplitudes are related to daily ER difficulties. Findings highlight the clinical utility of a lab-based neural measure of ER, suggesting that the CRN, rather than the ERN, reflects individual ER differences in the context of daily life among youth with pediatric anxiety disorders. As such, the CRN might serve as an important dimensional index of a treatment target that can be tracked with a validated, multi-method measure.

Non-invasive brain stimulation modulates neural correlates of performance monitoring in patients with obsessive-compulsive disorder

Overactive performance monitoring, as reflected by enhanced neural responses to errors (the error-related negativity, ERN), is considered a biomarker for obsessive-compulsive disorder (OCD) and may be a promising target for novel treatment approaches. Prior research suggests that non-invasive brain stimulation with transcranial direct current stimulation (tDCS) may reduce the ERN in healthy individuals, yet no study has investigated its efficacy in attenuating the ERN in OCD. In this preregistered, randomized, sham-controlled, crossover study, we investigated effects of tDCS on performance monitoring in patients with OCD (n = 28) and healthy individuals (n = 28). Cathodal and sham tDCS was applied over the presupplementary motor area (pre-SMA) in two sessions, each followed by electroencephalogram recording during a flanker task. Cathodal tDCS reduced the ERN amplitude compared to sham tDCS, albeit this effect was only marginally significant (p = .052; mean difference: 0.86 μV). Additionally, cathodal tDCS reduced the correct-response negativity and increased the error positivity. These neural modulations were not accompanied by behavioral changes. Moreover, we found no evidence that the tDCS effect was more pronounced in the patient group. In summary, our findings indicate that tDCS over the pre-SMA modulates neural correlates of performance monitoring across groups. Therefore, this study represents a valuable starting point for future research to determine whether repeated tDCS application induces a more pronounced ERN attenuation and normalizes aberrant performance monitoring in the long term, thereby potentially alleviating obsessive-compulsive symptoms and providing a psychophysiological intervention strategy for individuals who do not benefit sufficiently from existing interventions.

Enhanced error related negativity amplitude in medication-naïve, comorbidity-free obsessive compulsive disorder

Error monitoring and response inhibition is a key cognitive deficit in obsessive-compulsive disorder (OCD). Frontal midline regions such as the cingulate cortex and pre-supplementary motor area are considered critical brain substrates of this deficit. Electrophysiological equivalent of the above dysfunction is a fronto-central event related potential (ERP) which occurs after an error called the error related negativity (ERN). In this study, we sought to compare the ERN parameters between medication-naïve, comorbidity-free subjects with OCD and healthy controls (HC). Age, sex and handedness matched subjects with medication-naïve, comorbidity-free OCD (N = 16) and Healthy Controls (N = 17) performed a modified version of the flanker task while EEG was acquired for ERN. EEG signals were recorded from the electrodes FCz and Cz. Clinical severity of OCD was assessed using the Yale Brown Obsessive Compulsive Scale. The subjects with OCD had significantly greater ERN amplitude at Cz and FCz. There were no significant correlations between ERN measures and illness severity measures. Overactive performance monitoring as evidenced by enhanced ERN amplitude could be considered as a biomarker for OCD.

Pathophysiology of refractory obsessive-compulsive disorder: A study of visual search combined with overactive performance monitoring.

Based on both functional and structural studies of excessive activity, fronto-striatal-thalamic-cortical and cortico-striatal circuits have been hypothesized to underlie the pathophysiology of obsessive-compulsive disorder (OCD). However, the neurobiological underpinnings of OCD refractory to medication and therapy remain controversial. This study aimed to evaluate neuroanatomical abnormalities of the whole brain and to evaluate visual processing in patients with refractory OCD.This study was comprised of 2 experiments. The neuroanatomical abnormalities of the whole brain were evaluated using a visual search in combination with overactive performance monitoring (Experiment I), and visual processing was evaluated using event-related potentials recorded from subjects during performance of a visual search task. We also examined the amplitudes and latency of the error-related negativity (ERN) using a modified flanker task (Experiment II). Standard low-resolution electromagnetic tomography analysis was applied to determine the special areas.Patients with refractory OCD had a significantly greater number of saccades and prolonged latencies relative to the healthy controls. Scalp map topography confirmed that visual cognitive and executive dysfunction was localized to the fusiform gyrus. Furthermore, we found that during a modified flanker task, ERNs had a greater amplitude and a prolonged latency relative to those of the healthy controls. Further data analysis suggested that cognitive dysfunction and compulsive behavior in OCD patients were linked to abnormalities within the dorsolateral prefrontal cortex (DLPFC).We identified abnormal activities within the fusiform gyrus and DLPFC that likely play important roles in the pathophysiology of OCD.

Emotional interference modulates performance monitoring in patients with obsessive–compulsive disorder

BackgroundEnhanced performance monitoring in patients with obsessive–compulsive disorder (OCD), typically measured by error-related negativity (ERN), provides evidence for the fronto–striatal model of OCD. Here, we examined whether performance monitoring in OCD patients is modulated by emotional interference induced by task-irrelevant emotional stimuli. MethodsA modified version of the flanker task with emotional face stimuli (fearful vs. neutral faces) was performed by 22 OCD patients and 22 healthy control subjects while electroencephalogram signals were recorded. Response-locked ERN was defined as the mean amplitude from 20 to 120msec after the response. ResultsDuring trials with fearful face stimuli, OCD patients showed larger ERN amplitude than control subjects, but there was no difference between groups during trials with neutral face stimuli. Whereas OCD patients exhibited enhanced ERN amplitude in the fearful face condition compared with the neutral face condition, control subjects showed no variation between conditions. OCD patients also exhibited larger correct response negativity amplitude than control subjects in both fearful and neutral face conditions. ConclusionsThese results support the theory that OCD involves overactive performance monitoring and indicate that emotional interference modulates performance monitoring in patients with OCD, thus implying that affective function in the fronto–striatal network forms part of the neural basis of OCD.

Modulation of hyperactive error signals in obsessive-compulsive disorder by dual-task demands.

Brain correlates of performance-monitoring have been shown to be hyperactive in patients with obsessive-compulsive disorder (OCD), indexed by enhanced amplitudes of the error-related negativity (ERN) in the event-related potential (ERP). This hyperactivity was found to be temporally stable, independent of symptom remission, and could not be further increased by punishing committed errors. The current study examined whether the ERN in OCD is generally insensitive to modulatory influences or can be decreased by manipulation of task demands. Twenty-two OCD patients and 22 control participants performed a flanker task alone or with a concurrent n-back task to manipulate attentional resource allocation. Response-related ERP data were examined. OCD patients showed enhanced ERN-amplitudes in the standard flanker (ηp2 = .13). In both groups a significant decrease in ERN was found under dual-task conditions (ηp2 = .72) that was larger in the OCD group (ηp2 = .14), resulting in a nonsignificant ERN group difference in dual-task conditions. The current study replicated enhanced performance-monitoring in OCD as indexed by higher ERN-amplitudes. Importantly, it further showed a larger ERN-reduction with dual-task demands in patients compared to healthy participants. These results suggest that overactive performance-monitoring was normalized in patients with OCD by experimental conditions. Changing the attentional focus appears to be an effective strategy in modifying hyperactive error-signals in OCD and might be a target for innovative interventions.

Overactive Performance Monitoring Resulting from Chronic Exposure to High Altitude

The neural mechanisms underlying the influence of chronic exposure to high altitude on performance monitoring are not clear. We investigated performance monitoring in the context of chronic exposure to high altitude. A go/no-go task was used to obtain event-related potentials (ERP). The error-related negativity (ERN), correct-related negativity (CRN), and error positivity (Pe) components were measured in high-altitude and low-altitude groups. The high-altitude group had lived at high altitude for 3 yr, but were born and raised at low altitude, whereas the low-altitude group had lived at low altitude only. The ERN amplitudes were larger in the high-altitude group compared with the low-altitude group (-14.00 ± 8.34 μV vs. -7.82 ± 8.42 μV, respectively). Moreover, the CRN amplitudes were larger in the high-altitude group (3.51 ± 4.50 μV vs. 8.65 ± 3.23 μV, respectively). Group differences were not significant for the Pe component. These results suggest that chronic exposure to high altitude can cause overactive performance monitoring in the high-altitude group, but the later stage of error monitoring was not influenced.

Performance monitoring in obsessive-compulsive disorder and social anxiety disorder.

Overactive performance monitoring, indexed by greater error-related brain activity, has been frequently observed in individuals with obsessive-compulsive disorder (OCD). Similar alterations have been found in individuals with major depressive and generalized anxiety disorders. The main objective was to extend these findings by investigating performance monitoring in individuals with social anxiety disorder (SAD) and to evaluate the specificity of performance-monitoring changes in OCD. Event-related potentials were used to examine error-related brain activity during a flanker task in 24 individuals with OCD, 24 individuals with SAD, and 24 healthy controls with no history of neurological or psychiatric disorders. Error-related negativity (ERN) and correct-related negativity served as electrophysiological indicators for performance monitoring. Enhanced ERN was expected for both clinical groups, but differential associations with clinical symptoms were explored. ERN amplitudes were larger in individuals with OCD and SAD than in healthy controls. Correlational analyses did not reveal significant associations between ERN and clinical symptomatology in OCD, but a significant correlation with depressive symptoms was found in the SAD group. These findings further strengthen the idea that overactive performance monitoring is independent of clinical symptoms in OCD. Furthermore, it may also represent a transdiagnostic vulnerability indicator, although the relationship with clinical symptoms observed in the SAD group needs additional evaluation.

Overactive performance monitoring in obsessive–compulsive disorder is independent of symptom expression

Overactive performance monitoring has been consistently reported in obsessive-compulsive disorder (OCD). OCD is a clinically heterogeneous disorder and is characterized by several symptom dimensions that may have partially distinct neural correlates. We examined whether performance-monitoring alterations are related to symptom severity and symptom dimensions. Electrocortical correlates of performance monitoring were assessed in 72 OCD patients and 72 matched healthy comparison participants during a flanker task. Amplitudes of the error- and correct-related negativity as well as delta and theta power were used to quantify performance-monitoring activity, and a composite measure was derived using factor analysis. Symptom dimension scores were obtained from the Yale-Brown Obsessive Compulsive Scale symptom checklist. OCD patients showed increased electrocortical responses associated with correct and erroneous responses compared to healthy comparison participants. In patients, no correlations were obtained between performance monitoring and global symptom severity as well as lifetime symptom dimension scores. Only a statistical trend was found that higher symmetry/hoarding scores were associated with reduced performance-monitoring activity. For present symptom dimensions scores, an association with rituals/superstitious symptoms was obtained such that higher scores were associated with greater performance-monitoring activity. However, for both dimensions, subjects with low scores or high scores on each dimension were characterized by overactive performance monitoring compared to healthy controls. Overactive brain processes during performance monitoring are a neural correlate of OCD that is independent of global symptom severity and can be observed for all symptom dimensions. This supports the notion of overactive performance monitoring being a candidate endophenotype for OCD.

Performance monitoring in obsessive–compulsive disorder: A temporo-spatial principal component analysis

Hyperactive performance monitoring is a robust finding in obsessive-compulsive disorder (OCD). Patients show increased amplitudes of the error-related negativity (ERN) and correct-related negativity (CRN). Recently, two temporo-spatial factors were shown to contribute to both ERPs in healthy individuals. In the present study, it was investigated whether the factor structure underlying ERN and CRN is similar in OCD and which factors differ between groups. A principal component analysis (PCA) was employed to investigate the temporo-spatial factor structure of ERN and CRN. Twenty-six OCD patients and 26 healthy controls conducted a flanker task. EEG data were analyzed as conventional ERP components and as factor scores derived from temporo-spatial PCA. ERP results showed expected increases in ERN and CRN amplitudes in OCD patients. For both groups, the PCA confirmed the assumed factor structure of a central and a fronto-parietal factor contributing to ERN and CRN. Factor scores of both factors were differently affected by response correctness in OCD. Alterations in factor scores indicate increased activity in both an outcome-independent monitoring process and an error-sensitive process, contributing to overactive performance monitoring in OCD.

Neural correlates of feedback processing in obsessive–compulsive disorder.

Obsessive-compulsive disorder (OCD) patients show hyperactive performance monitoring when monitoring their own actions. Hyperactive performance monitoring is related to OCD symptomatology, like the unflexibility of compulsive behaviors, and was suggested as a potential endophenotype for the disorder. However, thus far the functioning of the performance monitoring system in OCD remains unclear in processes where performance is not monitored in one's own actions internally, but through external feedback during learning. The present study investigated whether electrocortical indicators of feedback processing are hyperactive, and whether feedback-guided learning is compromised in OCD. A modified deterministic four-choice object reversal learning task was used that required recurrent feedback-based behavioral adjustment in response to changing reward contingencies. Electrophysiological correlates of feedback processing (i.e. feedback-related negativity [FRN] and P300) were measured in 25 OCD patients and 25 matched healthy comparison subjects. Deficits in behavioral adjustment were found in terms of higher error rates of OCD patients in response to negative feedback. Whereas the FRN was unchanged for reversal negative feedback, it was reduced for negative feedback that indicated that a newly selected stimulus was still incorrect. The observed FRN reduction suggests attenuated monitoring of feedback during the learning process in OCD potentially contributing to a deficit in adaptive behavior reflected in obsessive thoughts and actions. The reduction of FRN amplitudes contrasts with overactive performance monitoring of self-generated errors. Nevertheless, the findings contribute to the theoretical framework of performance monitoring, suggesting a dissociation of processing systems for actions and feedback with specific alterations of these two systems in OCD.

Overactive Error-Related Brain Activity as a Candidate Endophenotype for Obsessive-Compulsive Disorder: Evidence From Unaffected First-Degree Relatives

Hyperactivity in frontal-striatal circuits is assumed to be involved in the pathophysiology of obsessive-compulsive disorder (OCD). In line with that, electrocortical correlates of overactive performance monitoring have been found to be associated with OCD independent from symptom state. The purpose of the present study was to elucidate whether overactive performance monitoring may represent a candidate endophenotype for OCD. In this case, unaffected first-degree relatives of OCD patients should also show this trait. Amplitudes of the error-related negativity and the correct-related negativity in the event-related brain potential during a flanker task were used to assess performance monitoring in three carefully matched groups: 30 patients with OCD, 30 unaffected first-degree relatives of OCD patients, and 30 healthy comparison subjects. Relative to the healthy comparison subjects, both unaffected first-degree relatives and OCD patients showed increased error-related brain potentials. No significant correlation was obtained between amplitudes and symptom severity measures, neither in patients nor in first-degree relatives. Increased error-related brain potentials were observed not only in OCD patients but also in unaffected first-degree relatives. Overactive error monitoring may reflect a trait marker for OCD that is independent of the presence of clinical symptoms. Thus, enhanced error-related brain activity represents a candidate neurocognitive endophenotype for OCD.

Overactive performance monitoring in obsessive-compulsive disorder: ERP evidence from correct and erroneous reactions

Obsessive-compulsive disorder (OCD) has repeatedly been associated with hyperactivity in fronto-striatal brain regions and regions related to performance monitoring. The aim of the current study was to further investigate electrophysiological correlates of performance monitoring. Specifically, we intended to replicate previous results revealing enhanced error-related negativity (ERN) amplitudes in OCD patients. Furthermore, we examined whether OCD patients also showed alterations regarding the correct-related negativity (CRN), the error positivity (Pe) and behavioural correlates of performance monitoring. Event-related brain potentials (ERPs) were recorded from a group of 20 OCD patients and 20 healthy control participants during a modified flanker task. Force sensitive response buttons were utilized to separate correct trials from incorrect trials with full and partial response activation. Both groups displayed substantial ERN and Pe amplitudes for full and partial errors. On error trials OCD patients showed enhanced ERN amplitudes, but group differences were not significant for the Pe and for behavioural adjustment. Further, the OCD group also exhibited enhanced CRN amplitudes and a correlation of frontal CRN amplitudes with symptom severity. These data provide further support for the view that performance monitoring is overactive in OCD. Further, since the amplitude enhancement is not specific to error processing, but is also observed for correct reactions, a response monitoring or evaluation process that contributes to both ERP components might be overactive in OCD. This is in line with fMRI results that revealed higher error- and conflict-related activity in the medial frontal cortex in OCD patients.