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

Clin Neurophysiol. 2014 Jul;125(7):1407-16. doi: 10.1016/j.clinph.2013.11.031. Epub 2013 Dec 7.

Abstract

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.

Keywords: Attention-deficit/hyperactivity disorder (ADHD); Event-related potential (ERP); Mindfulness-based cognitive therapy (MBCT); Performance monitoring system.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Analysis of Variance
  • Attention / physiology
  • Attention Deficit Disorder with Hyperactivity / diagnosis
  • Attention Deficit Disorder with Hyperactivity / physiopathology*
  • Attention Deficit Disorder with Hyperactivity / therapy*
  • Cognitive Behavioral Therapy / methods*
  • Electroencephalography
  • Evoked Potentials* / physiology
  • Female
  • Humans
  • Impulsive Behavior
  • Male
  • Middle Aged
  • Mindfulness*
  • Neurophysiological Monitoring / methods
  • Neuropsychological Tests
  • Reaction Time / physiology
  • Signal Processing, Computer-Assisted
  • Statistics as Topic
  • Young Adult