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

• Published in: Child neuropsychology 2023-11, Vol.29 (8), p.1362-1387
• Main Authors: Marsh, Carolyn L., Groves, Nicole B., Mehra, Lushna M., Black, Katie E., Irwin Harper, Lauren N., Meyer, Alexandria, Kofler, Michael J.
• Format: Article
• Language: English
• Subjects: ADHD; Attention Deficit Disorder with Hyperactivity - psychology; Brain; Child; cognitive control; Electroencephalography - methods; error positivity; Error-related negativity; Evoked Potentials - physiology; executive function; Executive Function - physiology; Female; Humans
• ISSN: 0929-7049; 1744-4136; 1744-4136
• DOI: 10.1080/09297049.2023.2166029

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.