The British Journal of Psychiatry Aug 2015

Cognitive and neurophysiological markers of ADHD persistence and remission

Celeste H. M. Cheung, Fruhling Rijsdijk, Gráinne McLoughlin, Daniel Brandeis, Tobias Banaschewski, Philip Asherson, Jonna Kuntsi

DOI: 10.1192/bjp.bp.114.145185

Abstract

Background
Attention-deficit hyperactivity disorder (ADHD) persists in around two-thirds of individuals in adolescence and early adulthood.

Aims
To examine the cognitive and neurophysiological processes underlying the persistence or remission of ADHD.

Method
Follow-up data were obtained from 110 young people with childhood ADHD and 169 controls on cognitive, electroencephalogram frequency, event-related potential (ERP) and actigraph movement measures after 6 years.

Results
ADHD persisters differed from remitters on preparation-vigilance measures (contingent negative variation, delta activity, reaction time variability and omission errors), IQ and actigraph count, but not on executive control measures of inhibition or working memory (nogo-P3 amplitudes, commission errors and digit span backwards).

Conclusions
Preparation-vigilance measures were markers of remission, improving concurrently with ADHD symptoms, whereas executive control measures were not sensitive to ADHD persistence/remission. For IQ, the present and previous results combined suggest a role in moderating ADHD outcome. These findings fit with previously identified aetiological separation of the cognitive impairments in ADHD. The strongest candidates for the development of non-pharmacological interventions involving cognitive training and neurofeedback are the preparation-vigilance processes that were markers of ADHD remission.