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分析注意缺陷多动障碍儿童的心脏自主神经调节。

Analysis of cardiac autonomic modulation of children with attention deficit hyperactivity disorder.

机构信息

Departamento de Medicina, Disciplina de Cardiologia, Universidade Federal de São Paulo, UNIFESP, São Paulo, Brazil ; Laboratório de Escrita Científica da Faculdade de Medicina do ABC, FMABC, Santo André, Brazil.

Núcleo Especializado em Aprendizagem, Programa de pós-graduação em Ciências da Saúde da Faculdade de Medicina do ABC, FMABC, Santo André, Brazil.

出版信息

Neuropsychiatr Dis Treat. 2014 Apr 11;10:613-8. doi: 10.2147/NDT.S49071. eCollection 2014.

Abstract

BACKGROUND

Attention deficit hyperactivity disorder (ADHD) is characterized by decreased attention span, impulsiveness, and hyperactivity. Autonomic nervous system imbalance was previously described in this population. We aim to compare the autonomic function of children with ADHD and controls by analyzing heart rate variability (HRV).

METHODS

Children rested in supine position with spontaneous breathing for 20 minutes. Heart rate was recorded beat by beat. HRV analysis was performed in the time and frequency domains and Poincaré plot.

RESULTS

Twenty-eight children with ADHD (22 boys, aged 9.964 years) and 28 controls (15 boys, age 9.857 years) participated in this study. It was determined that the mean and standard deviation of indexes which indicate parasympathetic activity is higher in children with ADHD than in children without the disorder: high frequency in normalized units, 46.182 (14.159) versus 40.632 (12.247); root mean square of successive differences, 41.821 (17.834) versus 38.150 (18.357); differences between adjacent normal-to-normal intervals greater than 50 milliseconds, 199.75 (144.00) versus 127.46 (102.21) (P<0.05); percentage of differences between adjacent normal-to-normal intervals greater than 50 milliseconds, 23.957 (17.316) versus 16.211 (13.215); standard deviation of instantaneous beat-to-beat interval, 29.586 (12.622) versus 26.989 (12.983).

CONCLUSION

Comparison of the autonomic function by analyzing HRV suggests an increase in the activity of the parasympathetic autonomic nervous systems in children with ADHD in relation to the control group.

摘要

背景

注意缺陷多动障碍(ADHD)的特征是注意力持续时间缩短、冲动和多动。此前曾描述过该人群自主神经系统失衡。我们旨在通过分析心率变异性(HRV)比较 ADHD 儿童和对照组的自主功能。

方法

儿童取仰卧位,自然呼吸 20 分钟。心率逐拍记录。在时域和频域以及 Poincaré 图上进行 HRV 分析。

结果

本研究纳入 28 例 ADHD 儿童(22 名男性,年龄 9.964 岁)和 28 例对照儿童(15 名男性,年龄 9.857 岁)。结果表明,提示副交感神经活动的指标的平均值和标准差在 ADHD 儿童中高于无该疾病的儿童:归一单位的高频,46.182(14.159)比 40.632(12.247);连续差异均方根,41.821(17.834)比 38.150(18.357);大于 50 毫秒的相邻正常-正常间期差值,199.75(144.00)比 127.46(102.21)(P<0.05);大于 50 毫秒的相邻正常-正常间期差值百分比,23.957(17.316)比 16.211(13.215);即时逐拍间期标准差,29.586(12.622)比 26.989(12.983)。

结论

通过分析 HRV 比较自主功能表明,与对照组相比,ADHD 儿童的副交感自主神经系统活动增加。

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