title: Increased error-related brain activity in pediatric obsessive-compulsive disorder before and after treatment.
abstract: OBJECTIVE
  The error-related negativity is a negative deflection in the event-related potential maximal approximately 50 msec after the commission of errors. The error-related negativity is generated in the anterior cingulate cortex, and both anterior cingulate cortex hyperactivity and increased error-related brain activity have been reported in adults with obsessive-compulsive disorder (OCD). However, no study to date, to the authors' knowledge, has examined error-related brain activity in pediatric patients with OCD, and no study has examined error-related brain activity in OCD both before and after treatment.
  
  
  METHODS
  The error-related negativity was measured in 18 treatment-seeking pediatric patients with OCD and 18 age-matched comparison subjects. Of these patients, 10 returned for a second testing session after cognitive behavior therapy; 13 comparison children participated a second time after a comparable interval.
  
  
  RESULTS
  In the pretreatment group, the error-related negativity was reliably larger in pediatric patients with OCD in relation to comparison subjects. This difference was also evident after treatment. There was no relationship between error-related negativity and symptom severity or changes in symptom severity.
  
  
  CONCLUSIONS
  Consistent with studies in adult patients, increased error-related brain activity is evident in pediatric patients with OCD. Furthermore, increased error-related brain activity does not appear to change as a function of symptom reduction after therapy. These results suggest that an increased error-related negativity may be a trait-like marker for psychopathology and might be a useful endophenotype.
authors.affiliation: Department of Psychology, Stony Brook University, Stony Brook, NY 11794-2500, USA. greg.hajcak@stonybrook.edu
authors.forename: Greg
authors.initials: G
authors.lastname: Hajcak
authors.forename: Martin E
authors.initials: ME
authors.lastname: Franklin
authors.forename: Edna B
authors.initials: EB
authors.lastname: Foa
authors.forename: Robert F
authors.initials: RF
authors.lastname: Simons
mesh_terms: D000293:Adolescent; D001921:Brain / Q000503:physiopathology*; D015928:Cognitive Behavioral Therapy / Q000379:methods; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004569:Electroencephalography / Q000706:statistics & numerical data; D005071:Evoked Potentials / Q000502:physiology*; D005260:Female; D006179:Gyrus Cinguli / Q000503:physiopathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D009048:Motor Skills / Q000502:physiology; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011597:Psychomotor Performance / Q000502:physiology*; D011930:Reaction Time / Q000502:physiology*; D012720:Severity of Illness Index; D013647:Task Performance and Analysis; D016896:Treatment Outcome; D014796:Visual Perception / Q000502:physiology