Mismatch negativity and P3a in drug-naive adults with attention-deficit hyperactivity disorder

Abstract

Background Individuals with attention-deficit hyperactivity disorder (ADHD) often display over-response to stimuli that are irrelevant to the ongoing task, and their attentional abilities disproportionately worsen in the presence of competing stimuli. Auditory event-related potentials (ERPs) such as mismatch negativity (MMN) and P3a using the passive oddball paradigm have been studied in children and adolescents with ADHD. Still, there is no such data for adults with ADHD. This study aimed to compare the MMN and P3a and their clinical and neurocognitive correlations between drug-naive adults with ADHD and control adults. Methods We recruited 52 adults with ADHD (26.5 ± 6.2 years), and 62 age-matched controls (25.6 ± 5.6 years). They received the psychiatric interviews, auditory ERP, the Conners' continuous performance test (CCPT), and the Cambridge gambling test (CGT). They also completed the questionnaires about ADHD symptoms and real-world executive functions. MMN and P3a were assessed during a passive duration-deviant auditory oddball paradigm from the midline electrodes Cz. Results Adults with ADHD demonstrated smaller Cz MMN amplitude, more severe ADHD symptoms, poorer attention profiles (CCPT), and a wide range of executive dysfunctions than controls. As for the correlates, Cz peak amplitude of MMN correlated with inattention symptoms, executive dysfunctions, attentional vigilance (CCPT), and decision-making (CGT) in ADHD adults but only with decision-making in controls. Conclusions Our findings that smaller amplitude of MMN and its differential associated pattern with inattention, real-world executive dysfunction, and decision-making, in drug-naive adults with ADHD from adult controls, provide evidence to support the potential electrophysiological biomarker for adult ADHD.

Conner’s Continuous Performance Test and Adult ADHD: A Systematic Literature Review

“…More research is needed on older adult population to determine whether the CCPT is generally effective at discriminating ADHD from normative, age-related cognitive changes. Additionally, with few exceptions (Alaghband-Rad et al, 2021; Hsieh et al, 2021; Mesquita et al, 2016; Ni et al, 2016; Schweiger et al, 2007; Shang et al, 2018), most of the studies were conducted on a Caucasian, Westernized population. It is necessary for future studies to target a diverse pool of racial/ethnic participants to discover any cultural variances in CCPT performance in adults with ADHD from differing cultures.…”

“…While some studies found no significant differences in the CCPT subscales with one comparison group (e.g., Alaghband-Rad et al, 2021;Kovner et al, 1998;Solanto et al, 2004), other studies examining differences between ADHD and control participants without ADHD have found between 4 and 9 significant differences in CCPT subscales (Cohen & Shapiro, 2007;Hsieh et al, 2021;Weyandt et al, 2017). Fasmer et al (2016) used the CPT-II to distinguish between patients with ADHD versus those with other psychiatric diagnoses.…”

Can biomarkers be used to diagnose attention deficit hyperactivity disorder?

“…Adult ADHD patients showed significantly lower arousal levels and substantially less stable brain arousal regulation than controls ( 15 ). Compared with adult controls, it was also observed that a smaller amplitude of mismatch negativity and its differential associated pattern with inattention, real-world executive dysfunction, and poor decision-making ability in drug-naive adults with ADHD ( 16 ).…”

Short-term neuronal and synaptic plasticity act in synergy for deviance detection in spiking networks

“…DD has been studied widely across sensory systems including the auditory [3,7,8], visual [9,10], somatosensory [11] domains and beyond. Impairments in DD have been reported in various disorders [4], including autism [12][13][14][15][16], schizophrenia [17][18][19][20], ADHD [21][22][23] and others, highlighting the need to better understand its mechanistic underpinnings.…”