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P300 deficits in adults with attention deficit hyperactivity disorder: a meta-analysis

  • B. Szuromi (a1), P. Czobor (a1) (a2), S. Komlósi (a1) and I. Bitter (a1)
Abstract
Background

The P300 (P3) event-related potential (ERP) component, a possible endophenotype for attention deficit hyperactivity disorder (ADHD), has been widely examined in children, but received little attention in adults. Our objective was to conduct a meta-analysis of P3 studies in adults with ADHD.

Method

We searched the Medline and PsycINFO databases for controlled studies examining both adult ADHD and matched healthy controls. Six relevant publications were identified for the meta-analysis, which had comparable data across studies with regard to the amplitude of ERP components related to target detection (P3, P3b). Pooled effect size (ES) for P3 amplitude as well as the association of the ES with age and gender were investigated using meta-regression.

Results

Comparing the ADHD group versus controls, the pooled effect size for a decrease in P3 amplitude was in the medium range (Cohen's d=−0.55, p=0.0006). Additionally, meta-regression revealed that decrease in P3 amplitude significantly varied with the mean age of ADHD patients (p=0.0087), with a gradual increasing of the difference at higher ages. Results also showed a significant association between the ES and gender, indicating a more pronounced reduction of P3 amplitude in the ADHD group versus controls when females were predominantly represented in the sample.

Conclusions

To our knowledge, this is the first meta-analysis of P3 characteristics in adults with ADHD. It reveals a significantly decreased P3 amplitude during target detection. Our result that the reduction in P3 amplitude increases with age is interpreted in a neurodevelopmental context.

Copyright
Corresponding author
*Address for correspondence: B. Szuromi, M.D., Department of Psychiatry and Psychotherapy, Semmelweis University, 1083 Budapest, Balassa u. 6, Hungary. (Email: szuromi@psych.sote.hu)
References
Hide All
Aston-Jones G, Cohen JD (2005). An integrative theory of locus coeruleus-norepinephrine function: adaptive gain and optimal performance. Annual Review of Neuroscience 28, 403450.
Banaschewski T, Brandeis D (2007). Annotation: what electrical brain activity tells us about brain function that other techniques cannot tell us – a child psychiatric perspective. Journal of Child Psychology and Psychiatry 48, 415435.
Barkley RA (2002). Major life activity and health outcomes associated with attention-deficit/hyperactivity disorder. Journal of Clinical Psychiatry 63 (Suppl. 12), 1015.
Barry RJ, Clarke AR, McCarthy R, Selikowitz M, Brown CR, Heaven PC (2009). Event-related potentials in adults with attention-deficit/hyperactivity disorder: an investigation using an inter-modal auditory/visual oddball task. International Journal of Psychophysiology 71, 124131.
Barry RJ, Johnstone SJ, Clarke AR (2003). A review of electrophysiology in attention-deficit/hyperactivity disorder: II. Event-related potentials. Clinical Neurophysiology 114, 184198.
Bekker EM, Overtoom CC, Kooij JJ, Buitelaar JK, Verbaten MN, Kenemans JL (2005). Disentangling deficits in adults with attention-deficit/hyperactivity disorder. Archives of General Psychiatry 62, 11291136.
Biederman J, Mick E, Faraone SV, Braaten E, Doyle A, Spencer T, Wilens TE, Frazier E, Johnson MA (2002). Influence of gender on attention deficit hyperactivity disorder in children referred to a psychiatric clinic. American Journal of Psychiatry 159, 3642.
Bledowski C, Prvulovic D, Goebel R, Zanella FE, Linden DE (2004 a). Attentional systems in target and distractor processing: a combined ERP and fMRI study. Neuroimage 22, 530540.
Bledowski C, Prvulovic D, Hoechstetter K, Scherg M, Wibral M, Goebel R, Linden DE (2004 b). Localizing P300 generators in visual target and distractor processing: a combined event-related potential and functional magnetic resonance imaging study. Journal of Neuroscience 24, 93539360.
Bouret S, Sara SJ (2005). Network reset: a simplified overarching theory of locus coeruleus noradrenaline function. Trends in Neurosciences 28, 574582.
Bramon E, Rabe-Hesketh S, Sham P, Murray RM, Frangou S (2004). Meta-analysis of the P300 and P50 waveforms in schizophrenia. Schizophrenia Research 70, 315329.
Bush G, Valera EM, Seidman LJ (2005). Functional neuroimaging of attention-deficit/hyperactivity disorder: a review and suggested future directions. Biological Psychiatry 57, 12731284.
Castellanos FX, Lee PP, Sharp W, Jeffries NO, Greenstein DK, Clasen LS, Blumenthal JD, James RS, Ebens CL, Walter JM, Zijdenbos A, Evans AC, Giedd JN, Rapoport JL (2002). Developmental trajectories of brain volume abnormalities in children and adolescents with attention-deficit/hyperactivity disorder. Journal of the American Medical Association 288, 17401748.
Castellanos FX, Margulies DS, Kelly C, Uddin LQ, Ghaffari M, Kirsch A, Shaw D, Shehzad Z, Di MA, Biswal B, Sonuga-Barke EJ, Rotrosen J, Adler LA, Milham MP (2008). Cingulate–precuneus interactions: a new locus of dysfunction in adult attention-deficit/hyperactivity disorder. Biological Psychiatry 63, 332337.
Cherkasova MV, Hechtman L (2009). Neuroimaging in attention-deficit hyperactivity disorder: beyond the frontostriatal circuitry. Canadian Journal of Psychiatry 54, 651664.
Corbetta M, Patel G, Shulman GL (2008). The reorienting system of the human brain: from environment to theory of mind. Neuron 58, 306324.
Dayan P, Yu AJ (2006). Phasic norepinephrine: a neural interrupt signal for unexpected events. Network 17, 335350.
DerSimonian R, Laird N (1986). Meta-analysis in clinical trials. Controlled Clinical Trials 7, 177188.
Dhar M, Been PH, Minderaa RB, Althaus M (2008). Distinct information processing characteristics in dyslexia and ADHD during a covert orienting task: an event-related potential study. Clinical Neurophysiology 119, 20112025.
Donchin E, Coles MGH (1988). Is the P300 component a manifestation of context updating? Behavioral and Brain Sciences 11, 357374.
Downar J, Crawley AP, Mikulis DJ, Davis KD (2002). A cortical network sensitive to stimulus salience in a neutral behavioral context across multiple sensory modalities. Journal of Neurophysiology 87, 615620.
Doyle AE, Willcutt EG, Seidman LJ, Biederman J, Chouinard VA, Silva J, Faraone SV (2005). Attention-deficit/hyperactivity disorder endophenotypes. Biological Psychiatry 57, 13241335.
Ehlis AC, Bahne CG, Jacob CP, Herrmann MJ, Fallgatter AJ (2008). Reduced lateral prefrontal activation in adult patients with attention-deficit/hyperactivity disorder (ADHD) during a working memory task: a functional near-infrared spectroscopy (fNIRS) study. Journal of Psychiatric Research 42, 10601067.
Fallgatter AJ, Brandeis D, Strik WK (1997). A robust assessment of the NoGo-anteriorisation of P300 microstates in a cued continuous performance test. Brain Topography 9, 295302.
Faraone SV, Biederman J, Spencer T, Wilens T, Seidman LJ, Mick E, Doyle AE (2000). Attention-deficit/hyperactivity disorder in adults: an overview. Biological Psychiatry 48, 9–20.
Ford JM, Sullivan EV, Marsh L, White PM, Lim KO, Pfefferbaum A (1994). The relationship between P300 amplitude and regional gray matter volumes depends upon the attentional system engaged. Electroencephalography and Clinical Neurophysiology 90, 214228.
Gilmore CS, Malone SM, Iacono WG (2010). Brain electrophysiological endophenotypes for externalizing psychopathology: a multivariate approach. Behavior Genetics , 186200.
Gershon J (2002). A meta-analytic review of gender differences in ADHD. Journal of Attention Disorders 5, 143154.
Gonsalvez CJ, Gordon E, Grayson S, Barry RJ, Lazzaro I, Bahramali H (1999). Is the target-to-target interval a critical determinant of P3 amplitude? Psychophysiology 36, 643654.
Hoffman LD, Polich J (1999). P300, handedness, and corpus callosal size: gender, modality, and task. International Journal of Psychophysiology 31, 163174.
Horovitz SG, Skudlarski P, Gore JC (2002). Correlations and dissociations between BOLD signal and P300 amplitude in an auditory oddball task: a parametric approach to combining fMRI and ERP. Magnetic Resonance Imaging 20, 319325.
Johnstone SJ, Barry RJ, Anderson JW, Coyle SF (1996). Age-related changes in child and adolescent event-related potential component morphology, amplitude and latency to standard and target stimuli in an auditory oddball task. International Journal of Psychophysiology 24, 223238.
Key AP, Dove GO, Maguire MJ (2005). Linking brainwaves to the brain: an ERP primer. Developmental Neuropsychology 27, 183215.
Kiehl KA, Laurens KR, Duty TL, Forster BB, Liddle PF (2001). Neural sources involved in auditory target detection and novelty processing: an event-related fMRI study. Psychophysiology 38, 133142.
Kiss I, Dashieff RM, Lordeon P (1989). A parieto-occipital generator for P300: evidence from human intracranial recordings. International Journal of Neuroscience 49, 133139.
Kok A (2001). On the utility of P3 amplitude as a measure of processing capacity. Psychophysiology 38, 557577.
Kok A, Ramautar JR, De Ruiter MB, Band GP, Ridderinkhof KR (2004). ERP components associated with successful and unsuccessful stopping in a stop-signal task. Psychophysiology 41, 9–20.
MacLaren VV, Taukulis HK, Best LA (2007). Inhibition in adults with attention deficit/hyperactivity disorder: event-related potentials in the stop task. Applied Psychophysiology and Biofeedback 32, 155162.
Makris N, Biederman J, Valera EM, Bush G, Kaiser J, Kennedy DN, Caviness VS, Faraone SV, Seidman LJ (2007). Cortical thinning of the attention and executive function networks in adults with attention-deficit/hyperactivity disorder. Cerebral Cortex 17, 13641375.
Makris N, Buka SL, Biederman J, Papadimitriou GM, Hodge SM, Valera EM, Brown AB, Bush G, Monuteaux MC, Caviness VS, Kennedy DN, Seidman LJ (2008). Attention and executive systems abnormalities in adults with childhood ADHD: a DT-MRI study of connections. Cerebral Cortex 18, 12101220.
McPherson DL, Salamat MT (2004). Interactions among variables in the P300 response to a continuous performance task in normal and ADHD adults. Journal of the American Academy of Audiology 15, 666677.
Nieuwenhuis S, Aston-Jones G, Cohen JD (2005). Decision making, the P3, and the locus coeruleus–norepinephrine system. Psychological Bulletin 131, 510532.
Polich J (2007). Updating P300: an integrative theory of P3a and P3b. Clinical Neurophysiology 118, 21282148.
Prox V, Dietrich DE, Zhang Y, Emrich HM, Ohlmeier MD (2007). Attentional processing in adults with ADHD as reflected by event-related potentials. Neuroscience Letters 419, 236241.
Rodriguez PD, Baylis GC (2007). Activation of brain attention systems in individuals with symptoms of ADHD. Behavioural Neurology 18, 115130.
Schiff S, Valenti P, Andrea P, Lot M, Bisiacchi P, Gatta A, Amodio P (2008). The effect of aging on auditory components of event-related brain potentials. Clinical Neurophysiology 119, 17951802.
Schulze KK, Hall MH, McDonald C, Marshall N, Walshe M, Murray RM, Bramon E (2008). Auditory P300 in patients with bipolar disorder and their unaffected relatives. Bipolar Disorders 10, 377386.
Shaw P, Eckstrand K, Sharp W, Blumenthal J, Lerch JP, Greenstein D, Clasen L, Evans A, Giedd J, Rapoport JL (2007). Attention-deficit/hyperactivity disorder is characterized by a delay in cortical maturation. Proceedings of the National Academy of Sciences USA 104, 1964919654.
Shaw P, Lerch J, Greenstein D, Sharp W, Clasen L, Evans A, Giedd J, Castellanos FX, Rapoport J (2006). Longitudinal mapping of cortical thickness and clinical outcome in children and adolescents with attention-deficit/hyperactivity disorder. Archives of General Psychiatry 63, 540549.
Shulman GL, McAvoy MP, Cowan MC, Astafiev SV, Tansy AP, d'Avossa G, Corbetta M (2003). Quantitative analysis of attention and detection signals during visual search. Journal of Neurophysiology 90, 33843397.
Simon V, Czobor P, Balint S, Meszaros A, Bitter I (2009). Prevalence and correlates of adult attention-deficit hyperactivity disorder: meta-analysis. British Journal of Psychiatry 194, 204211.
Smith ME, Halgren E, Sokolik M, Baudena P, Musolino A, Liegeois-Chauvel C, Chauvel P (1990). The intracranial topography of the P3 event-related potential elicited during auditory oddball. Electroencephalography and Clinical Neurophysiology 76, 235248.
Sowell ER, Peterson BS, Thompson PM, Welcome SE, Henkenius AL, Toga AW (2003). Mapping cortical change across the human life span. Nature Neuroscience 6, 309315.
Stanley JA, Kipp H, Greisenegger E, MacMaster FP, Panchalingam K, Keshavan MS, Bukstein OG, Pettegrew JW (2008). Evidence of developmental alterations in cortical and subcortical regions of children with attention-deficit/hyperactivity disorder: a multivoxel in vivo phosphorus 31 spectroscopy study. Archives of General Psychiatry 65, 14191428.
Steffensen SC, Ohran AJ, Shipp DN, Hales K, Stobbs SH, Fleming DE (2008). Gender-selective effects of the P300 and N400 components of the visual evoked potential. Vision Research 48, 917925.
Strik WK, Fallgatter AJ, Brandeis D, Pascual-Marqui RD (1998). Three-dimensional tomography of event-related potentials during response inhibition: evidence for phasic frontal lobe activation. Electroencephalography and Clinical Neurophysiology 108, 406413.
Taylor MJ (1988). Developmental changes in ERPs to visual language stimuli. Biological Psychology 26, 321338.
Toga AW, Thompson PM, Sowell ER (2006). Mapping brain maturation. Trends in Neurosciences 29, 148159.
Valera EM, Faraone SV, Murray KE, Seidman LJ (2007). Meta-analysis of structural imaging findings in attention-deficit/hyperactivity disorder. Biological Psychiatry 61, 13611369.
van Boxtel GJ, van der Molen MW, Jennings JR, Brunia CH (2001). A psychophysiological analysis of inhibitory motor control in the stop-signal paradigm. Biological Psychology 58, 229262.
van der Stelt O, Kok A, Smulders FT, Snel J, Boudewijn GW (1998). Cerebral event-related potentials associated with selective attention to color: developmental changes from childhood to adulthood. Psychophysiology 35, 227239.
van Houwelingen HC, Arends LR, Stijnen T (2002). Advanced methods in meta-analysis: multivariate approach and meta-regression. Statistics in Medicine 21, 589624.
Wiersema R, van der Meere J, Antrop I, Roeyers H (2006). State regulation in adult ADHD: an event-related potential study. Journal of Clinical and Experimental Neuropsychology 28, 11131126.
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