Hostname: page-component-78c5997874-j824f Total loading time: 0 Render date: 2024-11-17T13:11:47.578Z Has data issue: false hasContentIssue false
  • English
  • Français

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

Published online by Cambridge University Press:  20 October 2010

B. Szuromi ,
P. Czobor ,
S. Komlósi  and
I. Bitter
B. Szuromi*
Affiliation:
Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
P. Czobor
Affiliation:
Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA
S. Komlósi
Affiliation:
Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
I. Bitter
Affiliation:
Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
*
*Address for correspondence: B. Szuromi, M.D., Department of Psychiatry and Psychotherapy, Semmelweis University, 1083 Budapest, Balassa u. 6, Hungary. (Email: [email protected])
Get access Rights & Permissions [Opens in a new window]

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.

Keywords

ADHDadultagemeta-analysisP300
Type
Original Articles
Information
Psychological Medicine , Volume 41 , Issue 7 , July 2011 , pp. 1529 - 1538
Copyright
Copyright © Cambridge University Press 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aston-Jones, G, Cohen, JD (2005). An integrative theory of locus coeruleus-norepinephrine function: adaptive gain and optimal performance. Annual Review of Neuroscience 28, 403–450.CrossRefGoogle ScholarPubMed
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, 415–435.CrossRefGoogle Scholar
Barkley, RA (2002). Major life activity and health outcomes associated with attention-deficit/hyperactivity disorder. Journal of Clinical Psychiatry 63 (Suppl. 12), 10–15.Google ScholarPubMed
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, 124–131.CrossRefGoogle ScholarPubMed
Barry, RJ, Johnstone, SJ, Clarke, AR (2003). A review of electrophysiology in attention-deficit/hyperactivity disorder: II. Event-related potentials. Clinical Neurophysiology 114, 184–198.CrossRefGoogle ScholarPubMed
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, 1129–1136.CrossRefGoogle ScholarPubMed
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, 36–42.CrossRefGoogle ScholarPubMed
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, 530–540.CrossRefGoogle ScholarPubMed
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, 9353–9360.CrossRefGoogle ScholarPubMed
Bouret, S, Sara, SJ (2005). Network reset: a simplified overarching theory of locus coeruleus noradrenaline function. Trends in Neurosciences 28, 574–582.CrossRefGoogle Scholar
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, 315–329.CrossRefGoogle ScholarPubMed
Bush, G, Valera, EM, Seidman, LJ (2005). Functional neuroimaging of attention-deficit/hyperactivity disorder: a review and suggested future directions. Biological Psychiatry 57, 1273–1284.CrossRefGoogle ScholarPubMed
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, 1740–1748.CrossRefGoogle ScholarPubMed
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, 332–337.CrossRefGoogle ScholarPubMed
Cherkasova, MV, Hechtman, L (2009). Neuroimaging in attention-deficit hyperactivity disorder: beyond the frontostriatal circuitry. Canadian Journal of Psychiatry 54, 651–664.CrossRefGoogle ScholarPubMed
Corbetta, M, Patel, G, Shulman, GL (2008). The reorienting system of the human brain: from environment to theory of mind. Neuron 58, 306–324.CrossRefGoogle ScholarPubMed
Dayan, P, Yu, AJ (2006). Phasic norepinephrine: a neural interrupt signal for unexpected events. Network 17, 335–350.CrossRefGoogle ScholarPubMed
DerSimonian, R, Laird, N (1986). Meta-analysis in clinical trials. Controlled Clinical Trials 7, 177–188.CrossRefGoogle ScholarPubMed
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, 2011–2025.CrossRefGoogle ScholarPubMed
Donchin, E, Coles, MGH (1988). Is the P300 component a manifestation of context updating? Behavioral and Brain Sciences 11, 357–374.CrossRefGoogle Scholar
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, 615–620.CrossRefGoogle Scholar
Doyle, AE, Willcutt, EG, Seidman, LJ, Biederman, J, Chouinard, VA, Silva, J, Faraone, SV (2005). Attention-deficit/hyperactivity disorder endophenotypes. Biological Psychiatry 57, 1324–1335.CrossRefGoogle ScholarPubMed
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, 1060–1067.CrossRefGoogle ScholarPubMed
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, 295–302.CrossRefGoogle Scholar
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.CrossRefGoogle ScholarPubMed
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, 214–228.CrossRefGoogle ScholarPubMed
Gilmore, CS, Malone, SM, Iacono, WG (2010). Brain electrophysiological endophenotypes for externalizing psychopathology: a multivariate approach. Behavior Genetics , 186–200.CrossRefGoogle ScholarPubMed
Gershon, J (2002). A meta-analytic review of gender differences in ADHD. Journal of Attention Disorders 5, 143–154.CrossRefGoogle ScholarPubMed
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, 643–654.CrossRefGoogle ScholarPubMed
Hoffman, LD, Polich, J (1999). P300, handedness, and corpus callosal size: gender, modality, and task. International Journal of Psychophysiology 31, 163–174.CrossRefGoogle ScholarPubMed
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, 319–325.CrossRefGoogle Scholar
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, 223–238.CrossRefGoogle Scholar
Key, AP, Dove, GO, Maguire, MJ (2005). Linking brainwaves to the brain: an ERP primer. Developmental Neuropsychology 27, 183–215.CrossRefGoogle Scholar
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, 133–142.Google ScholarPubMed
Kiss, I, Dashieff, RM, Lordeon, P (1989). A parieto-occipital generator for P300: evidence from human intracranial recordings. International Journal of Neuroscience 49, 133–139.CrossRefGoogle ScholarPubMed
Kok, A (2001). On the utility of P3 amplitude as a measure of processing capacity. Psychophysiology 38, 557–577.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle Scholar
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, 155–162.CrossRefGoogle ScholarPubMed
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, 1364–1375.CrossRefGoogle ScholarPubMed
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, 1210–1220.CrossRefGoogle ScholarPubMed
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, 666–677.Google ScholarPubMed
Nieuwenhuis, S, Aston-Jones, G, Cohen, JD (2005). Decision making, the P3, and the locus coeruleus–norepinephrine system. Psychological Bulletin 131, 510–532.CrossRefGoogle ScholarPubMed
Polich, J (2007). Updating P300: an integrative theory of P3a and P3b. Clinical Neurophysiology 118, 2128–2148.CrossRefGoogle ScholarPubMed
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, 236–241.CrossRefGoogle ScholarPubMed
Rodriguez, PD, Baylis, GC (2007). Activation of brain attention systems in individuals with symptoms of ADHD. Behavioural Neurology 18, 115–130.CrossRefGoogle ScholarPubMed
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, 1795–1802.CrossRefGoogle ScholarPubMed
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, 377–386.CrossRefGoogle ScholarPubMed
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, 19649–19654.CrossRefGoogle ScholarPubMed
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, 540–549.CrossRefGoogle ScholarPubMed
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, 3384–3397.CrossRefGoogle ScholarPubMed
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, 204–211.CrossRefGoogle ScholarPubMed
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, 235–248.CrossRefGoogle ScholarPubMed
Sowell, ER, Peterson, BS, Thompson, PM, Welcome, SE, Henkenius, AL, Toga, AW (2003). Mapping cortical change across the human life span. Nature Neuroscience 6, 309–315.CrossRefGoogle ScholarPubMed
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, 1419–1428.CrossRefGoogle ScholarPubMed
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, 917–925.CrossRefGoogle ScholarPubMed
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, 406–413.CrossRefGoogle ScholarPubMed
Taylor, MJ (1988). Developmental changes in ERPs to visual language stimuli. Biological Psychology 26, 321–338.CrossRefGoogle ScholarPubMed
Toga, AW, Thompson, PM, Sowell, ER (2006). Mapping brain maturation. Trends in Neurosciences 29, 148–159.CrossRefGoogle ScholarPubMed
Valera, EM, Faraone, SV, Murray, KE, Seidman, LJ (2007). Meta-analysis of structural imaging findings in attention-deficit/hyperactivity disorder. Biological Psychiatry 61, 1361–1369.CrossRefGoogle ScholarPubMed
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, 229–262.CrossRefGoogle ScholarPubMed
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, 227–239.CrossRefGoogle ScholarPubMed
van Houwelingen, HC, Arends, LR, Stijnen, T (2002). Advanced methods in meta-analysis: multivariate approach and meta-regression. Statistics in Medicine 21, 589–624.CrossRefGoogle ScholarPubMed
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, 1113–1126.CrossRefGoogle ScholarPubMed