Brain Imaging and Behavior

, Volume 11, Issue 6, pp 1616–1628 | Cite as

Electrophysiological indices of aberrant error-processing in adults with ADHD: a new region of interest

  • Pál Czobor
  • Brigitta Kakuszi
  • Kornél Németh
  • Livia Balogh
  • Szilvia Papp
  • László Tombor
  • István Bitter
Original Research


Deficits in error-processing are postulated in core symptoms of ADHD. Our goal was to investigate the neurophysiological basis of abnormal error-processing and adaptive adjustments in ADHD, and examine whether error-related alterations extend beyond traditional Regions of Interest (ROIs), particularly to those involved in adaptive adjustments, such as the Salience Network system. We obtained event-related potentials (ERPs) during a Go/NoGo task from 22 adult-ADHD patients and 29 matched healthy controls using a high-density 256-electrode array. Error-related ERPs with error-negativity (ERN) and error-positivity (Pe) served as probes of error-processing. In ADHD patients both ERN and Pe were significantly reduced, and the reduction was associated with core psychopathological symptoms. The ERP-attenuation was prominent not only at traditional ROI-electrodes but across many other brain areas, with a distinctive subset of group-differences and symptom-correlations manifested at temporo-parietal sites, with right-lateralization. Source-localization uncovered two neural-sources for the error-related ERPs: one in the cingulate cortex near midline, which was present in both groups; and one in the right insular cortex, which was present only in the control group. The neural patterns of impairments may be the result of coexisting deficits in the dorsal midline error-processing brain network involved in “error-processing proper” and the right-lateralized temporo-parietal salience network involved in the evaluation of significance of the error-signals. Our source-localization findings potentially identify a missing link between the previously reported structural change, i.e., reduced insular volume, and the well-established behavioral deficits in ADHD.


ADHD Error-processing ERN Pe Response-locked ERP 



The authors would like to acknowledge the help of Bálint Szuromi and Attila Pulay for their participation in the recruitment and clinical examination of the subjects.

Compliance with ethical standards

Financial disclosures

Supported by the Hungarian National Brain Research Program (KTIA_NAP_13–1–2013-0001 project).

Conflict of interest

Authors P. Czobor, B. Kakuszi, K. Németh, L. Balogh, S. Papp, L. Tombor and I. Bitter declare that they have no conflict of interest.

Informed consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, and the applicable revisions at the time of the investigation. Informed consent was obtained from all patients for being included in the study.


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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Pál Czobor
    • 1
  • Brigitta Kakuszi
    • 1
  • Kornél Németh
    • 1
  • Livia Balogh
    • 1
  • Szilvia Papp
    • 1
  • László Tombor
    • 1
  • István Bitter
    • 1
  1. 1.Department of Psychiatry and PsychotherapySemmelweis UniversityBudapestHungary

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