Increased error-related brain activity in youth with obsessive-compulsive disorder and other anxiety disorders

Abstract

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.

Error-related brain activity in youth and young adults before and after treatment for generalized or social anxiety disorder

“…There is consistent evidence that OCD in youth and adults is characterized by an enhanced ERN (e.g., Carrasco et al, 2013b; Endrass and Ullsperger, 2014; Gehring et al, 2000). Importantly, there is also evidence that an enhanced ERN reflects an endophenotype or vulnerability for OCD, as it has been observed among unaffected first-degree relatives of patients with OCD (Carrasco et al, 2013a; Riesel et al, 2011), and has been shown to persist after completion of cognitive behavioral therapy (CBT) for OCD (Hajcak et al, 2008; Riesel et al, 2015).…”

“…Relatively little work has examined the ERN in specific anxiety disorders in youth. Though there is some evidence of an enhanced ERN in children and adolescents with GAD, these studies are limited to small samples with mixed anxiety disorders (Carrasco et al, 2013b; Ladouceur et al, 2006). In addition, several studies have found an enhanced ERN among children high in behavioral inhibition (BI; Lahat et al, 2014; McDermott et al, 2009), a temperamant style characterized by fearfulness and increased risk for anxiety disorders, particularly SAD (Hirshfeld-Becker et al, 2007).…”

“…Based on prior work in OCD (Hajcak et al, 2008; Riesel et al, 2015), we hypothesized that patients with anxiety disorders would exhibit an enhanced ERN relative to controls both before and after treatment. As studies of the ERN and anxiety in youth have typically included youth with mixed anxiety disorders (Carrasco et al, 2013b; Ladouceur et al, 2006; Meyer et al, 2015), we first examined the effects of both anxiety disorders on the ERN, with secondary exploratory analyses evaluating whether distinct patterns emerge for GAD and SAD examined separately.…”

Error related negativity and multi-source interference task in children with attention deficit hyperactivity disorder-combined type

“…Youths with OCD showed an increase in ERN amplitudes when compared with controls, treatment with serotonergic antidepressant or cognitive-behavioral therapy had no effects in ERN 11 .…”

Sending mixed signals: worry is associated with enhanced initial error processing but reduced call for subsequent cognitive control

“…Importantly, the successful recruitment of mPCF/lPFC-mediated control processes is inferred from post-error behavior such as slowed RTs and increased accuracy (Garavan et al, 2002;Kerns et al, 2004;Kerns, 2006;Hester et al, 2007;Danielmeier and Ullsperger, 2011;Schroder and Moser, 2014). The recruitment of cognitive control in anxiety, on the other hand, has generally been inferred from an enhanced ERN/ACC activity as anxiety (and worry in particular) is not reliably associated with posterror behavior (Hajcak and Simons, 2002;Hajcak et al, 2003;Hajcak et al, 2008;Hanna et al, 2012;Meyer et al, 2013;Moran et al, 2012;Weinberg et al, 2010Pourtois, 2010, 2012;Carrasco et al, 2013). This leads to the question 'if anxiety enhances error-related cognitive control processes (i.e.…”