ERROR PROCESSING IN CLINICAL POPULATIONS IN CONTRAST TO ADHD J.J.VAN DER MEERE

Transcription

1 ERROR PROCESSING IN CLINICAL POPULATIONS IN CONTRAST TO ADHD J.J.VAN DER MEERE 1

2 THEORETICAL FRAMEWORK OF ERROR PROCESSING Mean RT x error x 500 ms x x x RTe+1 2

3 CEREBRAL PALSY an umbrella term covering a group of non-progressive, but often changing, motor impairment syndromes secondary to lesions or anomalies of the brain arising in the early stages of development new definition (2005): motor disorder is emphasized, other developmental disorders can accompany it 3

4 SPASTIC TYPES OF CEREBRAL PALSY (DIAGNOSIS IS BASED ON SYMPTOMS) diplegia hemiplegia quadriplegia white unaffected areas gray - mildly affected areas black - most affected areas 4

5 5

6 GROUP CHARACTERISTICS Patient FIQ VIQ PIQ GMFCS MACS Diagnosis Lesion site Prematurity Diplegia Bilateral Diplegia Bilateral Diplegia Bilateral Hemiplegia Bilateral Hemiplegia Unilateral Hemiplegia Bilateral Hemiplegia Bilateral Diplegia Bilateral Hemiplegia Unilateral Hemiplegia Unilateral Hemiplegia Unilateral Diplegia Bilateral Diplegia Bilateral Diplegia Bilateral + FIQ = Full-Scale Intelligence Quotient, VIQ = Verbal Intelligence Quotient, PIQ = Performance Intelligence Quotient, GMFCS = Gross Motor Function Classification System (score 1 = ambulatory, score 2 = some limitations in walking, score 3 = some assistive devices), MACS= Manual Ability Classification System (score 1 = average fine motor functionality, score 2 = some limitations, score 3 = pronounced limitations). Note: Intelligence was estimated using the Wechsler Intelligence Scale for Children-Third Edition. 6

7 EEG was recorded during the task performance. Frontal Central Parietal Midline 7

8 Encoding Reaction time Decision making 8

9 Cognitive model ERP component: N2 P3 CNV Encoding Memory Decision making Motor preparation Processing 9

10 The children were instructed to memorize the memory set of letters and to compare it with a diplay set. Does one or no letter of the memory set occur in the display set? 10

11 POSITIVE TRIAL 11

12 + 12

13 K 13

14 + 14

15 K P T V 15

16 The response was given by pressing the green yes button or red no button with a dominant hand. Yes No Hand position between the responses 16

17 Only correct responses were included CP black Control grey 17

18 18

19 Memory Mallikirjain set Display set Motor preparation 19

20 Conclusions The performance of the CP group was slower and more inaccurate compared to the controls ERP analyses, focused on correct responses, suggest that slowness in performance is not caused by the speed of evaluating the stimuli 20

21 The second study The brain state before, during, and after an error 21

22 REACTION TIMES C = correct response E = error response C C -C C E C Performance monitoring Preventing error-making Effort/cognitive control/action monitoring 22

23 BRAIN ACTIVATION STATE BEFORE ERROR MAKING C C -C C E The amplitude of the parietal P300 potential reflects the quality of stimulus evaluation therefore Error preceding trials are characterized by a smaller amplitude of the P300 potential 23

24 P300 AMPLITUDE ON TRIALS BEFORE ERROR MAKING Cognitive evaluation decreases towards the same extent before error making in the two groups 24

25 CONTINGENT NEGATIVE VARIATION The late part of this negative slow wave reflects Motor preparation Readiness to respond (Bereitschaftspotential) Stimulus anticipation Errors are preceded by a decrease of the late CNV 25

26 The late CNV amplitude becomes less negative one trial before error making in the patient group, indicating poor motor preparation 26

27 IN SUM: BRAIN ACTIVATION STATE BEFORE ERROR MAKING C C -C C E poor motor preparation 27

28 BRAIN ACTIVATION STATE DURING AND AFTER ERROR MAKING C C -C C E C Error awareness leads to performance improvement on the subsequent trial 28

29 RESPONSE-RELATED NEGATIVITY REFLECTING ERROR AWARENESS 29

30 RESPONSE-RELATED NEGATIVITY RRN most pronounced in patient group indicating full awareness of error making 30

31 AS A RESULT, PERFORMANCE IMPROVEMENT AFTERERROR AWARENESS IS MOST PRONOUNCED IN THE PATIENT GROUP Mean reaction time Also normalization of the motor preparation occurred after error making in the patient group 31

32 IN SUM Performance monitoring C E C poor normalizes Motor preparation 32

33 WHAT IS THE CNV? Key publication: van Rijn et al (2011). Frontiers in Integrative Neuroscience The CNV reflects unspecific preparatory activation Anticipating an event of interest It is mediated by cortical/basal ganglia/thalamus/cortical circuits 33

34 ERROR PROCESSING IN AUTISM AGAINST ADHD ms 700 ms RTE RT C conditie RTE+1 control ADHD Double dissociation between ADHD and HFA? RTE RTC RTE+1 conditie control HFA Bogte H et al., Post-error adaptation in adults with HFA. Neuropsychologia 2007,45. 34

35 WIERSEMA JR ET AL. ERP CORRELATES OF IMPAIRED ERROR MONITORING IN CHILDREN WITH ADHD. J.NEURAL TRANSMISSION 2005, 112. Children with ADHD showed less pronounced post-error slowing on Go/No-Go and S1-S2 task No difference in ERN but diminished Pe in ADHD ms 700 Cz [µv] ERN Pe Controls Correct RTE RTC RTE+1 control ADHD [ms] Controls Error ADHD Correct ADHD Error Intact error detection but abnormal response strategy adjustments and deviant conscious (emotional) evaluation of the error Possible ACC disturbance 35

36 BRAIN ACTIVITY AFTER ERROR MAKING Controls > ADHD ADHD > Controls Conclusion: brain activity after error making most pronounced in the control group Kooistra L. et al. Preliminary fmri findings on the effects of event rate in adults with ADHD. J Neural Transmission 2010,

37 END CONCLUSION Error monitoring, which is the most important skill in learning, is Intact in mild spastic CP Overactive in HFA Weak in ADHD 37