The relation between executive functions, error-related brain activity, and ADHD symptoms in clinically evaluated school-aged children

ABSTRACT

Two event-related potentials (ERPs) elicited following errors, the error-related negativity (ERN) and error positivity (Pe), have been proposed to reflect cognitive control, though the specific processes remain debated. Few studies have examined the ERN and Pe’s relations with individual differences in cognitive control/executive functioning using well-validated tests administered separately from the inhibition tasks used to elicit the ERN/Pe. Additionally, neurocognitive tests of executive functions tend to strongly predict ADHD symptoms, but the extent to which task-based and EEG-based estimates of executive functioning/cognitive control account for the same variance in ADHD symptoms remains unclear. The current study addressed these limitations by examining relations between the ERN/Pe and three core executive functions (working memory, inhibitory control, set shifting) in a clinically-evaluated sample of 53 children ages 8–12 (M_age = 10.36, SD = 1.42; 77.4% White/Non-Hispanic; 16 girls) with and without ADHD. Results demonstrated that neither the ERN nor Pe were related to overall cognitive control/executive functioning, or to working memory or set shifting specifically (all 95%CIs include 0.0). In contrast, a larger Pe was associated with better-developed inhibitory control (β=-.35, 95%CI excludes 0.0), but did not capture aspects of inhibitory control that are important for predicting ADHD symptoms. Neither the ERN nor Pe predicted ADHD symptoms (95%CIs include 0.0). Results were generally robust to control for age, sex, SES, ADHD symptom cluster, and anxiety, and emphasize the need for caution when interpreting the ERN/Pe as indices of broad-based cognitive control/executive functioning, as well as using the ERN/Pe to examine cognitive processes contributing to ADHD symptomatology.

KEYWORDS:

• Error-related negativity
• error positivity
• executive function
• cognitive control
• ADHD

Disclosure statement

The principal investigator (Michael Kofler) holds a patent for a neurocognitive intervention that targets central executive working memory and is licensed to Sky Therapeutics, where Michael Kofler serves as consultant. This intervention was not used in the current study, and there are no other current licensing, financial, or other conflicts to report.

Supplementary data

Supplemental data for this article can be accessed at https://doi.org/10.1080/09297049.2023.2166029.

Notes

¹ Nigg (2017) concluded that cognitive control overlaps significantly with specific facets of executive function, particularly the core “lower-level” executive functions that appear first developmentally (working memory and response inhibition, followed by set shifting; Diamond, 2013; Karr et al., 2018; Nigg, 2017). The subtle distinction between the two terms is rooted in their development within different disciplines (Nigg, 2017). Given that cognitive control and executive functioning are closely related constructs from separate disciplines, we use the terms interchangeably in the present study. Relatedly, our use of the term “executive functions” is consistent with Nigg (2017)’s conceptualization of “lower-level executive functions,” which reflect the “core” executive functions in the Miyake et al. (2000) model (Kofler et al., 2019).

² Sensitivity analyses were conducted using Peak scores for the ERN and produced no deviations from the primary study analyses.

³ Sensitivity analyses were conducted using differences scores for the ERN and Pe (average voltage for error trials minus average voltage for correct trials) and produced no deviations from the primary study analyses.

⁴ Due to prior research demonstrating that generalized anxiety, social anxiety, and obsessive-compulsive disorders are most reliably associated with error-related neural activity (Meyer 2016), the models were also run only covarying the presence of these three disorders. The results were unchanged from those reported when anxiety disorder status was included as a covariate.

Additional information

Funding

This work was supported by NIH grant R01 MH115048 (PI: Kofler). The sponsor had no role in design and conduct of the study; collection, management, analysis, and interpretation of the data; or preparation, review, or approval of the manuscript.