Effects of mindfulness-based cognitive therapy on neurophysiological correlates of performance monitoring in adult attention-deficit/hyperactivity disorder.

Author: Schoenberg PL1, Hepark S2, Kan CC2, Barendregt HP3, Buitelaar JK4, Speckens AE2.
Affiliation: 1Faculty of Science, Intelligent Systems, Radboud University Nijmegen, The Netherlands; Radboud University Nijmegen Medical Centre, Department of Cognitive Neuroscience, Nijmegen, The Netherlands. Electronic address: schoenberg@scientist.com. 2Department of Psychiatry, Radboud University Medical Centre, Nijmegen, The Netherlands. 3Faculty of Science, Intelligent Systems, Radboud University Nijmegen, The Netherlands. 4Department of Psychiatry, Radboud University Medical Centre, Nijmegen, The Netherlands; Radboud University Nijmegen Medical Centre, Department of Cognitive Neuroscience, Nijmegen, The Netherlands.
Conference/Journal: Clin Neurophysiol.
Date published: 2013 Dec 7
Other: Pages: S1388-2457(13)01228-5 , Special Notes: doi: 10.1016/j.clinph.2013.11.031 , Word Count: 239



OBJECTIVE:
To examine whether mindfulness-based cognitive therapy (MBCT) would enhance attenuated amplitudes of event-related potentials (ERPs) indexing performance monitoring biomarkers of attention-deficit/hyperactivity disorder (ADHD).
METHODS:
Fifty adult ADHD patients took part in a randomised controlled study investigating ERP and clinical measures pre-to-post MBCT. Twenty-six patients were randomly allocated to MBCT, 24 to a wait-list control. Main outcome measures included error processing (ERN, Pe), conflict monitoring (NoGo-N2), and inhibitory control (NoGo-P3) ERPs concomitant to a continuous performance task (CPT-X). Inattention and hyperactivity-impulsivity ADHD symptoms, psychological distress and social functioning, and mindfulness skills were also assessed.
RESULTS:
MBCT was associated with increased Pe and NoGo-P3 amplitudes, coinciding with reduced 'hyperactivity/impulsivity' and 'inattention' symptomatology. Specific to the MBCT; enhanced Pe amplitudes correlated with a decrease in hyperactivity/impulsivity symptoms and increased 'act-with-awareness' mindfulness skill, whereas, enhanced P3 correlated with amelioration in inattention symptoms.
CONCLUSIONS:
MBCT enhanced ERP amplitudes associated with motivational saliency and error awareness, leading to improved inhibitory regulation.
SIGNIFICANCE:
MBCT suggests having comparable modulation on performance monitoring ERP amplitudes as pharmacological treatments. Further study and development of MBCT as a treatment for ADHD is warranted, in addition to its potential scope for clinical applicability to broader defined externalising disorders and clinical problems associated with impairments of the prefrontal cortex.
Copyright © 2013 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.
KEYWORDS:
Attention-deficit/hyperactivity disorder (ADHD), Event-related potential (ERP), Mindfulness-based cognitive therapy (MBCT), Performance monitoring system

PMID: 24374088