title: Changes of Heart Rate Variability during Methylphenidate Treatment in Attention-Deficit Hyperactivity Disorder Children: A 12-Week Prospective Study.
abstract: OBJECTIVE
  The aim of this study was to clarify the relationship between the autonomic nervous system and attention deficit hyperactivity disorder (ADHD) rating scales and to evaluate the usefulness of heart rate variability (HRV) as a psychophysiological biomarker for ADHD.
  
  
  METHODS
  Subjects were recruited from outpatients in the Department of Child and Adolescent Psychiatry at the Korea University Medical Center from August 2007 to December 2010. Subjects received methylphenidate. Time- and frequency-domain analyses of HRV, the Korean ADHD rating scale (K-ARS), and computerized ADHD diagnostic system were evaluated before treatment. After a 12-week period of medication administration, we repeated the HRV measurements and K-ARS rating.
  
  
  RESULTS
  Eighty-six subjects were initially enrolled and 37 participants completed the 12-week treatment and HRV measurements subsequent to the treatment. Significant correlations were found between the K-ARS inattention score and some HRV parameters. All of the HRV parameters, except the standard deviations of the normal-to-normal interval, very low frequency, and low frequency to high frequency, showed a significant positive correlation between baseline and endpoint measures in completers. High frequency (HF) and the square root of the mean squared differences of successive normal-to-normal intervals (RMSSD), which are related to parasympathetic vagal tone, showed significant decreases from baseline to endpoint.
  
  
  CONCLUSIONS
  The HRV test was shown to be reproducible. The decrease in HF and RMSSD suggests that parasympathetic dominance in ADHD can be altered by methylphenidate treatment. It also shows the possibility that HRV parameters can be used as psychophysiological markers in the treatment of ADHD.
authors.affiliation: Department of Psychiatry, Korea University, College of Medicine, Seoul, Korea.
authors.forename: Hayeon Jennifer
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Department of Psychiatry, Korea University, College of Medicine, Seoul, Korea.
authors.forename: Jaewon
authors.initials: J
authors.lastname: Yang
authors.affiliation: Department of Psychiatry, Korea University, College of Medicine, Seoul, Korea. npboard@korea.ac.kr.
authors.forename: Moon Soo
authors.initials: MS
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D001288:Attention / Q000187:drug effects / Q000502:physiology*; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000188:drug therapy*; D001341:Autonomic Nervous System / Q000503:physiopathology; D015415:Biomarkers; D000697:Central Nervous System Stimulants / Q000494:pharmacology / Q000627:therapeutic use*; D002648:Child; D005260:Female; D006339:Heart Rate / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000494:pharmacology / Q000627:therapeutic use*; D011446:Prospective Studies; D056910:Republic of Korea; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D000697:Central Nervous System Stimulants; D008774:Methylphenidate
keywords: Attention deficit hyperactivity disorder; autonomic nervous system; heart rate variability; methylphenidate