Health Psychology PhD Program, University of North Carolina at Charlotte, Charlotte, NC, United States.
Department of Psychological Science, University of North Carolina at Charlotte, Charlotte, NC, United States.
Front Endocrinol (Lausanne). 2022 Mar 1;13:738065. doi: 10.3389/fendo.2022.738065. eCollection 2022.
Attention-Deficit/Hyperactivity Disorder (ADHD) is the most common neurodevelopmental disorder diagnosed in children. Questions regarding its increased diagnostic rates and pharmacological treatments in developing children have led to a more holistic review of the multi-system pathophysiology observed in ADHD. The dopaminergic neurotransmitter system, known for its influence on reward-motivated behaviors and motor control, and the frontostriatal systems, that mediate motor, cognition, and behavior, are associated with ADHD's development. However, studies have shown that these neural systems do not wholly account for ADHD's multilayered and heterogeneous symptom presentation. For instance, the literature suggests that emotional dysregulation, the inability to regulate one's emotional responses to provoking stimuli, is associated with increased risk for social impairment in ADHD. A broader examination of physiological systems in children with ADHD has found potential markers in the heart-brain and gut-brain axes that correspond with certain behaviors associated with emotional dysregulation in recent studies. Hence, the purpose of this meta-analysis is to aggregate ten applicable published case studies and analyze task-related heart rate reactivity (HRR; n = 5 studies) and gut microbiota (n = 5 studies) data in children with and without ADHD. Data from a total of 531 youth with ADHD and 603 youth without ADHD revealed significant small and medium effect sizes for higher Chao1 levels and Actinobacteria levels in the ADHD group, respectively, but no evidence of altered task-related HRR. Thus, further research into multi-system psychophysiological measures of emotional dysregulation and ADHD is warranted. The clinical, empirical, and educational implications of these findings are discussed.
https://www.crd.york.ac.uk/prospero/, identifier PROSPERO (CRD42021236819).
注意力缺陷多动障碍（ADHD）是儿童中最常见的神经发育障碍。关于其在发展中国家儿童中诊断率增高和药物治疗的问题，促使人们更全面地研究 ADHD 中观察到的多系统病理生理学。多巴胺能神经递质系统，以其对奖励动机行为和运动控制的影响而闻名，以及额纹体系统，介导运动、认知和行为，与 ADHD 的发展有关。然而，研究表明，这些神经系统不能完全解释 ADHD 的多层次和异质的症状表现。例如，文献表明，情绪调节障碍，即无法调节对刺激性刺激的情绪反应，与 ADHD 中社交障碍的风险增加有关。对 ADHD 儿童的生理系统进行更广泛的检查发现，心脏-大脑和肠道-大脑轴中的潜在标志物与最近研究中与情绪调节障碍相关的某些行为相对应。因此，本荟萃分析的目的是汇总十项适用的已发表病例研究，并分析 ADHD 儿童和非 ADHD 儿童的与任务相关的心率反应性（HRR；n = 5 项研究）和肠道微生物群（n = 5 项研究）数据。共有 531 名 ADHD 青少年和 603 名非 ADHD 青少年的数据显示，ADHD 组的 Chao1 水平和放线菌水平分别具有较高的小和中等效应量，但与任务相关的 HRR 没有变化的证据。因此，需要进一步研究情绪失调和 ADHD 的多系统心理生理测量。讨论了这些发现的临床、实证和教育意义。
https://www.crd.york.ac.uk/prospero/，标识符 PROSPERO（CRD42021236819）。
