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The utility of ERPs in clinical psychology: examples from neural correlates of performance monitoring
Freitag, 04.06.2021:
8:30 - 10:00

Chair der Sitzung: Julia Klawohn, Humboldt Universität zu Berlin
Chair der Sitzung: Anja Riesel, Universität Hamburg
Ort: Clinical challenges and the ageing brain

Zusammenfassung der Sitzung

Several forms of psychopathology have been shown to be characterized by aberrant neural correlates of performance-monitoring, including reward, inhibition, and error processing. The current symposium will evaluate new findings on performance-monitoring event-related potentials (ERPs) as markers of mechanisms, risk, and change in relation to depression, obsessive-compulsive disorder (OCD), and excessive behaviors. Raoul Dieterich will present single-trial based associations between neural correlates of feedback and inhibition specific to high binge-watchers compared to non-binge-watching controls, supporting the notion that simultaneous outcome insensitivity and inhibitory deficits may facilitate compulsive watching. Then, Julia Klawohn will present data on impaired reward-processing and emotional reactivity in current depression, demonstrating the utility of these indices for classification and prediction of disorder trajectory. Ellen de Bruijn will present results on social mechanisms in performance-monitoring from an error-responsibility paradigm. Her data indicate that participants with high obsessive-compulsive (OC) characteristics show enhanced error signals to harmful mistakes compared to low OC individuals. Anja Riesel will present data suggesting that the ERN predicts perceived risk and stress during the COVID-19 pandemic. Increased stress was in turn associated with a range of psychopathological symptom dimensions including anxiety, depression, and obsessive-compulsive symptoms. Finally, Luisa Balzus will present results from a sham-controlled crossover-study on the efficacy of transcranial direct current stimulation (tDCS) over the medial-frontal cortex applied to target aberrant error monitoring in OCD. Collectively, this symposium highlights the clinical utility of neural correlates of performance-monitoring for improving our understanding of pathomechanisms involved in mental disorders and for identifying targets of innovative intervention approaches.

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Loss of control over binge-watching: Interactions of inhibitory and feedback processing

Raoul Dieterich, Verena Wüllhorst, Julia Berghäuser, Rebecca Overmeyer, Tanja Endrass

TU Dresden, Deutschland

Binge-watching may involve a maladaptive interplay of low self-regulation and sensitivity to action consequences such that dysfunctional inhibition and outcome processing might facilitate problematic binge-watching. We examined whether decreased inhibitory and attenuated feedback-related brain activity are coupled in binge-watchers. High (n = 32) and non-binge-watchers (n = 31) performed go/nogo and stop signal tasks and a flanker paradigm with performance feedback during electroencephalography. We assessed the temporo-spatial relationship of inhibition and stopping with outcome processing in each group using a single-trial regression approach. High binge-watchers, but not non-binge-watchers, who differentiated less between gains and losses (feedback-P3b) also recruited less brain activity during both inhibition and stopping (inhibition-P3 and stopping-P3). Additionally, this was specific to individuals with low control over watching. We thus observed a potentially problematic interaction between inhibitory and outcome processing in binge-watchers. Insensitivity to behavioral consequences along with inhibitory impairments may confer a long-term risk for compulsive watching. Our multi-modal approach may be particularly suited to detect such an underlying risk marker.

Social performance monitoring: Obsessive-compulsive symptoms and processing of harmful mistakes

Ellen RA de Bruijn1,2, Myrthe Jansen1,2

1Department of Clinical Psychology, Leiden University, the Netherlands; 2Leiden Institute for Brain and Cognition

Errors are usually associated with affective distress and errors made in a social context are often even more distressing, as they may not only be noticed by others but may also have consequences for them. They may thus be linked to one’s self-image and self-esteem or increased sense of responsibility for others and may elicit feelings of embarrassment. These social performance-monitoring processes, however, have received relatively little attention in research so far. This is surprising as many disorders are characterized by both severe social dysfunctions and aberrant neural correlates of performance monitoring. The general starting premise of research in our lab is therefore that we can only advance our understanding of neurocognitive alterations in psychopathology by including a social perspective and examining individual differences. Over the past years, we have been developing experimental paradigms to investigate relevant social performance-monitoring processes, such as observing others’ errors (e.g., highly relevant for psychopathy), making mistakes in the presence of others (e.g., the greatest fear of socially anxious individuals), or making harmful mistakes (e.g., a massive worry for patients suffering from obsessive-compulsive disorder). I will present recent findings from one of these paradigms, the so-called error-responsibility task, and will specifically focus on error-related ERP components following harmful mistakes in healthy volunteers scoring high on obsessive-compulsive symptoms.

Efficacy of transcranial direct current stimulation in modulating aberrant error monitoring in obsessive-compulsive disorder

Luisa Balzus1,2, Julia Klawohn1, Stephan A. Brandt3, Sein Schmidt3, Norbert Kathmann1

1Department of Psychology, Humboldt-Universität zu Berlin, Germany; 2Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Germany; 3Department of Neurology, Charité – Universitätsmedizin Berlin, Germany

Overactive performance monitoring, as indexed by enhanced electrophysiological correlates of error processing, is discussed as a biomarker for obsessive-compulsive disorder (OCD) and may provide a promising target for novel treatment approaches. Non-invasive stimulation of the medial frontal cortex has been found to modulate neural error signals (error-related negativity, ERN; error positivity, Pe) in healthy participants and has promising potential to reduce obsessive-compulsive symptomatology, but no study has yet investigated its efficacy in modulating neural correlates of performance monitoring in OCD.

We conducted a preregistered, double-blind, sham-controlled, crossover study to investigate the modifiability of event-related potentials (ERPs) of error processing using transcranial direct current stimulation (tDCS) in 28 patients with OCD and 28 healthy control participants. Following application of either cathodal or sham tDCS over the medial frontal cortex, EEG was recorded while participants performed a flanker task.

Results indicated that one session of cathodal tDCS reduced ERN and correct-response negativity (CRN) amplitude, albeit the stimulation effect on the ERN was only marginally significant, as were general group differences in these ERPs. Additionally, cathodal tDCS increased Pe amplitude. These ERP modifications were not accompanied by behavioral changes. We found no evidence that the stimulation effect on neural error signals was more pronounced in OCD patients compared to the control group.

Our findings provide tentative evidence that cathodal tDCS over the medial frontal cortex has the potential to modulate neural correlates of performance monitoring, leading to the conclusion that its efficacy to target aberrant error processing in clinical populations deserves further investigation.

The predictive validity of ERN and CRN for perceived risk, stress, and internalizing symptoms during the COVID-19 pandemic

Anja Riesel1, Kai Härpfer1, Norbert Kathmann2, Julia Klawohn2

1Universität Hamburg, Deutschland; 2Humboldt-Universität zu Berlin

The COVID-19 pandemic is a major life stressor posing serious threats to physical and mental health and has been linked to increased levels of depression and anxiety. This raises the question of vulnerabilities that make some individuals particularly susceptible to internalizing symptoms following stress. The ERN has been discussed as a neural risk marker for various forms of psychopathology and the present study examined its predictive validity for perceived risk, stress, and psychopathological symptoms during the COVID-19 pandemic. One hundred thirteen individuals who had participated as healthy participants in previous EEG studies (2014-2019) completed a follow-up online survey during the first COVID-19 wave in Germany. Mediation models were used to examine the association of pre-pandemic ERN and CRN with perceived risk, stress, and internalizing symptoms during the pandemic. Results indicate that pre-pandemic ERN and CRN were associated with increased perceived risk for a COVID-19 infection and a severe outcome. Moreover, this perceived COVID-19 risk functioned as mediator for indirect effects of pre-pandemic ERN and CRN on stress during the pandemic. Finally, mediated by perceived risk and increased stress levels ERN and CRN, were associated with increased internalizing symptoms during the pandemic (anxiety, depression, obsessive-compulsive symptoms). This suggests that pre-pandemic ERPs of performance monitoring (ERN, CRN) are useful to predict risk perception, stress, and exacerbation of internalizing symptoms during a real-world stressor such as the COVID-19 pandemic. This further strengthens the assumed role of ERN as a transdiagnostic neural risk marker and highlights the importance of stress for symptom development.

Neural markers of depression - reward processing and attentional allocation as predictors of symptom status, disorder trajectories, and symptom development under stress

Julia Klawohn1,3, Anja Riesel2, Kai Härpfer2, C.J. Brush3, Greg Hajcak3, Norbert Kathmann1

1Humboldt-Universität zu Berlin; 2Universität Hamburg; 3Florida State University

Reward processing and attentional allocation have repeatedly been shown to be associated with clinical depression. In this talk, findings regarding event-related potentials (ERPs) of reward processing (i.e., RewP), sustained attention to emotional stimuli (i.e., LPP), and attentional allocation to task-relevant stimuli (i.e., P300) from two studies will be presented. In the first study, RewP and LPP were assessed in participants with a current affective disorder (n=83) and healthy individuals (n=44). Results indicated that the RewP and LPP were differentially associated to clinical characteristics and both represented independent predictors of depression status, so that employing both ERPs together improved classification accuracy. Moreover, as longitudinal data from that study indicated, both ERPs could be used to predict likelihood of a full remission from depression during a 9-month follow-up, showing that deficits in either reward processing or sustained attention to emotional stimuli could be indicative of a more severe course of depressive disorder. In another investigation in healthy adults, we explored the P300 as a predictor of increases in symptoms during a real-live stressor. Participants of previous EEG studies (n=113) were recontacted during the initial phase of the COVID-19-pandemic in Germany. Results indicated that the P300 measured from a flanker task before the pandemic predicted increases in depressive symptoms during the pandemic, controlling for pre-pandemic symptoms. Altogether, this talk highlights the utility of ERP indices of reward processing and attentional allocation for improved characterization of depression status and prediction of depressive disorder trajectories; implications for clinical application and future studies will be discussed.

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