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The objective of this study was to investigate the effects of methylphenidate (MPH) on attention and inhibition in children with Attention Deficit Hyperactivity Disorder (ADHD) and to establish what the relative contributions of the noradrenergic and dopaminergic systems to this effect were. In addition to MPH, two other drugs were administered in order to affect both transmitter systems more selectively, L-dopa (dopamine (DA) agonist) and desipramine (DMI) (noradrenaline (NA) re-uptake inhibitor). Sixteen children with ADHD performed a stop-task, a laboratory task that measures the ability to inhibit an ongoing action, in a double-blind randomized within-subjects design. Each child received an acute clinical dose of MPH, DMI, L-dopa, and placebo; measures of performance and plasma were determined. The results indicated that inhibition performance was improved under DMI but not under MPH or L-dopa. The response-time to the stop-signal was marginally shortened after intake of DMI. MPH decreased omission and choice-errors and caused faster reaction times to the trials without the stop-tone. No effects of L-dopa whatsoever were noted. Prolactin levels were increased and 5-HIAA levels were lowered under DMI relative to placebo. It is suggested that the effects of MPH on attention are due to a combination of noradrenergic and dopaminergic mechanisms. The improved inhibition under DMI could be serotonergically mediated.

In the present study it was investigated whether the smaller P3s in attention-deficit hyperactivity disorder (ADHD) children are caused by a shortage of capacity underlying P3 processes or whether they are due to a capacity allocation problem. Also, effects of methylphenidate on these processes were investigated. Performance and event-related potentials (ERPs) of 14 ADHD and 14 control children were measured using an irrelevant-probe technique. Three types of task irrelevant visual probes (standards, deviants, and novels) were presented against the background of two visual tasks that varied in task difficulty. The parietal P3 wave was measured in response to task stimuli and probes. ADHD subjects made significantly fewer correct detections than normal controls in both the easy and the hard tasks. Controls showed an enhanced P3 to task-relevant stimuli in the hard task, whereas ADHD children did not. Probe (novel) P3 amplitudes decreased from the easy to the hard task to the same extent in both groups. Methylphenidate enhanced the percentage of correct responses and task P3 amplitudes in both the easy and the hard task but probe P3 amplitudes were not influenced by methylphenidate. It was concluded that ADHD children do not suffer from a shortage in attentional capacity; rather, the evidence is in favor of a problem with capacity allocation. Furthermore, methylphenidate had enhancing effects on performance and ERPs, but did not improve the capacity-allocation deficit.

Objectives: First, to differentiate between inattention and impulsivity based on type of errors made in the AX version of the Continuous Performance Task (CPT), and second, to investigate whether differences in performance between children with attention-deficit hyperactivity disorder (ADHD) and normal controls also occur in specific forms of brain activity, namely event-related potentials (ERPs), presumably related to inattention and impulsivity or inhibition., Method: Sixteen ADHD and 16 normal control children performed the CPT-AX. ERPs were recorded at occipital (Oz), parietal (Pz), central (Cz), and frontal (Fz) leads., Results: The ADHD children had a higher CPT-Inattention score and showed smaller parietal positive waves at a latency of approximately 300 msec in reaction to target stimuli, target P3s, likewise indicating less attention. In contrast, they showed neither higher CPT-Impulsivity nor a smaller frontocentral negative wave at about 200 msec (N2); the N2 is generally seen as reflecting inhibition. A subgroup of children with ADHD and oppositional defiant disorder (n = 6) had smaller N2 waves than controls, however., Conclusions: The ADHD group studied showed deficits in attention but not in impulsivity (or inhibition).

Attention-deficit hyperactivity disorder (ADHD) children participated in a double-blind placebo-controlled study in which the effects of a dosage of 15 mg methylphenidate (MPH) on auditory and visual selective attention tasks was determined by presenting frequent (90%) and infrequent (10%) stimuli in both relevant and irrelevant input channels. The subject's task was to respond to the infrequent tones in the relevant input channel. Processing activity (negativity and positivity) was assessed for both tasks. N1, P2, N2, and P3b peaks were scored in the auditory task and N1, P1, N2, P2, P3(1), and P3b peaks were scored in the visual task. Effects of MPH were more prevalent in the visual than in the auditory condition. In the visual condition MPH enhanced the percentage of hits, caused higher central, parietal, and occipital P3b amplitudes to attended stimuli (both standards and deviants), and also enhanced the frontal processing negativity (PN). In the auditory task MPH did not influence performance, but it enhanced the frontal PN as well as the parietal and occipital P3b amplitudes to all stimulus types. In ADHD children, MPH ameliorates some, but not all, deficits and also improves processing where no differences with normal children are present.

Attention-deficit hyperactivity disorder (ADHD) children and normal controls (7-13 yrs old) performed an auditory and visual selective attention task. Subjects were instructed to respond to the infrequent (10%) stimuli in the relevant channel. Processing negativity (PN) and several other ERP peaks were scored at the midline electrodes. In the auditory task, controls had more correct detections (hits), less false alarms, larger P3b amplitudes to nontarget stimuli (but not to hits), a larger central PN and larger early frontal positivity (100-250 ms) to target stimuli than ADHD subjects. In the visual modality, controls had more correct detections, less false alarms, larger P3b amplitudes to nontarget stimuli (but not to hits), and larger frontal P3(1) amplitudes to infrequent than to frequent stimuli. It was hypothesized that in ADHD children in both the auditory and the visual task, there is a deficit in the activation of the P3b process. Incorrect triggering of the P3b process might be caused by disturbances in other aspects of the attention process, preceding the P3b.

A recent review of the Continuous Performance Task (CPT) as a research tool by Corkum and Siegel, Journal of Child Psychology and Psychiatry, 34, 1217-1239, 1993, is criticized for insufficient covering of the relevant literature, disregard of the question of differentiation among clinical groups, and inadequacy of explanations of Attention-Deficit-Hyperactivity Disorder (ADHD) in terms of arousal, activation, and effort. An attention-deficit in ADHD children cannot be inferred from poor performance on a CPT. Impaired performance is anything but specific to ADHD children and is caused by a host of variables among which "attention" probably plays a minor role.

Although it has frequently been reported that hyperactive children have abnormally small P3 amplitudes of the event-related potential (ERP), which are normalized by the stimulant drug methylphenidate (MPH), the literature is inconsistent concerning earlier ERP waves. The aim of the present study was to investigate whether the normalizing effect of a 10-mg dose of MPH was also apparent on earlier waves, such as the N1, the P2, and the N2, besides the P3. Twelve attention deficit with hyperactivity disorder (ADHD) children performed a Continuous Performance Test involving a button-press response to the letter X (CPT-X) under the influence of MPH in a double-blind placebo controlled acute dosage design. ERPs were recorded at Oz, Pz, Cz, and Fz. The expected increase of the parietal P3, both to targets and nontargets, was apparent, as well as a significant increase in percentage of hits. There also was a significant increase of an earlier, negative going, wave, the N2, with a frontal maximum, under the influence of MPH. This wave was probably a manifestation of an increase in processing negativity for target stimuli only, after the intake of the stimulant drug. No effect of MPH was found on the N1 or the P2.

A review of the literature showed that in vigilance or oddball tasks, changes over time in event-related potentials (ERPs) and performance measures often seem to be unrelated, but a number of studies had some shortcomings. In the present study a visual vigilance experiment was carried out, in which single-trial ERPs and performance data of 40 males were obtained. A relationship between time trends in behavioral and ERP measures was found: an early P3 amplitude and response latency (RT) showed an inversely varying relation over time. Analysis of covariance showed that the two linear trends tap the same aspect of processing: both trends became insignificant when adjusted for common variance. A negative correlation between mean values of P3 amplitude and RT rather than for change scores has been observed in previous studies, but has been ignored in the literature. However, correlations with RT have also been reported for other ERP deflections. Although there were several correlations between mean scores, most time-induced changes in ERP parameters appeared to be unrelated to worsening performance, for which several explanations are advanced. The ERP results do not support the hypothesis that a decrement in performance is caused by increasing difficulty discriminating targets from nontargets. A gradual decline in effort or resources allocated to the task might be an alternative explanation of performance deterioration. However, an effort-hypothesis cannot easily be tested. Effort is often invoked post hoc, and has previously been associated with many ERP components. The relationship between ERPs and the signal detection measures "sensitivity" d' and "response bias" beta is discussed.

Thirty females performed a visual vigilance task under the influence of bromazepam (6 and 12 mg) in a placebo-controlled, double blind, experiment. Measures employed were percentage of hits, percentage of false alarms, response latency (RT), A' (sensitivity), B" (cautiousness), and RI (responsivity), as well as signal- and non-signal event-related potentials (ERPs). Bromazepam did not aggravate the normally occurring decrement in performance in vigilance tasks, but had an effect on overall level of performance: accuracy was reduced under the influence of the drug, but speed improved. A Drug x Period interaction for cautiousness (B") indicated increasingly less cautiousness with bromazepam, which probably contributed to faster motor responses (and more errors) than in the placebo group. The ERP data suggest that the effects of bromazepam are already manifest in the early stages of information processing (attention-detection) as mirrored by a drug effect on N1 amplitude. Deterioration at this early stage may affect later processing stages (P2-N2 amplitudes). As a result, subjects under the influence of the drug probably accumulate less signal evidence for their final evaluation.

Event-related brain potentials (ERPs) have been suggested as a brain correlate of attention in sustained task performance. However, a review of the literature shows that changes in ERPs and performance measures over time often are dissociated. It is suggested that this may partly be caused by the simultaneous occurrence of several, separate processes in ERP trends over time. Further, it has been claimed that ERP recordings are more finely textured than behavioral measures such as hits, RT, sensitivity or response bias. Shortcomings of some studies are discussed and an approach is suggested which may more validly be employed in the search for relationships between time effects in ERP measures and measures of performance.

This report describes a test of the prediction, made by Teichner in 1974, that on visual vigilance tasks dynamic stimuli result in greater performance decrements than do static stimuli. For correct detections and sensitivity there was only a nonsignificant trend in the predicted direction, but for response latency (RT) the prediction was supported. Positional uncertainty within displays did not affect vigilance performance. Teichner's assumption that ocular demand is responsible for the impairing effect of dynamic stimuli is questioned. Depletion of central capacity rather than an ocular effect may explain deteriorating performance. Just as in studies of visual fatigue, the contributions of central and modality-specific impairing effects are difficult to separate.

The literature on the effects of anxiolytic and hypnotic drugs on performance in tasks requiring sustained attention is confusing. This review is an attempt to evaluate the usefulness of vigilance tasks in the assessment of adverse effects of benzodiazepines. The long, monotonous, character of these tasks may be more relevant to many tasks performed in everyday life than the short, and often stimulating, tasks commonly employed in test batteries. From 37 available studies, 26 were examined in detail. In young, normal volunteers, vigilance tasks were found to be sensitive, often dose dependently, to the impairing effects of drugs, even in low doses (2.5 mg diazepam). With these subjects the tasks may be successfully used to compare different benzodiazepines with respect to residual activity. Both accuracy and speed of performance appear to be affected. However, in people actually using the drugs ("patients"), adverse effects on performance are usually not found. There is no evidence that benzodiazepines aggravate the vigilance decrement occurring under normal conditions. They do affect overall level of perceptual sensitivity, but show less effects on response criterion. The drugs do not seem to interact with anxiety or sleep quality in their effect on performance, but there are few studies with patients, and the assessment of anxiety is not without problems. It is unlikely that impairments in vigilance are simply a byproduct of global, sedative effects, but there is uncertainty regarding measures of general sedation. Developing tolerance with repeated doses has been noted only occasionally, but the opposite of tolerance, aggravated impairment, has also been reported.

In an attempt to specify the limiting conditions of the taxonomy of vigilance tasks, four tasks differing in memory load and in stimuli employed (sensory or cognitive) were compared. Electrodermal activity and subjective measures were used to determine the investment of effort. The data show that vigilance level and vigilance decrement dissociate. The level seems to relate to effort demand and investment; the decrement seems to be task driven, determined mainly by the type of stimuli used. Tasks employing unfamiliar stimuli showed a decline in sensitivity; "cognitive" tasks employing alphanumeric stimuli did not. Principal components analyses suggest that measures of speed and accuracy may reflect relatively independent systems. Subjective data showed that good performers expand more effort in difficult and complex tasks. Effortful processing seems to prevent rather than induce a decline in efficiency.