Peripheral Hypoarousal but Not Preparation-Vigilance Impairment Endures in ADHD Remission
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Objective: This study investigates whether impairments associated with persistent ADHD—impaired attention allocation (P3 amplitude), peripheral hypoarousal (skin conductance level [SCL]), and adjustment in preparatory state (contingent negative variation [CNV])—reflect enduring deficits unrelated to ADHD outcome or are markers of ADHD remission. Method: Young people with childhood ADHD (73 persisters and 18 remitters) and 144 controls were compared on neurophysiological measures during two conditions (baseline and fast-incentive) of a four-choice reaction time task. Results: ADHD remitters differed from persisters, and were indistinguishable from controls, on baseline P3 amplitude and fast-incentive CNV amplitude ( p ≤ .05). ADHD remitters differed from controls ( p ≤ .01), and were indistinguishable from persisters ( p > .05), on baseline SCL. Conclusion: Preparation-vigilance measures were markers of ADHD remission, confirming previous findings with other measures. Yet, SCL-measured peripheral hypoarousal emerges as an enduring deficit unrelated to ADHD improvement. Future studies should explore potential compensatory mechanisms that enable efficient preparation-vigilance processes in ADHD remitters.
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Hypo-arousal has been associated with RTV.
“Decreased arousal could be another possible underlying mechanism of impaired CV under guanfacine, since hypo-arousal has been associated with RTV (80, 81).”
From Differential effects of a single dose of Lisdexamfetamine and Guanfacine on cognitive function in children with ADHD (2025) · cites this paper as [81]
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Boucsein, W. (2012) · doi:10.1007/978-1-4614-1126-0 · Cited by 2,526 · see citing works
FARAONE, S. V., BIEDERMAN, J., & MICK, E. (2006) · Psychological Medicine · doi:10.1017/s003329170500471x · Cited by 2,267 · see citing works
Prevalence and correlates of adult attention-deficit hyperactivity disorder: meta-analysis
Simon, V., Czobor, P., Bálint, S., Mészáros, Á., & Bitter, I. (2009) · British Journal of Psychiatry · doi:10.1192/bjp.bp.107.048827 · Cited by 1,601 · see citing works
Williams, L. M., Phillips, M. L., Brammer, M. J., Skerrett, D., Lagopoulos, J., Rennie, C., Bahramali, H., Olivieri, G., David, A. S., Peduto, A., et al. (2001) · NeuroImage · doi:10.1006/nimg.2001.0904 · Cited by 300 · see citing works
Halperin, J. M., Trampush, J. W., Miller, C. J., Marks, D. J., & Newcorn, J. H. (2008) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.2008.01926.x · Cited by 252 · see citing works
Kuntsi, J., Wood, A. C., Johnson, K. A., Andreou, P., Arias-Vasquez, A., Buitelaar, J. K., Rommelse, N. N. J., Sergeant, J. A., Sonuga-Barke, E. J., Uebel, H., et al. (2010) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2010.139 · Cited by 162 · see citing works
Self-citationCognitive and neurophysiological markers of ADHD persistence and remission
Cheung, C. H. M., Rijsdijk, F., McLoughlin, G., Brandeis, D., Banaschewski, T., Asherson, P., & Kuntsi, J. (2016) · British Journal of Psychiatry · doi:10.1192/bjp.bp.114.145185 · Cited by 146 · see citing works
Self-citationDoes neurocognitive functioning predict future or persistence of ADHD? A systematic review
van Lieshout, M., Luman, M., Buitelaar, J., Rommelse, N. N. J., & Oosterlaan, J. (2013) · Clinical Psychology Review · doi:10.1016/j.cpr.2013.02.003 · Cited by 133 · see citing works
Flagged first, then by citations
Research works printed but not linked: 22
- Albrecht B. Brandeis D. Uebel H. Valko L. Heinrich H. Drechsler R.... Banaschewski T. (2013). Familiality of neural preparation and response control in childhood attention deficit-hyperactivity disorder. Psychological Medicine, 43, 1997- 2011. 23200032
- American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
- Andreou P. Neale B. M. Chen W. Christiansen H. Gabriels I. Heise A.... Kuntsi J. (2007). Reaction time performance in ADHD: Improvement under fast-incentive condition and familial effects. Psychological Medicine, 37, 1703- 1715. 17537284 PMC3770126
- Banaschewski T. Brandeis D. Heinrich H. Albrecht B. Brunner E. Rothenberger A. (2003). Association of ADHD and conduct disorder—Brain electrical evidence for the existence of a distinct subtype. The Journal of Child Psychology and Psychiatry, and Allied Disciplines, 44, 356- 376. 12635966
- Barkley R. A. Murphy K. R. (2006). Attention deficit hyperactivity disorder: A clinical workbook (3rd ed.). New York, NY: Guildford Press.
- Bédard A.-C. V. Trampush J. W. Newcorn J. H. Halperin J. M. (2010). Perceptual and motor inhibition in adolescents/young adults with childhood-diagnosed ADHD. Neuropsychology, 24, 424- 434. 20604617 PMC2900812
- Biederman J. Petty C. R. Ball S. W. Fried R. Doyle A. E. Cohen D.... Faraone S. V. (2009). Are cognitive deficits in attention deficit/hyperactivity disorder related to the course of the disorder? A prospective controlled follow-up study of grown up boys with persistent and remitting course. Psychiatry Research, 170, 177- 182. 19900713 PMC2787767
- Cheung C. H. M. McLoughlin G. Brandeis D. Banaschewski T. Asherson P. Kuntsi J. (2017). Neurophysiological correlates of attentional fluctuation in attention-deficit/hyperactivity disorder. Brain Topography, 30, 320- 332. doi: 10.1007/s10548-017-0554-2 28289850 PMC5408051 · DOI
- Cheung C. H. M. Rijsdijk F. McLoughlin G. Faraone S. V. Asherson P. Kuntsi J. (2015). Childhood predictors of adolescent and young adult outcome in ADHD. Journal of Psychiatric Research, 62, 92- 100. 25680235 PMC4480336
- Figner B. Murphy R. (2011). Using skin conductance in judgment and decision making research. In Schulte-Mecklenbeck M. Kuehberger A. Ranyard R. (Eds.), A handbook of process tracing methods for decision research (pp. 163- 184). New York, NY: Psychology Press.
- Francx W. Oldehinkel M. Oosterlaan J. Heslenfeld D. Hartman C. A. Hoekstra P. J.... Mennes M. (2015). The executive control network and symptomatic improvement in attention-deficit/hyperactivity disorder. Cortex; A Journal Devoted to the Study of the Nervous System and Behavior, 73, 62- 72. 26363140
- James S.-N. Cheung C. H. M. Rijsdijk F. Asherson P. Kuntsi J. (2016). Modifiable arousal in ADHD and its etiological association with fluctuating reaction times. Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, 1, 539- 547. doi: 10.1016/j.bpsc.2016.06.003 27840854 PMC5094448 · DOI · Paper page
- Lim C. L. Rennie C. Barry R. J. Bahramali H. Lazzaro I. Manor B. Gordon E. (1997). Decomposing skin conductance into tonic and phasic components. International Journal of Psychophysiology: Official Journal of the International Organization of Psychophysiology, 25, 97- 109. 9101335
- Luck S. J. (2012). Event-related potentials. In Cooper H. Camic P. Long D. Panter A. Rindskopf D. Sher K. (Eds.), APA handbook of research methods in psychology: Volume 1, foundations, planning, measures, and psychometrics. Washington, DC: American Psychological Association.
- McAuley T. Crosbie J. Charach A. Schachar R. (2014). The persistence of cognitive deficits in remitted and unremitted ADHD: A case for the state-independence of response inhibition. The Journal of Child Psychology and Psychiatry, and Allied Disciplines, 55, 292- 300. PMC4263232 24261515
- Michelini G. Kitsune G. L. Cheung C. H. M. Brandeis D. Banaschewski T. Asherson P.... Kuntsi J. (2016). ADHD remission is linked to better neurophysiological error detection and attention-vigilance processes. Biological Psychiatry, 15, 923- 932. doi: 10.1016/j.biopsych.2016.06.021 PMC5120985 27591125 · DOI
- Pazvantoğlu O. Aker A. A. Karabekiroğlu K. Akbaş S. Sarısoy G. Baykal S.... Sahin A. R. (2012). Neuropsychological weaknesses in adult ADHD: Cognitive functions as core deficit and roles of them in persistence to adulthood. Journal of the International Neuropsychological Society: JINS, 18, 819- 826. 22687463
- Polanczyk G. de Lima M. S. Horta B. L. Biederman J. Rohde L. A. (2007). The worldwide prevalence of ADHD: A systematic review and metaregression analysis. American Journal of Psychiatry, 164, 942- 948. 17541055
- Tye C. Rijsdijk F. Greven C. U. Kuntsi J. Asherson P. McLoughlin G. (2012). Shared genetic influences on ADHD symptoms and very low-frequency EEG activity: A twin study. The Journal of Child Psychology and Psychiatry, and Allied Disciplines, 53, 706- 715. PMC3859923 22118296
- Wechsler D. (1991). Wechsler intelligence scale for children (3rd ed.). London, UK: The Psychological Corporation.
- Williams L. M. Brammer M. J. Skerrett D. Lagopolous J. Rennie C. Kozek K.... Gordon E. (2000). The neural correlates of orienting: An integration of fMRI and skin conductance orienting. Neuroreport, 11, 3011- 3015. 11006985
- Wood A. C. Asherson P. Rijsdijk F. Kuntsi J. (2009). Is overactivity a core feature in ADHD? Familial and receiver operating characteristic curve analysis of mechanically assessed activity level. Journal of the American Academy of Child & Adolescent Psychiatry, 48, 1023- 1030. 19701105
Cited by
Sorted by citations
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Franke, B., Michelini, G., Asherson, P., Banaschewski, T., Bilbow, A., Buitelaar, J. K., Cormand, B., Faraone, S. V., Ginsberg, Y., Haavik, J., et al. (2018) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2018.08.001 · Cited by 643 · see citing works
Self-citationMichelini, G., Cheung, C. H. M., Kitsune, V., Brandeis, D., Banaschewski, T., McLoughlin, G., Asherson, P., Rijsdijk, F., & Kuntsi, J. (2021) · Journal of Attention Disorders · doi:10.1177/1087054718771191 · Cited by 27 · see citing works
Self-citationZhao, X., Li, H., Wang, E., Luo, X., Han, C., Cao, Q., Liu, L., Chen, J., Wang, C., Johnstone, S. J., et al. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.00348 · Cited by 19 · see citing works
El Masri, S., Kowalczyk, O. S., Chiu, T. H., Criaud, M., Lukito, S., Mazibuko, N., Salazar de Pablo, G., Perez Rodriguez, V., Makos, O., Lam, S.-L., et al. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1676472
“Decreased arousal could be another possible underlying mechanism of impaired CV under guanfacine, since hypo-arousal has been associated with RTV (80, 81).”
- Authors
- James, S.-N., Cheung, C. H. M., Rommel, A.-S., McLoughlin, G., Brandeis, D., Banaschewski, T., Asherson, P., & Kuntsi, J.
- Affiliations
- King's College London (GB)
- University of London (GB)
- University of Zurich (CH)
- Heidelberg University (DE)
- Corresponding author
- Kuntsi, Jonna
- ORCID
- Venue
- Journal of Attention Disorders
- Publisher
- SAGE Publications
- Published
- 2017-03-31
- Volume
- 24
- Issue
- 13
- Pages
- 1944-1951
- ISSN
- 1087-0547 (ISSN-L)
- 1557-1246
- PMC
- PMC5617106
- OpenAlex
- W2598600783
- Cited by
- 22
- References
- 8
- Citations by year
- 2025: 3 · 2024: 1 · 2023: 3 · 2021: 1 · 2020: 5 · 2019: 2 · 2018: 5 · 2017: 2
- FWCI
- 3.15
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Journal of Attention Disorders (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Zurich Open Repository and Archive (University of Zurich) (acceptedVersion, cc-by)
- Europe PMC (PubMed Central) (acceptedVersion, cc-by-nc-nd)
- Research Portal (King's College London) (submittedVersion, cc-by)
- UCL Discovery (University College London) (submittedVersion)
- Zurich Open Repository and Archive (University of Zurich) (submittedVersion, cc-by)
- Zurich Open Repository and Archive (University of Zurich)
- Funders
- Action Medical Research
- National Institute of Mental Health Grant
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Developmental and Educational Neuropsychology
- Keywords
- persistent ADHD, skin conductance level, P300 amplitude, contingent negative variation, attention allocation, compensatory mechanisms, childhood ADHD, neurophysiological markers
- MeSH terms
- Adolescent, Attention, Attention Deficit Disorder with Hyperactivity, Child, Contingent Negative Variation, Electroencephalography, Humans, Reaction Time, Wakefulness
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