Error-Related Negativity and Tic History in Pediatric Obsessive-Compulsive Disorder

Objective: The error-related negativity (ERN) is a negative deflection in the event-related potential after an incorrect response, which is often increased in patients with obsessive-compulsive disorder (OCD). However, the relation of the ERN to comorbid tic disorders has not been examined in patients with OCD. This study compared ERN amplitudes in patients with tic-related OCD, patients with non tic-related OCD, and healthy controls. Method: The ERN, correct response negativity, and error number were measured during an Eriksen flanker task to assess performance monitoring in 44 youth with a lifetime diagnosis of OCD and 44 matched healthy controls ranging in age from 10 to 19 years. Nine youth with OCD had a lifetime history of tics. Results: ERN amplitude was significantly increased in patients with OCD compared with healthy controls. ERN amplitude was significantly larger in patients with non tic-related OCD than in patients with tic-related OCD or controls. ERN amplitude had a significant negative correlation with age in healthy controls but not in patients with OCD. Instead, in patients with non-tic-related OCD, ERN amplitude had a significant positive correlation with age at onset of OCD symptoms. ERN amplitude in patients was unrelated to OCD symptom severity, current diagnostic status, or treatment effects. Conclusions: The results provide further evidence of increased error-related brain activity in pediatric OCD. The difference in the ERN between patients with tic-related and those with non tic-related OCD provides preliminary evidence of a neurobiological difference between these two OCD subtypes. The results indicate the ERN is a trait-like measurement that may serve as a biomarker for non-tic-related OCD. J. Am. Acad. Child Adolesc. Psychiatry, 2012;51(9):902-910.