Electrophysiological indices of error monitoring in juvenile and adult attention deficit hyperactivity disorder (ADHD)—A meta-analytic appraisal

Attempts to identify the central disturbed processes explaining the overt symptoms of juvenile and adult ADHD rely heavily on the concept of deficient error monitoring processes. A number of studies have investigated event-related potentials (ERPs) and behavioral performance in tasks traditionally used to probe the interference control and inhibition of motor responses. The inspection of the error negativity (Ne/ERN) and error positivity (Pe) components evoked in these tasks has produced conflicting results with respect to the nature and extent of an error monitoring deficit in ADHD. A meta-analytic aggregation of these single studies should help develop a reliable appraisal of the evidence for the compromised performance monitoring processes in ADHD.Our meta-analysis was confined to studies of adult and juvenile ADHD participants examined in GoNogo and Flanker task studies that also reported the Ne/ERN and Pe ERP components. Only seven studies were suited for the meta-analysis, but their aggregation nevertheless led to clear results: Ne was attenuated in adult and adolescent ADHD participants for both tasks, and Pe was attenuated only in the GoNogo tasks. The ADHD participants made more errors than the controls in both tasks but responded slower only in the Flanker task.To our knowledge, this meta-analysis is the first to compare electrophysiological and behavioral indices of error monitoring in adult and juvenile ADHD patients and healthy controls. Admittedly, the data available for this comparison were sparse and heterogeneous; nevertheless, this meta-analysis produced salient results that indicate a monitoring deficit as a central feature of the ADHD syndrome.

► This meta-analysis found attenuated Ne/ERN and Pe in adult and juvenile ADHD. ► ERPs and behavioral indices revealed impaired error monitoring in ADHD patients. ► The Ne amplitude is consistently reduced in adult and juvenile ADHD. ► The Pe reduction is dependent on error awareness and task characteristics. ► Behavioral results are more consistent in Flanker tasks than in GoNogo tasks.