Heart rate and reinforcement sensitivity in ADHD

Abstract
Background:  Both theoretical and clinical accounts of attention‐deficit/hyperactivity disorder (ADHD) implicate a dysfunctional reinforcement system. This study investigated heart rate parameters in response to feedback associated with reward and response cost in ADHD children and controls aged 8 to 12.Methods:  Heart rate responses (HRRs) following feedback and heart rate variability (HRV) in the low frequency band (.04–.08 Hz), a measure of mental effort, were calculated during a time production paradigm. Performance was coupled to monetary gain, loss or feedback‐only in a cross‐over design.Results:  Children with ADHD exhibited smaller HRRs to feedback compared to controls. HRV of children with ADHD decreased when performance was coupled to reward or response cost compared to feedback‐only. HRV of controls was similar across conditions.Conclusions:  Children with ADHD were characterised by (a) possible abnormalities in feedback monitoring and (b) motivational deficits, when no external reinforcement is present.