title: Attention-Deficit/Hyperactivity Disorder Remission Is Linked to Better Neurophysiological Error Detection and Attention-Vigilance Processes.
abstract: The processes underlying persistence and remission of attention-deficit/hyperactivity disorder (ADHD) are poorly understood. We examined whether cognitive and neurophysiological impairments on a performance-monitoring task distinguish between ADHD persisters and remitters.
  
  
  
  On average 6 years after initial assessment, 110 adolescents and young adults with childhood ADHD (87 persisters, 23 remitters) and 169 age-matched control participants were compared on cognitive-performance measures and event-related potentials of conflict monitoring (N2) and error processing (error-related negativity and positivity) from an arrow flanker task with low-conflict and high-conflict conditions. ADHD outcome was examined with parent-reported symptoms and functional impairment measures using a categorical (DSM-IV) and a dimensional approach.
  
  
  
  ADHD persisters were impaired compared with controls on all cognitive-performance and event-related potential measures (all p < .05). ADHD remitters differed from persisters and were indistinguishable from control participants on the number of congruent (low-conflict) errors, reaction time variability, error-related negativity, and error-related positivity (all p ≤ .05). Remitters did not differ significantly from the other groups on incongruent (high-conflict) errors, mean reaction time, and N2. In dimensional analyses on all participants with childhood ADHD, ADHD symptoms and functional impairment at follow-up were significantly correlated with congruent errors, reaction time variability, and error-related positivity (r = .19-.23, p ≤ .05).
  
  
  
  Cognitive and neurophysiological measures of attention-vigilance and error detection distinguished ADHD remitters from persisters. These results extend our previous findings with other tasks and indicate that such measures are markers of remission and candidates for the development of nonpharmacological interventions.
authors: MRC Social, Genetic and Developmental Psychiatry Centre, London, United Kingdom.
authors: Giorgia
authors: G
authors: Michelini
authors: MRC Social, Genetic and Developmental Psychiatry Centre, London, United Kingdom; Department of Psychological Medicine, London, United Kingdom.
authors: Glenn L
authors: GL
authors: Kitsune
authors: Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Department of Psychological Sciences, Centre for Brain and Cognitive Development, Birkbeck, University of London, London, United Kingdom.
authors: Celeste H M
authors: CH
authors: Cheung
authors: Department of Child and Adolescent Psychiatry and Psychotherapy , Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany; Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, Zurich, Switzerland; Center for Integrative Human Physiology, Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich, Zurich, Switzerland.
authors: Daniel
authors: D
authors: Brandeis
authors: Department of Child and Adolescent Psychiatry and Psychotherapy , Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany.
authors: Tobias
authors: T
authors: Banaschewski
authors: MRC Social, Genetic and Developmental Psychiatry Centre, London, United Kingdom.
authors: Philip
authors: P
authors: Asherson
authors: MRC Social, Genetic and Developmental Psychiatry Centre, London, United Kingdom.
authors: Gráinne
authors: G
authors: McLoughlin
authors: MRC Social, Genetic and Developmental Psychiatry Centre, London, United Kingdom. Electronic address: jonna.kuntsi@kcl.ac.uk.
authors: Jonna
authors: J
authors: Kuntsi
mesh_terms: D000293:Adolescent; D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications / Q000503:physiopathology*; D060825:Cognitive Dysfunction / Q000209:etiology / Q000503:physiopathology*; D018450:Disease Progression; D004569:Electroencephalography; D005071:Evoked Potentials / Q000502:physiology*; D056344:Executive Function / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011597:Psychomotor Performance / Q000502:physiology*; D012074:Remission Induction; D055815:Young Adult
keywords: ADHD; Cognitive impairments; EEG; Event-related potentials; Persistence; Remission