Griffiths Kristi R, Quintana Daniel S, Hermens Daniel F, Spooner Chris, Tsang Tracey W, Clarke Simon, Kohn Michael R
Brain Dynamics Centre, The Westmead Institute for Medical Research, The University of Sydney, Westmead, Australia.
NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, University of Oslo, and Oslo University Hospital, Oslo, Norway.
Biol Psychol. 2017 Mar;124:11-20. doi: 10.1016/j.biopsycho.2017.01.004. Epub 2017 Jan 15.
The autonomic nervous system (ANS) plays an important role in attention and self-regulation by modulating physiological arousal to meet environmental demands. Core symptoms of ADHD such as inattention and behavioral disinhibition may be related to dysregulation of the ANS, however previous findings have been equivocal. We examined autonomic activity and reactivity by assessing heart rate variability (HRV) in a large sample of un-medicated children and adolescents (6-19 years) with ADHD (n=229) compared to typically-developing controls (n=244) during rest and sustained attention. Four heart rate variability measures were extracted: Root mean square of successive differences between inter-beat-intervals (rMSSD), absolute high frequency (HFA) power, absolute low frequency (LFA) power and ratio of low frequency power to high frequency power (LF/HF). There were no group differences in HFA or rMSSD, even when assessing across child and adolescent groups separately, by gender or ADHD subtype. LF/HF however was higher in ADHD during both rest and sustained attention conditions, particularly in male children. Sustained attention was impaired in ADHD relative to controls, and a higher LF/HF ratio during sustained attention was associated with poorer performance in both groups. Lower rMSSD and HFA were associated with higher anxiety, oppositional behaviors and social problems, supporting prevailing theories that these measures index emotion regulation and adaptive social behavior. Different measures of heart rate variability provide important insights into the sustained attention and emotional and behavioral regulation impairments observed in ADHD and may aid in delineating ADHD pathophysiology.
自主神经系统（ANS）通过调节生理唤醒以满足环境需求，在注意力和自我调节方面发挥着重要作用。注意力缺陷多动障碍（ADHD）的核心症状，如注意力不集中和行为抑制障碍，可能与自主神经系统功能失调有关，然而先前的研究结果并不明确。我们通过评估大样本未用药的ADHD儿童和青少年（6 - 19岁，n = 229）与发育正常的对照组（n = 244）在静息和持续注意力状态下的心率变异性（HRV），来研究自主神经活动和反应性。提取了四项心率变异性指标：逐搏间期连续差值的均方根（rMSSD）、绝对高频（HFA）功率、绝对低频（LFA）功率以及低频功率与高频功率之比（LF/HF）。在HFA或rMSSD方面，两组之间没有差异，即使分别按儿童和青少年组、性别或ADHD亚型进行评估时也是如此。然而，在静息和持续注意力状态下，ADHD组的LF/HF均较高，尤其是在男性儿童中。与对照组相比，ADHD组的持续注意力受损，并且在持续注意力状态下较高的LF/HF比值与两组的较差表现相关。较低的rMSSD和HFA与较高的焦虑、对立行为和社会问题相关，这支持了现有理论，即这些指标反映了情绪调节和适应性社会行为。不同的心率变异性测量方法为ADHD中观察到的持续注意力以及情绪和行为调节障碍提供了重要见解，并可能有助于阐明ADHD的病理生理学。
