Increased error-related brain potentials were observed not only in pediatric OCD patients but also in unaffected siblings. The results provide evidence that enhanced error-related brain activity may serve as a biomarker for OCD in youth that is independent of the presence of clinical symptoms. The ERN may be a useful quantitative phenotype in genetic studies of OCD.

Objective The error-related negativity (ERN) is a negative deflection in the event-related potential following an incorrect response, which is often increased in patients with obsessive-compulsive disorder (OCD). However, the relationship of the ERN to comorbid tic disorders has not been examined in patients with OCD. This study compared ERN amplitudes in patients with tic-related OCD, patients with non-tic-related OCD, and healthy controls. Method The ERN, correct response negativity, and error number were measured during an Eriksen flanker task to assess performance monitoring in 44 youth with a lifetime diagnosis of OCD and 44 matched healthy controls ranging in age from 10 to 19 years. Nine youth with OCD had a lifetime history of tics. Results ERN amplitudewas significantly increased in OCD patients compared to healthy controls. ERN amplitude was significantly larger in patients with non-tic-related OCD than either patients with tic-related OCD or controls. ERN amplitude had a significant negative correlation with age in healthy controls but not patients with OCD. Instead, in patients with non-tic-related OCD, ERN amplitude had a significant positive correlation with age at onset of OCD symptoms. ERN amplitude in patients was unrelated to OCD symptom severity, current diagnostic status, or treatment effects. Conclusions The results provide further evidence of increased error-related brain activity in pediatric OCD. The difference in the ERN between patients with tic-related and non-tic-related OCD provides preliminary evidence of a neurobiological difference between these two OCD subtypes. The results indicate the ERN is a trait-like measure that may serve as a biomarker for non-tic-related OCD.

The error-related negativity (ERN) is a negative deflection in the event-related potential after an incorrect response that is thought to reflect activity in the anterior cingulate cortex (ACC) and is often increased in patients with anxiety disorders. This study measured the ERN and correct response negativity (CRN) during an Eriksen flanker task to assess performance monitoring in 26 youth with obsessive-compulsive disorder (OCD), 13 youth with a non-OCD anxiety disorder consisting of either generalized anxiety disorder or separation anxiety disorder, and 27 age-matched healthy controls ranging in age from 8 to 16 years. Compared to healthy controls, ERN amplitude was significantly increased in patients with either OCD or a non-OCD anxiety disorder. There were no significant group differences in CRN amplitude. Treatment with a serotonergic antidepressant or cognitive-behavior therapy had no effect on the ERN in patients. Scores from the Child Behavior Checklist DSM-oriented anxiety problems scale had a significant correlation with ERN amplitude in all subjects. The results provide further evidence that the pathophysiology of OCD and some non-OCD anxiety disorders involves increased ACC activity and that the ERN may serve as a quantitative phenotype in genetic and longitudinal studies of these complex traits.

GMCs were found disproportionately among persons with bipolar I disorder and associated with significant impairments in health and psychosocial functioning. Health care providers should screen for and treat GMCs in service populations including persons with bipolar disorder, given the heightened rates of morbidity, mortality, and disability that attend untreated GMCs in this client group. Integrated and collaborative treatment approaches could significantly improve overall functioning and quality of life for persons with this treatable disorder.