title: Alcohol dependence and anxiety increase error-related brain activity.
abstract: OBJECTIVE
  Detection of errors is crucial for efficient goal-directed behaviour. The ability to monitor behaviour is found to be diminished in patients with substance dependence, as reflected in decreased error-related brain activity, i.e. error-related negativity (ERN). The ERN is also decreased in other psychiatric disorders with impaired response inhibition, such as attention-deficit hyperactivity disorder and borderline personality disorder, but increased in anxiety disorders. The objective of the current study was to assess error monitoring in alcohol-dependent patients in relation to psychiatric comorbidity. We expected decreased error monitoring in alcohol-dependent patients with impulse control disorders and increased error monitoring in anxious alcohol-dependent patients.
  
  
  METHODS
  In a case-control design alcohol-dependent patients were compared with healthy controls.
  
  
  METHODS
  A consecutive series of 29 male alcohol-dependent patients, between 18 and 55 years of age, applying for in-patient detoxification were recruited at Novadic Kentron Center for Addiction Treatment. Fifteen age-matched healthy controls were recruited through advertisements in regional newspapers.
  
  
  METHODS
  Event-related potentials were recorded while performing a speeded choice-reaction task, from which ERN amplitudes were calculated. Axis-I and -II psychiatric comorbidity were assessed using the MINI International Neuropsychiatric Interview and the Structured Interview for DSM-IV Personality disorders. All participants completed the Temperament and Character Inventory and Profile of Mood States.
  
  
  RESULTS
  ERN amplitudes were increased for alcohol-dependent patients compared to healthy controls, particularly in patients with comorbid anxiety disorders.
  
  
  CONCLUSIONS
  Increased error monitoring in alcohol-dependent patients, particularly those with comorbid anxiety disorders, is in contrast with previous studies that suggested decreased error monitoring to be a general feature in substance use disorders. Psychiatric disorders co-occurring with alcohol dependence, such as anxiety disorders, may indicate subpopulations of alcohol-dependent patients, with distinct neurobiological and genetic characteristics, possibly requiring different treatment strategies.
authors.affiliation: Department of Psychiatry, University Medical Centre St Radboud, Nijmegen, the Netherlands.
authors.forename: Arnt F A
authors.initials: AF
authors.lastname: Schellekens
authors.forename: Ellen R A
authors.initials: ER
authors.lastname: de Bruijn
authors.forename: Christa A A
authors.initials: CA
authors.lastname: van Lankveld
authors.forename: Wouter
authors.initials: W
authors.lastname: Hulstijn
authors.forename: Jan K
authors.initials: JK
authors.lastname: Buitelaar
authors.forename: Cor A J
authors.initials: CA
authors.lastname: de Jong
authors.forename: Robbert J
authors.initials: RJ
authors.lastname: Verkes
mesh_terms: D000293:Adolescent; D000328:Adult; D000437:Alcoholism / Q000503:physiopathology* / Q000523:psychology; D001007:Anxiety / Q000503:physiopathology; D001008:Anxiety Disorders / Q000503:physiopathology* / Q000523:psychology; D016022:Case-Control Studies; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000503:physiopathology / Q000523:psychology; D004569:Electroencephalography; D005071:Evoked Potentials; D006179:Gyrus Cinguli / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D010552:Personality Assessment / Q000706:statistics & numerical data; D011930:Reaction Time; D055815:Young Adult