What does this research mean for the field?

In children with ADHD, poorer impulsivity and hyperactivity performance on the MOXO d-CPT is associated with increased sympathetic activation, specifically indicated by higher very-low-frequency (VLF) power and SNS Index. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

March 3, 2026Open Access

Heart Rate Variability and MOXO d-CPT Relationship in Children with in Attention Deficit Hyperactivity Disorder

Key Points

Significantly lower VLF power is associated with better performance on the MOXO d-CPT, indicating a link between heart rate variability and cognitive abilities.
HRV metrics, particularly the SNS Index, show notable differences, marking increased sympathetic activation in poorer performers compared to those with better outcomes.

Structured PICO

Are resting-state heart rate variability metrics associated with MOXO d-CPT performance profiles in children with ADHD?

Population

52 children aged 6-12 years, including 33 with ADHD (17 boys, 16 girls) without comorbidities, and 19 healthy controls (12 boys, 7 girls).

Intervention

Resting-state heart rate variability (HRV) recording for 5 min using Polar H10 device and MOXO d-CPT performance profiling.

Comparator

Healthy control group (n=19).

Outcome

Time-domain (SDNN, RMSSD), frequency-domain (VLF, LF, HF), and non-linear HRV indices.surrogate

VLF power and the SNS Index are robust HRV metrics associated with impulsivity and hyperactivity performance on the MOXO d-CPT in children with ADHD, indicating increased sympathetic activation with poorer performance.

Abstract

This study examined heart rate variability (HRV) in children with attention deficit hyperactivity disorder (ADHD) using a case-control design. A total of 52 children aged 6-12 years participated. ADHD diagnosis was confirmed by a child psychiatrist according to DSM-5 criteria, and comorbidities (e.g., anxiety, ODD) were excluded. Participants were then stratified into ADHD (n = 33; 17 boys, 16 girls) and control groups (n = 19; 12 boys, 7 girls), with MOXO d-CPT used to characterize performance profiles. Resting-state HRV was recorded for 5 min using the validated Polar H10 device. Time-domain (SDNN, RMSSD), frequency-domain (VLF, LF, HF), and non-linear indices were analyzed. The Good performance group demonstrated significantly lower VLF power compared to the Weak group (η2 = 0.176, p 2 = 0.08) and RMSSD (η2 = 0.07), suggesting modest parasympathetic differences, though these did not reach statistical significance. These findings highlight VLF and the SNS Index as the most robust HRV metrics associated with impulsivity and hyperactivity performance on the MOXO d-CPT, while other HRV domains showed only preliminary or non-significant effects. Future longitudinal studies are needed to evaluate HRV's potential for monitoring treatment response and its specificity to cognitive subdomains in ADHD.

Bookmark

View Full Paper