Error detection and the Error-related ERP in patients with lesions involving the anterior cingulate and adjacent regions

Abstract

Evidence indicates that the anterior cingulate region generates what appears to be a specific electrophysiological marker for the monitoring of error responses. When an auditory or visual stimulus is presented in such a way that the subject is likely to make an error, averaged encephalography (EEG) trials to erroneous responses consistently show a negative-going waveform which has been coined the error-related negativity (ERN). We examined ERNs in patients with a ruptured aneurysm of the anterior communicating artery (AACA), who are particularly prone to showing damage in the anterior cingulate and adjacent regions, and frequently display a variety of behavioral and cognitive disturbances such as disorientation, confabulation, apathy, unawareness of deficit, and problems of attention, control and monitoring. We found that these patients generally did not produce an ERN in comparison to healthy control participants suggesting that the anterior cingulate is essential for the ERN response. However, the patients' error rates were comparable to that of the controls and they showed a dissociation between overt error awareness and ERN production, suggesting that the ERN does not simply represent an error detection signal.