Garner David M, de Carvalho Tatiana Dias, Wajnsztejn Rubens, Vanderlei Luiz Carlos Marques, Valenti Vitor Engracia, de Abreu Luiz Carlos, Raimundo Rodrigo Daminello
Cardiorespiratory Research Group, School of Biological and Medical Sciences, Faculty of Health and Life Sciences, Oxford Brookes University, Headington Campus, Gipsy Lane, Oxford, OX3 0BP, UK.
Departamento de Ciencias de la Salud, Universidad Nacional de La Matanza (UNLaM), Licenciatura en Kinesiología y Fisiatría, Florencia Varela 1903, San Justo, Buenos Aires, Argentina.
Eur J Appl Physiol. 2025 Apr 3. doi: 10.1007/s00421-025-05774-6.
The aim is to scrutinize approximate entropy (ApEn) to distinguish optimal complexity of heart rate variability (HRV) in children diagnosed with attention deficit hyperactivity disorder (ADHD). This was accomplished by varying their embedding dimension m and tolerance r. Determination of optimal m and r is heuristic. ApEn was enforced in ADHD to assess its effects on the HRV chaotic response.
We studied 56 children divided equally into two groups: ADHD and control. Autonomic modulation of the heart rate was monitored for 20 min in the supine position without any physical, sensory or pharmacological stimuli. ApEn initially had r: 0.1 → 1.0 in 0.1 intervals and m: 1 → 10 in intervals of 1. The statistical significances were measured by three effect sizes: Cohen's d, Hedges' g and Glass's Δ.
Those most statistically important were for r = 0.9334, and m = 1, 2 and 3. Cohen's d (1.1277; m = 2) and Hedges' g (1.1119; m = 2) are the most reliable effect sizes. Glass's Δ (1.3724; m = 1) is unfortunately less reliable. ROC curve analysis shows AUC > 0.77 for r = 0.9334 and m = 1, 2, and 3.
ApEn recognized the increased chaotic response in ADHD. This was confirmed by three effect sizes, AUC and p value during ROC analysis. Still, ApEn is an unreliable mathematical marker. ADHD discrimination was only achieved by extending the surveillance ranges for r; 0.8 → 1.0 and m; 1 → 3 at intervals of 0.0167. This necessitates an 'a priori' study making it inapt for online analysis. Even so, it could be useful in 'post hoc' analysis.
目的是通过审视近似熵（ApEn）来区分被诊断为注意力缺陷多动障碍（ADHD）的儿童心率变异性（HRV）的最佳复杂性。这是通过改变其嵌入维度m和容忍度r来实现的。确定最佳m和r是启发式的。在ADHD中应用ApEn来评估其对HRV混沌反应的影响。
我们研究了56名儿童，平均分为两组：ADHD组和对照组。在仰卧位且无任何身体、感官或药物刺激的情况下，监测心率的自主调节20分钟。ApEn最初r取值范围为0.1→1.0，间隔为0.1，m取值范围为1→10，间隔为1。通过三种效应量来衡量统计学意义：科恩d值、赫奇斯g值和格拉斯Δ值。
在统计学上最重要的是r = 0.9334，以及m = 1、2和3。科恩d值（1.1277；m = 2）和赫奇斯g值（1.1119；m = 2）是最可靠的效应量。不幸的是，格拉斯Δ值（1.3724；m = 1）不太可靠。ROC曲线分析显示，当r = 0.9334且m = 1、2和3时，曲线下面积（AUC）> 0.77。
ApEn识别出ADHD中增加的混沌反应。这在ROC分析期间通过三种效应量、AUC和p值得到了证实。然而，ApEn是一个不可靠的数学指标。只有通过将r的监测范围扩展为0.8→1.0，m的监测范围扩展为1→3，间隔为0.0167，才能实现ADHD的鉴别。这需要进行一项“先验”研究，使其不适用于在线分析。即便如此，它在“事后”分析中可能会有用。
