Abnormal centroparietal ERP response in predominantly medication-naive adolescent boys with ADHD during both response inhibition and execution

SUMMARY: Abnormal event-related potential (ERP) responses have been reported in children and adolescents with attention deficit hyperactivity disorder (ADHD) and a medication history compared with in healthy controls during tasks of response control and conflict inhibition. This study reports neurophysiologic correlates of a task dependent on these cognitive functions in a large, predominantly medication naive, group of adolescents with ADHD compared with that in healthy age- and intelligence quotient (IQ)-matched controls using area-under-the-curve (AUC) analysis. Fifty-four adolescents with ADHD and 55 healthy comparisons completed a hybrid conflict and response inhibition Go/NoGo ERP task. The performance data showed that children with ADHD compared with controls had deficits in both the inhibitory measures (higher commission errors) and the Go process of the task (slower reaction times and enhanced omission errors). The ERP data showed significant impairments in brain function in the ADHD relative to the control group for late, endogenous ERPs (N2, P3a, and P3b), whereas no group differences were found for the earlier P200. All findings remained when a minority of children with medication history was excluded. Furthermore, deficits were not specific to the inhibitory processes of the task but were equally observed during the execution functions. Group differences were particularly pronounced over central and centroparietal sites across all time points, presumably reflecting the midline attention system mediated by anterior and posterior cingulate that is important for generic, condition-independent visual-spatial attention and response selection processes. The findings demonstrate that adolescents with ADHD have abnormal ERP responses not only during inhibitory, but also execution-related processes and, furthermore, that these deficits are independent from medication history.