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Aranberri Ruiz A, Nevado B, Migueles Seco M, Aritzeta Galán A. Heart Rate Variability Biofeedback Intervention Programme to Improve Attention in Primary Schools. Appl Psychophysiol Biofeedback 2024:10.1007/s10484-024-09659-w. [PMID: 39179947 DOI: 10.1007/s10484-024-09659-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2024] [Indexed: 08/26/2024]
Abstract
The importance of attentional capacity for academic performance is highlighted by the increasing demands placed on students during primary school. Between the ages of 7 and 12, there is an evolutionary improvement in attentional capacity and the school environment is considered an appropriate setting in which to develop programmes to improve attention. Heart rate variability is an appropriate indicator of attentional capacity. For all these reasons, a heart rate variability biofeedback intervention focused on breathing was developed and implemented to improve attention. The intervention consisted of two phases. In the first phase, the school teachers were trained to develop the intervention; in the second, students received five individual sessions from their teachers. In each individual session, they learned to breathe to increase their heart rate variability. A total of 272 girls and 314 boys (N = 586) aged 7-12 years participated in the programme. To study the impact of the intervention on three primary school age groups, the attention of Control and Experimental groups was assessed before and after the implementation of the programme. According to the data obtained, despite developmental improvements, the students who participated in the programme showed an increase in heart rate variability and an improvement in attentional capacity, with a greater impact on the first cycle of primary school. The usefulness of heart rate variability biofeedback interventions in improving attention in primary school is discussed and arguments for their use in children are presented.
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Affiliation(s)
- Ainara Aranberri Ruiz
- Department of Basic Psychological Processes and their Development, Faculty of Psychology, University of the Basque Country UPV/EHU, Donostia-San Sebastián, Spain.
| | - Borja Nevado
- Department of Basic Psychological Processes and their Development, Faculty of Psychology, University of the Basque Country UPV/EHU, Donostia-San Sebastián, Spain
| | - Malen Migueles Seco
- Department of Basic Psychological Processes and their Development, Faculty of Psychology, University of the Basque Country UPV/EHU, Donostia-San Sebastián, Spain
| | - Aitor Aritzeta Galán
- Department of Basic Psychological Processes and their Development, Faculty of Psychology, University of the Basque Country UPV/EHU, Donostia-San Sebastián, Spain
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Andrikopoulos D, Vassiliou G, Fatouros P, Tsirmpas C, Pehlivanidis A, Papageorgiou C. Machine learning-enabled detection of attention-deficit/hyperactivity disorder with multimodal physiological data: a case-control study. BMC Psychiatry 2024; 24:547. [PMID: 39103819 DOI: 10.1186/s12888-024-05987-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 07/25/2024] [Indexed: 08/07/2024] Open
Abstract
BACKGROUND Attention-Deficit/Hyperactivity Disorder (ADHD) is a multifaceted neurodevelopmental psychiatric condition that typically emerges during childhood but often persists into adulthood, significantly impacting individuals' functioning, relationships, productivity, and overall quality of life. However, the current diagnostic process exhibits limitations that can significantly affect its overall effectiveness. Notably, its face-to-face and time-consuming nature, coupled with the reliance on subjective recall of historical information and clinician subjectivity, stand out as key challenges. To address these limitations, objective measures such as neuropsychological evaluations, imaging techniques and physiological monitoring of the Autonomic Nervous System functioning, have been explored. METHODS The main aim of this study was to investigate whether physiological data (i.e., Electrodermal Activity, Heart Rate Variability, and Skin Temperature) can serve as meaningful indicators of ADHD, evaluating its utility in distinguishing adult ADHD patients. This observational, case-control study included a total of 76 adult participants (32 ADHD patients and 44 healthy controls) who underwent a series of Stroop tests, while their physiological data was passively collected using a multi-sensor wearable device. Univariate feature analysis was employed to identify the tests that triggered significant signal responses, while the Informative k-Nearest Neighbors (KNN) algorithm was used to filter out less informative data points. Finally, a machine-learning decision pipeline incorporating various classification algorithms, including Logistic Regression, KNN, Random Forests, and Support Vector Machines (SVM), was utilized for ADHD patient detection. RESULTS Results indicate that the SVM-based model yielded the optimal performance, achieving 81.6% accuracy, maintaining a balance between the experimental and control groups, with sensitivity and specificity of 81.4% and 81.9%, respectively. Additionally, integration of data from all physiological signals yielded the best results, suggesting that each modality captures unique aspects of ADHD. CONCLUSIONS This study underscores the potential of physiological signals as valuable diagnostic indicators of adult ADHD. For the first time, to the best of our knowledge, our findings demonstrate that multimodal physiological data collected via wearable devices can complement traditional diagnostic approaches. Further research is warranted to explore the clinical applications and long-term implications of utilizing physiological markers in ADHD diagnosis and management.
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Affiliation(s)
| | - Georgia Vassiliou
- First Department of Psychiatry, Eginition Hospital, Medical School National and Kapodistrian University of Athens, Athens, Greece
| | | | | | - Artemios Pehlivanidis
- First Department of Psychiatry, Eginition Hospital, Medical School National and Kapodistrian University of Athens, Athens, Greece
| | - Charalabos Papageorgiou
- First Department of Psychiatry, Eginition Hospital, Medical School National and Kapodistrian University of Athens, Athens, Greece
- Neurosciences and Precision Medicine Research Institute "Costas Stefanis", University Mental Health, Athens, Greece
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Venn R, Northey JM, Naumovski N, McKune A. Reliability of an "At-Home" Method for Monitoring Resting and Reactive Autonomic Nervous System Activity in Children: A Pilot Study. CHILDREN (BASEL, SWITZERLAND) 2024; 11:835. [PMID: 39062284 PMCID: PMC11275235 DOI: 10.3390/children11070835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 06/22/2024] [Accepted: 07/03/2024] [Indexed: 07/28/2024]
Abstract
BACKGROUND Heart rate variability (HRV), an index of the functional status of the autonomic nervous system (ANS), provides an opportunity for early detection of ANS dysfunction. Lower resting, vagally related HRV parameters are associated with increased risk of physical and mental illness. External factors influencing the ANS, such as the testing environment, may impact the interpretation of HRV. This study's main aim was to determine the reliability of HRV resting and reactivity tests performed at home with children aged 4-9 years. METHODS Fourteen healthy children (female n = 8) aged 6.8 ± 1.5 years participated. Two HRV tests were performed at home via online supervision 7 days apart using a Polar H10 heart rate monitor. The absolute and relative reliability of the pre-exercise resting (5 min) and sub-maximal exercise step test recovery (4 × 30 s segments) HRV time and frequency domains were calculated. RESULTS The Pearson correlation coefficients for day 1 versus day 7 for the vagal activity HRV domains (RMSSD log) at rest and in the first 30 s and 30-60 s of recovery indicated good-to-excellent relative reliability (r > 0.8, p < 0.01). Absolute reliability was moderate for the resting RMSSD log, with a coefficient of variation (CV) of 5.2% (90% CI: 3.9, 7.8%), high for the first 30 s of standing recovery, with a CV of 10.7% (90% CI: 8.2, 15.7%), and moderate for 30-60 s of recovery, with a CV of 8.7% (90% CI: 6.6, 12.9%). CONCLUSIONS The findings of this pilot study indicate that the resting and exercise recovery HRV measures of vagal activity can be measured reliably at home in children. This represents a novel "at-home" protocol for monitoring ANS health and development in children.
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Affiliation(s)
- Rachel Venn
- School of Rehabilitation and Exercise Sciences, Faculty of Health, University of Canberra, Canberra, ACT 2617, Australia; (R.V.); (J.M.N.); (N.N.)
- Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT 2617, Australia
| | - Joseph M. Northey
- School of Rehabilitation and Exercise Sciences, Faculty of Health, University of Canberra, Canberra, ACT 2617, Australia; (R.V.); (J.M.N.); (N.N.)
- Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT 2617, Australia
| | - Nenad Naumovski
- School of Rehabilitation and Exercise Sciences, Faculty of Health, University of Canberra, Canberra, ACT 2617, Australia; (R.V.); (J.M.N.); (N.N.)
- Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT 2617, Australia
- Functional Foods and Nutrition Research (FFNR) Laboratory, University of Canberra, Ngunnawal Land, Canberra, ACT 2617, Australia
- Department of Nutrition and Dietetics, Harokopio University, 17671 Kallithea, Attica, Greece
| | - Andrew McKune
- School of Rehabilitation and Exercise Sciences, Faculty of Health, University of Canberra, Canberra, ACT 2617, Australia; (R.V.); (J.M.N.); (N.N.)
- Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT 2617, Australia
- Functional Foods and Nutrition Research (FFNR) Laboratory, University of Canberra, Ngunnawal Land, Canberra, ACT 2617, Australia
- School of Health Sciences, University of Kwazulu-Natal, Durban 3629, South Africa
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Christoffel K, De Asis-Cruz J, Govindan RB, Kim JH, Cook KM, Kapse K, Andescavage N, Basu S, Spoehr E, Limperopoulos C, du Plessis A. Central Autonomic Network and heart rate variability in premature neonates. Dev Neurosci 2024:000536513. [PMID: 38320522 PMCID: PMC11300706 DOI: 10.1159/000536513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 01/18/2024] [Indexed: 02/08/2024] Open
Abstract
INTRODUCTION The Central Autonomic Network (CAN) is a hierarchy of brain structures that collectively influence cardiac autonomic input, mediating the majority of brain-heart interactions, but has never been studied in premature neonates. In this study, we use heart rate variability (HRV), which has been described as the "primary output" of the CAN, and resting state functional MRI to characterize brain-heart relationships in premature neonates. METHODS We studied premature neonates who underwent resting state functional MRI (rsfMRI) at term, (37-weeks postmenstrual age [PMA] or above) and had HRV data recorded during the same week of their MRI. HRV was derived from continuous electrocardiogram data during the week of the rsfMRI scan. For rsfMRI, a seed-based approach was used to define regions of interest (ROI) pertinent to the CAN, and blood oxygen level-dependent signal was correlated between each ROI as a measure of functional connectivity. HRV was correlated with CAN connectivity (CANconn) for each region, and sub-group analysis was performed based on sex and clinical comorbidities. RESULTS Forty-seven premature neonates were included in this study, with a mean gestational age at birth of 28.1 +/- 2.6 weeks. Term CANconn was found to be significantly correlated with HRV in approximately one-fifth of CAN connections. Two distinct patterns emerged among these HRV-CANconn relationships. In the first, increased HRV was associated with stronger CANconn of limbic regions. In the second pattern, stronger CANconn at the precuneus was associated with impaired HRV maturation. These patterns were especially pronounced in male premature neonates. CONCLUSION We report for the first time evidence of brain-heart relationships in premature neonates and an emerging CAN, most striking in male neonates, suggesting that the brain-heart axis may be more vulnerable in male premature neonates. Signatures in the heart rate may eventually become an important non-invasive tool to identify premature males at highest risk for neurodevelopmental impairment.
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Affiliation(s)
- Kelsey Christoffel
- Developing Brain Institute, Children’s National Hospital, Washington, DC
- Prenatal Pediatrics Institute, Children’s National Hospital, Washington, DC
| | | | | | - Jung Hoon Kim
- Developing Brain Institute, Children’s National Hospital, Washington, DC
| | - Kevin Michael Cook
- Developing Brain Institute, Children’s National Hospital, Washington, DC
| | - Kushal Kapse
- Developing Brain Institute, Children’s National Hospital, Washington, DC
| | | | - Sudeepta Basu
- Division of Neonatology, Children’s National Hospital, Washington, DC
| | - Emma Spoehr
- Developing Brain Institute, Children’s National Hospital, Washington, DC
| | | | - Adre du Plessis
- Prenatal Pediatrics Institute, Children’s National Hospital, Washington, DC
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Panteli M, Constantinou T, Vrachimi-Souroulla A, Fanti K, Panayiotou G. Subjective and Autonomic Arousal toward Emotional Stimuli in Preadolescents with Externalizing Problems and the Role of Explicit and Implicit Emotion Regulation. Brain Sci 2024; 14:84. [PMID: 38248299 PMCID: PMC10813789 DOI: 10.3390/brainsci14010084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 01/08/2024] [Accepted: 01/10/2024] [Indexed: 01/23/2024] Open
Abstract
Children and adolescents with externalizing problems show physiological hypo-reactivity toward affective stimuli, which may relate to their disruptive, antisocial, and thrill-seeking behaviors. This study examines differences in explicit and implicit emotion regulation between preadolescents with and without externalizing problems as well as the role of emotion regulation in subjective and autonomic responses to emotional stimuli. Preadolescents showing self- and other-reported externalizing psychopathology, and a control sample, without such difficulties, participated in a passive affective picture-viewing task with neutral, fearful, joyful, and sad images, while their heart rate and heart rate variability were measured. Participants also reported on their emotion regulation difficulties using the Difficulties in Emotion Regulation Scale. Compared to controls, youths scoring high on externalizing problems (1) reported greater emotion regulation difficulties, especially a lack of emotional clarity and difficulty in controlling impulsive actions, (2) showed higher resting heart rate variability and a lower resting heart rate, suggestive of higher emotion/autonomic regulation ability, and (3) showed both subjective and physiological hypo-arousal to emotional pictures. Heart rate variability and, to a lesser degree difficulties in emotional clarity, modulated the effects of emotional pictures on subjective and physiological arousal. Findings suggest that interventions to improve emotion regulation and awareness may help to prevent externalizing problems.
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Affiliation(s)
- Maria Panteli
- Department of Psychology, University of Cyprus, Nicosia 1678, Cyprus
- Center for Applied Neuroscience, University of Cyprus, Nicosia 1678, Cyprus
| | - Thekla Constantinou
- Department of Psychology, University of Cyprus, Nicosia 1678, Cyprus
- Center for Applied Neuroscience, University of Cyprus, Nicosia 1678, Cyprus
| | | | - Kostas Fanti
- Department of Psychology, University of Cyprus, Nicosia 1678, Cyprus
| | - Georgia Panayiotou
- Department of Psychology, University of Cyprus, Nicosia 1678, Cyprus
- Center for Applied Neuroscience, University of Cyprus, Nicosia 1678, Cyprus
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Ozdemir R, Tanır Y, Demir BB, Yılmaz S, Geçkalan Soysal D, Karadeniz C. The effect of long-term use of methylphenidate on cardiac autonomic functions and ventricular arrhythmogenesis: a prospective case-control study. Cardiol Young 2024; 34:32-36. [PMID: 37138525 DOI: 10.1017/s1047951123001038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
OBJECTIVE We aimed to assess cardiac autonomic balance with heart rate variability by using 24-hour Holter electrocardiography and also to assess susceptibility to ventricular arrhythmias by using microvolt T wave alternance in children with attention deficit hyperactivity disorder. METHOD This study was conducted with age- and gender-matched groups of 40 patients taking long-acting methylphenidate for more than a year and 55 healthy controls. Heart rate variability analysis for cardiac autonomic functions and microvolt T wave alternance measurements for susceptibility to ventricular arrhythmias were evaluated by 24-hour Holter electrocardiography. RESULTS The mean age 10.9 ± 2.7 years, mean duration of therapy 22.76 months, and mean methylphenidate doses were 37.64 mg/day. The study group had considerably higher rMSSD, higher HF, and a lower LF/HF ratio (respectively, p : 0.02, p : 0.001 and p : 0.01). While parasympathetic activity parameters were elevated, sympathetic activity parameters were low during the sleep period. Increase in the microvolt T wave alternance values of the study group was not found to be statistically significant (p > 0.05). CONCLUSION In children taking long-acting methylphenidate, the autonomic balance was shown to be in favour of the parasympathetic system. Determination of the vulnerability to life-threatening ventricular arrhythmias has been evaluated for the first time in children with attention deficit hyperactivity disorder. Accordingly, microvolt T-wave alternance values give the notion that drug use is safe.
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Affiliation(s)
- Rahmi Ozdemir
- Pediatric Cardiology, Kütahya Health Sciences University, Kutahya, Turkey
| | - Yaşar Tanır
- Child and Adolescent Psychiatry, Kütahya Health Sciences University, Kutahya, Turkey
| | | | - Seheryeli Yılmaz
- Child and Adolescent Psychiatry, Kütahya Health Sciences University, Kutahya, Turkey
| | | | - Cem Karadeniz
- Department of Pediatric Cardiology, School of Medicine, Katip Celebi University, Izmir, Turkey
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Haddad P, Ogurtsova K, Lucht S, Glaubitz L, Höppe P, Nowak D, Angerer P, Hoffmann B. Short-term exposure to ultrafine and fine particulate matter with multipollutant modelling on heart rate variability among seniors and children from the CorPuScula (coronary, pulmonary, sanguis) longitudinal study in Germany. FRONTIERS IN EPIDEMIOLOGY 2023; 3:1278506. [PMID: 38455908 PMCID: PMC10910943 DOI: 10.3389/fepid.2023.1278506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 10/19/2023] [Indexed: 03/09/2024]
Abstract
Background Short-term exposure particulate matter with a diameter of 10 µm or less (PM10) and fine particulate matter (PM2.5) has been associated with heart rate variability (HRV), but exposure to ultrafine particles (UFP) has been less well examined. We investigated the associations between the HRV outcomes and short-term exposure to UFP, PM10 and PM2.5 among school-aged children and seniors. Methods CorPuScula (Coronary, Pulmonary and Sanguis) is a longitudinal, repeated-measure panel study conducted in 2000-2002 in Munich, Germany including 52 seniors (58-94 years old) with 899 observations and 50 children (6-10 years old) with 925 observations. A 10-min resting electrocardiogram was performed to assess resting HRV outcomes [Standard Deviation of Normal to Normal Intervals (SDNN), Root Mean Square of Successive Differences between Normal Heartbeats (RMSSD), Low Frequency power (LF), High Frequency power (HF), ration between low and high frequency (LF/HF)]. UFP and PM exposures were measured near the care home and school yard for seniors and children, respectively. Mean exposures during the day of examination (9-21 h) as well as 3-h, 12-h, 24-h, one-day, and two-day lags were assessed. Linear mixed-effect models were used to investigate the associations between short-term air pollution and HRV outcomes separately in children and seniors. The models were adjusted for sex, age, weather conditions (temperature, precipitation, and water vapor pressure), BMI, lifestyle and medical information. Two and multipollutant models adjusted for NO2 and O3 were performed. Results Among seniors, we observed increases in SDNN, LF, HF and LF/HF ratio after short-term exposure to UFP (hourly and daily lags) in contrast to decreases in SDNN and RMSSD after exposure to PM10. Associations were generally robust to two- and multipollutant adjustment. Among children, we observed increases of the LF/HF ratio after short-term exposures to UFP at lags 12 and 24 h. In contrast, we observed decreases of the ratio after exposure to PM2.5 and PM10. Results were largely unchanged for multipollutant modelling, however we found a more pronounced increase in SDNN and LF/HF (UFP lag 12 and 24 h) after adjusting for NO2. Conclusions Overall, among seniors, we observed associations of UFP and PM10 exposure with sympathetic responses of the ANS, which play an important role in sudden heart attacks or arrhythmia. Among children we found more inconsistent associations between UFP and a delayed increase in HRV. Adjusting for co-pollutants including NO2 and O3 yielded robust results.
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Affiliation(s)
- Pascale Haddad
- Institute for Occupational Social and Environmental Medicine, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Katherine Ogurtsova
- Institute for Occupational Social and Environmental Medicine, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Sarah Lucht
- Institute for Occupational Social and Environmental Medicine, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Real-World Evidence & Insights, Cardinal Health, Dublin, OH, United States
| | - Lina Glaubitz
- Institute for Occupational Social and Environmental Medicine, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Peter Höppe
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Dennis Nowak
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Peter Angerer
- Institute for Occupational Social and Environmental Medicine, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Barbara Hoffmann
- Institute for Occupational Social and Environmental Medicine, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
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Karabulut M, Yıldırım K. Superior Vena Cava Flow in Children With Attention Deficit Hyperactivity Disorder. Psychiatry Investig 2023; 20:888-895. [PMID: 37794671 PMCID: PMC10555513 DOI: 10.30773/pi.2023.0162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 07/14/2023] [Accepted: 08/10/2023] [Indexed: 10/06/2023] Open
Abstract
OBJECTIVE Attention deficit/hyperactivity disorder (ADHD), whose definition, diagnosis and treatment has been the subject of debate in the scientific community for a long time, is the most common neurobehavioral disorder in childhood. There are many studies on the pathophysiology of attention deficit. However, there is no study in the literature based on direct or indirect measurement of cerebral venous circulation in ADHD, and the effect of methylphenidate (MPH) treatment on cerebral venous circulation. Therefore, it was aimed to noninvasively measure superior vena cava (SVC) flow, which is an indirect indicator of cerebral venous flow, by transthoracic echocardiography in patients with ADHD. METHODS In the study, 44 healthy children, and 40 ADHD patients who were planned to start on osmotic-release oral system (OROS)- MPH were included. SVC flows were measured in healthy children and before and after drug therapy of ADHD patients. RESULTS SVC flow was found to be higher in ADHD patients compared to healthy children. A significant decrease was found in SVC flow of ADHD patients after OROS-MPH treatment. There was no decrease in SVC flow of patients who did not respond adequately to MPH treatment. CONCLUSION This first study of SVC flow in children with ADHD showed that ADHD was associated with increased SVC flow and MPH treatment had a reducing effect on this increased SVC flow. We believe that noninvasive, easily measurable, and reproducible SVC flow may be a new focus of interest for future comprehensive studies as a biomarker to support clinical evaluation in the diagnosis and treatment follow-up of ADHD patients.
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Affiliation(s)
- Muhammed Karabulut
- Department of Paediatric Cardiology, Clinical of Paediatric Health and Diseases, Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye
| | - Kübra Yıldırım
- Department of Child and Adolescent Psychiatry, Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye
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Amadawala T, Rukadikar C, Deshpande D, Rukadikar A, Bhatt R. Effectiveness of yoga on Ewing's battery autonomic function test: cross-sectional study. INTERNATIONAL JOURNAL OF PHYSIOLOGY, PATHOPHYSIOLOGY AND PHARMACOLOGY 2023; 15:21-30. [PMID: 37216172 PMCID: PMC10195213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 03/20/2023] [Indexed: 05/24/2023]
Abstract
INTRODUCTION The cardiovascular autonomic functions can be tested by a Battery of five tests developed by Ewing and Clark in 1981 in Edinburgh. Yogic practices are immensely useful for physical, mental and spiritual development required for better autonomic function. AIM AND OBJECTIVES To assess the ANS (Autonomic function system) function with help of Ewing's Battery tests in yoga participants and healthy participants not practicing yoga. MATERIALS AND METHODS A cross-sectional study was conducted on 270 participants which were divided into two groups viz: 135 in healthy control (Group I) and 135 in yoga group (Group II). Subjects with informed consent between 40-50 years, were included in control (Group I) and those practicing yoga for past minimum 3 months were included in Group II. Anthropometric measurements were done and parasympathetic tests like Heart rate (HR) response to standing from the supine posture, to Valsalva maneuvers and to slow deep breathing were done. Also, sympathetic tests, Blood Pressure (BP) response to cold in cold pressor test (CPT), to sustained handgrip test and to standing from lying posture were carried out. RESULTS P value was found to be statically significant among yoga group as compared with healthy control group in all the sympathetic and parasympathetic tests except in CPT. As per the Ewing's criteria, normal, early, diseased and severe CAN (Cardiac autonomic neuropathy) in healthy controls findings were 11.11%, 58.51%, 37.03%, 17.77% and in yoga participants findings were 37.7%, 34.8%, 6.66% and 8.88% respectively. According to Bellavere's classification, maximum diseased CAN were found in healthy control as compared to yoga group. As per AIIMS (All India Institute of Medical Sciences) criteria, parasympathetic neuropathy was observed in 11.85% of the healthy controls and in 6.66% of the yoga group, and that maximum sympathetic neuropathy was observed in 11.11% of the healthy patients and only 3.7% of the yoga group. CONCLUSION More emphasis should be given on implementation of yoga from early ages at the institutional levels, hospital levels. Yoga practices will suffice and lead to improvement of unhealthy ANS condition. Overall, Yoga showed better ANS function than healthy control group.
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Affiliation(s)
| | - Charushila Rukadikar
- Department of Physiology, All India Institute of Medical SciencesGorakhpur, Uttar Pradesh, India
| | - Dileep Deshpande
- Department of Physiology, Zydus Medical College and HospitalDahod, Gujarat, India
| | - Atul Rukadikar
- Department of Microbiology, All India Institute of Medical SciencesGorakhpur, Uttar Pradesh, India
| | - Ravi Bhatt
- Department of Community Medicine and Family Medicine, Government Medical CollegeDungarpur, Rajasthan, India
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Sania A, Myers MM, Pini N, Lucchini M, Nugent JD, Shuffrey LC, Rao S, Barbosa J, Angal J, Elliott AJ, Odendaal HJ, Fifer WP. Prenatal smoking and drinking are associated with altered newborn autonomic functions. Pediatr Res 2023; 93:242-252. [PMID: 35440768 PMCID: PMC9579213 DOI: 10.1038/s41390-022-02060-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 03/22/2022] [Accepted: 03/24/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND Prenatal smoking and drinking are associated with sudden infant death syndrome and neurodevelopmental disorders. Infants with these outcomes also have altered autonomic nervous system (ANS) regulation. We examined the effects of prenatal smoking and drinking on newborn ANS function. METHODS Pregnant women were enrolled in Northern Plains, USA (NP) and Cape Town (CT), South Africa. Daily drinking and weekly smoking data were collected prenatally. Physiological measures were obtained during sleep 12-96 h post-delivery. RESULTS In all, 2913 infants from NP and 4072 from CT were included. In active sleep, newborns of mothers who smoked throughout pregnancy, compared to non-smokers, had higher breathing rates (2.2 breaths/min; 95% CI: 0.95, 3.49). Quit-early smoking was associated with reductions in beat-to-beat heart rate variability (HRV) in active (-0.08 s) and quiet sleep (-0.11 s) in CT. In girls, moderate-high continuous smoking was associated with increased systolic (3.0 mmHg, CI: 0.70, 5.24) and diastolic blood pressure (2.9 mmHg, CI: 0.72, 5.02). In quiet sleep, low-continuous drinking was associated with slower heart rate (-4.5 beat/min). In boys, low-continuous drinking was associated with a reduced ratio of low-to-high frequency HRV (-0.11, CI: -0.21, -0.02). CONCLUSIONS These findings highlight potential ANS pathways through which prenatal drinking and smoking may contribute to neurodevelopment outcomes. IMPACT In this prospective cohort study of 6985 mother-infant dyads prenatal drinking and smoking were associated with multiple ANS parameters. Smoking was associated with increased neonatal breathing rates among all infants, and heart rate variability (HRV) and blood pressure (BP) among girls. Drinking was associated with reductions in HR and BP among all newborns, and reductions in the ratio of low to-high frequency HRV among boys. These findings suggest that prenatal smoking and drinking alter newborn ANS which may presage future neurodevelopmental disorders.
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Affiliation(s)
- Ayesha Sania
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, 10032, USA. .,Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY, 10032, USA.
| | - Michael M. Myers
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY 10032,Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY 10032
| | - Nicolò Pini
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY 10032,Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY 10032
| | - Maristella Lucchini
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY 10032,Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY 10032
| | - J David Nugent
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY 10032,Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY 10032
| | - Lauren C. Shuffrey
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY 10032,Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY 10032
| | - Shreya Rao
- Department of Statistics, Columbia University, New York, NY 10032
| | - Jennifer Barbosa
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY 10032
| | - Jyoti Angal
- Avera Research Institute, Sioux Falls, SD 57108,Department of Pediatrics, University of South Dakota School of Medicine, Sioux Falls, SD 57105
| | - Amy J. Elliott
- Avera Research Institute, Sioux Falls, SD 57108,Department of Pediatrics, University of South Dakota School of Medicine, Sioux Falls, SD 57105
| | - Hein J. Odendaal
- Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Science, Stellenbosch University, Cape Town, Western Cape, South Africa 7530
| | - William P. Fifer
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY 10032,Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY 10032,Department of Pediatrics, Columbia University Irving Medical Center, New York, NY 10032
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11
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Goswami I, Maguire B, Chau V, Tam EW, Pinchefsky E, Whitney R, Wilson D, Miller SP, Cortez MA. Early transient dysautonomia predicts the risk of infantile epileptic spasm syndrome onset: A prospective cohort study. Front Neurol 2022; 13:1090155. [PMID: 36619920 PMCID: PMC9815183 DOI: 10.3389/fneur.2022.1090155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 11/30/2022] [Indexed: 12/24/2022] Open
Abstract
Background Infantile epileptic spasm syndrome (IESS) is an age-dependent epileptic encephalopathy with a significant risk of developmental regression. This study investigates the association between heart rate variability (HRV) in infants at risk of IESS and the clinical onset of IESS. Methods Sixty neonates at risk of IESS were prospectively followed from birth to 12 months with simultaneous electroencephalogram (EEG) and electrocardiogram recordings for 60 min at every 2-month interval. HRV metrics were calculated from 5 min time-epoch during sleep including frequency domain measures, Poincare analysis including cardiac vagal index (CVI) and cardiac sympathetic index (CSI), and detrended fluctuation analysis (DFA α1, DFA α2). To assess the effect of each HRV metric at the 2-month baseline on the time until the first occurrence of either hypsarrhythmia on EEG and/or clinical spasm, univariate cox-proportional hazard models were fitted for each HRV metric. Results Infantile epileptic spasm syndrome was diagnosed in 20/60 (33%) of the cohort in a 12-month follow-up and 3 (5%) were lost to follow-up. The median age of developing hypsarrhythmia was 25 (7-53) weeks and clinical spasms at 24 (8-40) weeks. Three (5%) patients had clinical spasms without hypsarrhythmia, and 5 (8%) patients had hypsarrhythmia before clinical spasms at the initial presentation. The infants with high CSI (hazard ratio 2.5, 95% CI 1.2-5.2, P = 0.01) and high DFA α1 (hazard ratio 16, 95% CI 1.1-240, P = 0.04) at 2 months were more likely to develop hypsarrhythmia by the first year of age. There was a trend toward decreasing CSI and DFA α1 and increasing CVI in the first 8 months of age. Conclusion Our data suggest that relative sympathetic predominance at an early age of 2 months may be a potential predictor for developing IESS. Hence, early HRV patterns may provide valuable prognostic information in children at risk of IESS allowing early detection and optimization of cognitive outcomes. Whether early intervention to restore sympathovagal balance per se would provide clinical benefit must be addressed by future studies.
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Affiliation(s)
- Ipsita Goswami
- Department of Pediatrics, Divisions of Neonatology, McMaster Children's Hospital, McMaster University, Hamilton, ON, Canada,*Correspondence: Ipsita Goswami ✉
| | - Bryan Maguire
- Child Health Evaluative Sciences Research Program, Toronto and Cancer Care Ontario, The Hospital for Sick Children, SickKids Research Institute, Toronto, ON, Canada
| | - Vann Chau
- Department of Pediatrics, Divisions of Neurology, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada,Department of Pediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Emily W. Tam
- Department of Pediatrics, Divisions of Neurology, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada,Department of Pediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Elana Pinchefsky
- Department of Pediatrics, Division of Neurology, Centre Hospitalier Universitaire Sainte-Justine, University of Montreal, Montreal, QC, Canada
| | - Robyn Whitney
- Department of Pediatrics, Divisions of Neurology, McMaster Children's Hospital, McMaster University, Hamilton, ON, Canada
| | - Diane Wilson
- Department of Pediatrics, Divisions of Neonatology, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Steven P. Miller
- Department of Pediatrics, Divisions of Neurology, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada,Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Miguel A. Cortez
- Department of Pediatrics, Divisions of Neurology, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada,Department of Pediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada,Miguel A. Cortez ✉
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12
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DiCriscio AS, Wain KE, Smith J, Beiler D, Walsh LK, Holdren K, Troiani V. Higher scores on autonomic symptom scales in pediatric patients with neurodevelopmental disorders of known genetic etiology. Brain Behav 2022; 12:e2813. [PMID: 36423250 PMCID: PMC9759134 DOI: 10.1002/brb3.2813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 10/03/2022] [Accepted: 10/18/2022] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Features of underlying autonomic dysfunction, including sleep disturbances, gastrointestinal problems, and atypical heart rate, have been reported in neurodevelopmental conditions, including autism spectrum disorder (ASD). The current cross-sectional, between-groups study aimed to quantify symptoms of autonomic dysfunction in a neurodevelopmental pediatric cohort characterized by clinical diagnoses as well as genetic etiology. METHOD The Pediatric Autonomic Symptom Scales (PASS) questionnaire was used to assess autonomic features across a group of patients with clinical neurodevelopmental diagnoses (NPD; N = 90) and genetic etiologies. Patients were subdivided based on either having a clinical ASD diagnosis (NPD-ASD; n = 37) or other non-ASD neurodevelopmental diagnoses, such as intellectual disability without ASD, speech and language disorders, and/or attention deficit hyperactivity disorder (NPD-OTHER; n = 53). Analyses focused on characterizing differences between the NPD group compared to previously published reference samples, as well as differences between the two NPD subgroups (NPD-ASD and NPD-OTHER). RESULTS Our results indicate higher PASS scores in our NPD cohort relative to children with and without ASD from a previously published cohort. However, we did not identify significant group differences between our NPD-ASD and NPD-OTHER subgroups. Furthermore, we find a significant relationship between quantitative ASD traits and symptoms of autonomic function. CONCLUSION This work demonstrates the utility of capturing quantitative estimates of autonomic trait dimensions that may be significantly linked with psychosocial impairments and other core clinical features of ASD.
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Affiliation(s)
- Antoinette S DiCriscio
- Geisinger Health System, Autism & Developmental Medicine Institute (ADMI), Lewisburg, Pennsylvania, USA
| | - K E Wain
- Geisinger Health System, Autism & Developmental Medicine Institute (ADMI), Lewisburg, Pennsylvania, USA
| | - J Smith
- Geisinger Health System, Autism & Developmental Medicine Institute (ADMI), Lewisburg, Pennsylvania, USA
| | - D Beiler
- Geisinger Health System, Autism & Developmental Medicine Institute (ADMI), Lewisburg, Pennsylvania, USA
| | - L K Walsh
- Geisinger Health System, Autism & Developmental Medicine Institute (ADMI), Lewisburg, Pennsylvania, USA
| | - K Holdren
- Geisinger Health System, Autism & Developmental Medicine Institute (ADMI), Lewisburg, Pennsylvania, USA
| | - Vanessa Troiani
- Geisinger Health System, Autism & Developmental Medicine Institute (ADMI), Lewisburg, Pennsylvania, USA.,Department of Imaging Science and Innovation, Center for Health Research, Geisinger, Danville, Pennsylvania, USA.,Neuroscience Institute, Geisinger, Danville, Pennsylvania, USA.,Department of Basic Sciences, Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania, USA
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13
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Knez R, Stevanovic D, Fernell E, Gillberg C. Orexin/Hypocretin System Dysfunction in ESSENCE (Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations). Neuropsychiatr Dis Treat 2022; 18:2683-2702. [PMID: 36411777 PMCID: PMC9675327 DOI: 10.2147/ndt.s358373] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 07/28/2022] [Indexed: 11/17/2022] Open
Abstract
Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations (ESSENCE) is an umbrella term covering a wide range of neurodevelopmental difficulties and disorders. Thus, ESSENCE includes attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and other neurodevelopmental disorders (NDDs) and difficulties, with a variety of symptoms in cognitive, motor, sensory, social, arousal, regulatory, emotional, and behavioral developmental domains, frequently co-occurring and likely having partly common neurobiological substrates. The ESSENCE concept is a clinical paradigm that promotes organizing NDDs in everyday clinical practice according to their coexistence, symptom dimensions overlapping, and treatment possibilities. Despite increased knowledge regarding NDDs, the neurobiological mechanisms that underlie them and other ESSENCE-related problems, are not well understood. With its wide range of neural circuits and interactions with numerous neurotransmitters, the orexin/hypocretin system (Orx-S) is possibly associated with a variety of neurocognitive, psychobiological, neuroendocrine, and physiological functions and behaviors. Dysfunction of Orx-S has been implicated in various psychiatric and neurological disorders. This article provides an overview of Orx-S dysfunctions' possible involvement in the development, presentation, and maintenance of ESSENCE. We provide a focused review of current research evidence linking orexin neuropeptides with specific clinical NDDs symptoms, mostly in ADHD and ASD, within the Research Domain Criteria (RDoC) framework. We propose that Orx-S dysfunction might have an important role in some of these neurodevelopmental symptom domains, such as arousal, wakefulness, sleep, motor and sensory processing, mood and emotional regulation, fear processing, reward, feeding, attention, executive functions, and sociability. Our perspective is presented from a clinical point of view. Further, more thorough systematic reviews are needed as well as planning of extensive new research into the Orx-S's role in ESSENCE, especially considering RDoC elements.
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Affiliation(s)
- Rajna Knez
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Pediatrics, Skaraborg Hospital, Skövde, Sweden
- School of Health Sciences, University of Skövde, Skövde, Sweden
| | - Dejan Stevanovic
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Elisabeth Fernell
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Christopher Gillberg
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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14
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Evaluation of Sympathetic and Parasympathetic Tone and Reactivity in Adolescents with Specific Learning Disorder (Dyslexia). Indian J Pediatr 2022; 89:657-664. [PMID: 35441957 DOI: 10.1007/s12098-022-04156-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 12/10/2021] [Indexed: 12/30/2022]
Abstract
OBJECTIVES To evaluate the autonomic function in specific learning disorder (SLD) and comorbid SLD attention-deficit hyperactivity disorder (SLD-ADHD). METHODS A cross-sectional study was conducted in a tertiary care hospital with 20 adolescent subjects each of confirmed SLD, SLD-ADHD, and healthy control (mean age 15.32 y). Heart-rate variability and autonomic-function tests were carried out using standard protocols. RESULTS Heart-rate variability parameters, viz., mean RR interval, number of RR intervals which differ by ≥ 50 ms (NN50), percentage NN50, standard deviation of differences between adjacent RR intervals, root square of mean of the sum of the squares of differences between adjacent RR intervals, coefficient of variance and absolute power of high-frequency band (HF) recorded apparently lower levels in SLD and SLD-ADHD as compared to healthy control indicating lower parasympathetic tone. Whereas, higher absolute power of low- frequency band (LF) in SLD and SLD-ADHD than healthy control indicated enhanced sympathetic activity. Higher LF/HF and lower SD1/SD2 ratios in SLD and SLD-ADHD than healthy control indicated higher sympathetic tone over parasympathetic tone. Values of autonomic-function tests such as E:I ratio, change in heart rate during deep-breathing test, 30:15 ratio, and Valsalva ratio showed a decrease in SLD and SLD-ADHD as compared to healthy control implying reduction in parasympathetic reactivity. Increased values for rise in diastolic blood pressure in the isometric handgrip test and cold pressor test recorded in SLD as compared to healthy control, revealed the increased sympathetic reactivity. CONCLUSION Overall, results of heart-rate variability and autonomic-function tests imply dysregulation of sympathetic and parasympathetic activities with sympathetic dominance in SLD and SLD-ADHD.
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15
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Cardiac Evaluation of Exercise Testing in a Contemporary Population of Preschool Children: A New Approach Providing Reference Values. CHILDREN 2022; 9:children9050654. [PMID: 35626831 PMCID: PMC9139640 DOI: 10.3390/children9050654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 03/26/2022] [Accepted: 04/29/2022] [Indexed: 11/24/2022]
Abstract
The objective of this study was to evaluate cardiac autonomic function at rest, during maximal exercise, and in post-exercise recovery, to determine sex-specific and age-specific differences in resting heart rate (RHR), linear and spectral parameters of Heart Rate Variability (HRV), HRpeak, and heart rate recovery (HRR) after one and five minutes, in preschool children. This study involved a cohort of 167 healthy children (79 girls) aged 3 to 6 years that were selected from several schools in southern Spain. A 10 × 20 m test was conducted, and the cardiovascular response was recorded. No significant differences were found in all variables between the sexes. However, a significant reduction in RHR and an increase in HRR were found from age 4 to age 6. HRV parameters at rest were higher in older children. No associations between 10 × 20 m performance, weight status, and cardiac parameters were found. Simple linear regression analysis revealed that heart rate reserve (HRr), HRR5min, RMSSD, and HF were the variables that showed association with all HR parameters. There was also a significant correlation between HRr and HRR5min. In conclusion, cardiovascular autonomic function during rest, exercise, and recovery in Spanish preschool children was not influenced by sex, although older children showed greater cardiovascular modulation. Cardiorespiratory fitness status was not associated with HR response.
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16
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Tanko D, Barua PD, Dogan S, Tuncer T, Palmer E, Ciaccio EJ, Acharya UR. EPSPatNet86: eight-pointed star pattern learning network for detection ADHD disorder using EEG signals. Physiol Meas 2022; 43. [PMID: 35377344 DOI: 10.1088/1361-6579/ac59dc] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 03/01/2022] [Indexed: 12/22/2022]
Abstract
Objective.The main objective of this work is to present a hand-modelled one-dimensional signal classification system to detect Attention-Deficit Hyperactivity Disorder (ADHD) disorder using electroencephalography (EEG) signals.Approach.A novel handcrafted feature extraction method is presented in this research. Our proposed method uses a directed graph and an eight-pointed star pattern (EPSPat). Also, tunable q wavelet transforms (TQWT), wavelet packet decomposition (WPD), statistical extractor, iterative Chi2 (IChi2) selector, and the k-nearest neighbors (kNN) classifier have been utilized to develop the EPSPat based learning model. This network uses two wavelet decomposition methods (TQWT and WPD), and 85 wavelet coefficient bands are extracted. The proposed EPSPat and statistical feature creator generate features from the 85 wavelet coefficient bands and the original EEG signal. The learning network is termed EPSPatNet86. The main purpose of the presented EPSPatNet86 is to detect abnormalities of the EEG signals. Therefore, 85 wavelet subbands have been generated to extract features. The created 86 feature vectors have been evaluated using the Chi2 selector and the kNN classifier in the loss value calculation phase. The final features vector is created by employing a minimum loss-valued eight feature vectors. The IChi2 selector selects the best feature vector, which is fed to the kNN classifier. An EEG signal dataset has been used to demonstrate the presented model's EEG signal classification ability. We have used an ADHD EEG dataset since ADHD is a commonly seen brain-related ailment.Main results.Our developed EPSPatNet86 model can detect the ADHD EEG signals with 97.19% and 87.60% accuracy using 10-fold cross and subject-wise validations, respectively.Significance.The calculated results demonstrate that the presented EPSPatNet86 attained satisfactory EEG classification ability. Results show that we can apply our developed EPSPatNet86 model to other EEG signal datasets to detect abnormalities.
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Affiliation(s)
- Dahiru Tanko
- Department of Digital Forensics Engineering, Technology Faculty, Firat University, Elazig, Turkey
| | - Prabal Datta Barua
- School of Management & Enterprise, University of Southern Queensland, Australia.,Faculty of Engineering and Information Technology, University of Technology Sydney, Australia.,Cogninet Brain Team, Cogninet Australia, Sydney, NSW 2010, Australia
| | - Sengul Dogan
- Department of Digital Forensics Engineering, Technology Faculty, Firat University, Elazig, Turkey
| | - Turker Tuncer
- Department of Digital Forensics Engineering, Technology Faculty, Firat University, Elazig, Turkey
| | - Elizabeth Palmer
- Centre of Clinical Genetics, Sydney Children's Hospitals Network, Randwick 2031, Australia.,School of Women's and Children's Health, University of New South Wales, Randwick 2031, Australia
| | - Edward J Ciaccio
- Department of Medicine, Columbia University Irving Medical Center, United States of America
| | - U Rajendra Acharya
- Ngee Ann Polytechnic, Department of Electronics and Computer Engineering, 599489, Singapore.,Department of Biomedical Engineering, School of Science and Technology, SUSS University, Singapore.,Department of Biomedical Informatics and Medical Engineering, Asia University, Taichung, Taiwan
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17
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Loh HW, Ooi CP, Barua PD, Palmer EE, Molinari F, Acharya UR. Automated detection of ADHD: Current trends and future perspective. Comput Biol Med 2022; 146:105525. [DOI: 10.1016/j.compbiomed.2022.105525] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 03/31/2022] [Accepted: 04/04/2022] [Indexed: 12/25/2022]
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18
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Koh JEW, Ooi CP, Lim-Ashworth NS, Vicnesh J, Tor HT, Lih OS, Tan RS, Acharya UR, Fung DSS. Automated classification of attention deficit hyperactivity disorder and conduct disorder using entropy features with ECG signals. Comput Biol Med 2022; 140:105120. [PMID: 34896884 DOI: 10.1016/j.compbiomed.2021.105120] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 11/25/2021] [Accepted: 12/02/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND The most prevalent neuropsychiatric disorder among children is attention deficit hyperactivity disorder (ADHD). ADHD presents with a high prevalence of comorbid disorders such as conduct disorder (CD). The lack of definitive confirmatory diagnostic tests for ADHD and CD make diagnosis challenging. The distinction between ADHD, ADHD + CD and CD is important as the course and treatment are different. Electrocardiography (ECG) signals may become altered in behavioral disorders due to brain-heart autonomic interactions. We have developed a software tool to categorize ADHD, ADHD + CD and CD automatically on ECG signals. METHOD ECG signals from participants were decomposed using empirical wavelet transform into various modes, from which entropy features were extracted. Robust ten-fold cross-validation with adaptive synthetic sampling (ADASYN) and z-score normalization were performed at each fold. Analysis of variance (ANOVA) technique was employed to determine the variability within the three classes, and obtained the most discriminatory features. Highly significant entropy features were then fed to classifiers. RESULTS Our model yielded the best classification results with the bagged tree classifier: 87.19%, 87.71% and 86.29% for accuracy, sensitivity and specificity, respectively. CONCLUSION The proposed expert system can potentially assist mental health professionals in the stratification of the three classes, for appropriate intervention using accessible ECG signals.
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Affiliation(s)
- Joel E W Koh
- School of Engineering, Ngee Ann Polytechnic, Singapore
| | - Chui Ping Ooi
- School of Science and Technology, Singapore University of Social Sciences, Singapore
| | | | | | - Hui Tian Tor
- School of Science and Technology, Singapore University of Social Sciences, Singapore
| | - Oh Shu Lih
- School of Engineering, Ngee Ann Polytechnic, Singapore
| | - Ru-San Tan
- National Heart Centre Singapore, Singapore.
| | - U Rajendra Acharya
- School of Engineering, Ngee Ann Polytechnic, Singapore; School of Science and Technology, Singapore University of Social Sciences, Singapore; Department of Bioinformatics and Medical Engineering, Asia University, Taiwan, ROC; School of Management and Enterprise University of Southern Queensland, Springfield, Australia.
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19
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Chiovato A, Demarzo M, Notargiacomo P. Evaluation of Mindfulness State for the Students Using a Wearable Measurement System. J Med Biol Eng 2021; 41:690-703. [PMID: 34608381 PMCID: PMC8482961 DOI: 10.1007/s40846-021-00658-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 09/07/2021] [Indexed: 11/27/2022]
Abstract
Purpose This study aimed to develop and evaluate the feasibility and preliminary efficiency of a methodology to measure the mindfulness state using a wearable device ("Cap") capable of monitoring students' levels of full attention by means of real-time measured heart rate variability (HRV). Methods The device was developed to export the data to the user's smartphone via Bluetooth, which in turn stores the securely accessible data in the cloud. The autonomous wearable device consists of electronic boards of the Arduino platform that detect the period in milliseconds between two subsequent referential R peaks of the QRS complex wave through infrared oxygenation sensor. Results In a population of 13 subjects (8 female, 5 male, age 16.1 years ± 0.58 ), the Z-test ( p < 0.05 ) using rMSSD (root mean squared successive differences) and the Toronto Mindfulness (Curiosity) Scale within two 50 min windows, shows that increased HRV values converge to high values for the mindfulness state when the time difference between R n and R n + 1 samples is greater than 88 ms. Conclusion The device proved to be viable and potentially effective for measuring the state of mindfulness. Thus, further studies should be conducted to test it on a large scale as well as in real classroom situations.
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Affiliation(s)
- André Chiovato
- Program in Electrical Engineering and Computing, Mackenzie Presbyterian University, São Paulo, Brazil
| | - Marcelo Demarzo
- Collective Health from Medicine Preventive Department, São Paulo State University, São Paulo, Brazil
| | - Pollyana Notargiacomo
- Program in Electrical Engineering and Computing, Mackenzie Presbyterian University, São Paulo, Brazil
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20
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Khaled Abd-Elhaleim El Azazy M, Kamel Mohamed EA, Ismail Abo El-Fadl HM, Abd El-Razik FH, Abu Elfotuh K. Omega-3 Rich Oils Attenuate ADHD-Like Behaviour Induced by Dietary Monosodium Glutamate in Rats. Pak J Biol Sci 2021; 24:868-880. [PMID: 34486354 DOI: 10.3923/pjbs.2021.868.880] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
<b>Background and Objective:</b> Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by inattention, hyperactivity and cognitive dysfunction. The present study was designed to examine the possible modulatory effect of Fish, Walnuts or Fenugreek Oils against Attention Deficit Hyperactivity Disorder (ADHD)-like Behavior induced by Monosodium Glutamate (MSG) in Rats. <b>Materials and Methods:</b> Fifty weaning rats were divided into five groups, (each group contain 10 rats) as follows: Group 1: Normal control rats were fed on a balanced diet. Groups from 2-5 rats were fed on a balanced diet+MSG (0.4 g kg<sup></sup><sup>1</sup> diet), Group 2 served as a positive control group whereas group 3, 4 and 5 treated with Fish, Walnuts and Fenugreek oil, respectively, (200 mg kg<sup></sup><sup>1</sup> b.wt.) by intra-gastric tube. Biochemical and behavioural parameters were tested as well as microscopic examination of brain tissue was done. <b>Results:</b> MSG ingestion caused marked disruption in locomotors activity, memory function and brain tissue structure along with significant abnormalities in some bio-markers and reduction in the gene expression level of Bcl-2 in brain tissue. However, treatment with the tested oils showed remarkable effect by reversing the condition. <b>Conclusion:</b> Dietary supplementation with walnut; fenugreek or fish oils at the tested dose could modulate the condition of ADHD in rats.
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Cattaneo LA, Franquillo AC, Grecucci A, Beccia L, Caretti V, Dadomo H. Is Low Heart Rate Variability Associated with Emotional Dysregulation, Psychopathological Dimensions, and Prefrontal Dysfunctions? An Integrative View. J Pers Med 2021; 11:872. [PMID: 34575648 PMCID: PMC8465800 DOI: 10.3390/jpm11090872] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 08/26/2021] [Accepted: 08/29/2021] [Indexed: 11/29/2022] Open
Abstract
Several studies have suggested a correlation between heart rate variability (HRV), emotion regulation (ER), psychopathological conditions, and cognitive functions in the past two decades. Specifically, recent data seem to support the hypothesis that low-frequency heart rate variability (LF-HRV), an index of sympathetic cardiac control, correlates with worse executive performances, worse ER, and specific psychopathological dimensions. The present work aims to review the previous findings on these topics and integrate them from two main cornerstones of this perspective: Porges' Polyvagal Theory and Thayer and Lane's Neurovisceral Integration Model, which are necessary to understand these associations better. For this reason, based on these two approaches, we point out that low HRV is associated with emotional dysregulation, worse cognitive performance, and transversal psychopathological conditions. We report studies that underline the importance of considering the heart-brain relation in order to shed light on the necessity to implement psychophysiology into a broader perspective on emotions, mental health, and good cognitive functioning. This integration is beneficial not only as a theoretical ground from which to start for further research studies but as a starting point for new theoretical perspectives useful in clinical practice.
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Affiliation(s)
| | - Anna Chiara Franquillo
- Department of Human Sciences, LUMSA University, 00193 Rome, Italy;
- Consorzio Universitario Humanitas, 00193 Rome, Italy
| | - Alessandro Grecucci
- Department of Psychology and Cognitive Science, DiPSCo, University of Trento, Corso Bettini, 38068 Rovereto, Italy;
- Center for Medical Sciences, CISMed, University of Trento, 38122 Trento, Italy
| | - Laura Beccia
- Schema Therapy Center, 21047 Saronno, Italy; (L.A.C.); (L.B.)
| | - Vincenzo Caretti
- Department of Human Sciences, LUMSA University, 00193 Rome, Italy;
- Consorzio Universitario Humanitas, 00193 Rome, Italy
| | - Harold Dadomo
- Neuroscience Unit, Department of Medicine and Surgery, University of Parma, 43125 Parma, Italy;
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Rahi V, Kumar P. Animal models of attention-deficit hyperactivity disorder (ADHD). Int J Dev Neurosci 2021; 81:107-124. [PMID: 33428802 DOI: 10.1002/jdn.10089] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 12/14/2020] [Accepted: 01/06/2021] [Indexed: 12/15/2022] Open
Abstract
Attention-deficit hyperactivity disorder (ADHD) is a heterogeneous neuropsychiatric disorder characterized by three primary symptoms hyperactivity, attention deficit, and impulsiveness, observed in both children and adults. In childhood, this disorder is more common in boys than in girls, and at least 75% will continue to suffer from the disorder until adulthood. Individuals with ADHD generally have poor academic, occupational, and social functioning resulting from developmentally inappropriate levels of hyperactivity and impulsivity, as well as impaired ability to maintain attention on motivationally relevant tasks. Very few drugs available in clinical practice altogether abolish the symptoms of ADHD, therefore, to find new drugs and target it is essential to understand the neuropathological, neurochemical, and genetic alterations that lead to the progression of ADHD. With this contrast, an animal study is the best approach because animal models provide relatively fast invasive manipulation, rigorous hypothesis testing, as well as it provides a better angle to understand the pathological mechanisms involved in disease progression. Moreover, animal models, especially for ADHD, serve with good predictive validity would allow the assessment and development of new therapeutic interventions, with this aim, the present review collect the various animal models on a single platform so that the research can select an appropriate model to pursue his study.
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Affiliation(s)
- Vikrant Rahi
- Department of Pharmaceutical Sciences and Technology, Maharaja Ranjit Singh Punjab Technical University, Bathinda, India
| | - Puneet Kumar
- Department of Pharmaceutical Sciences and Technology, Maharaja Ranjit Singh Punjab Technical University, Bathinda, India
- Department of Pharmacology, Central University of Punjab, Bathinda, India
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Callaghan B, Pini N, Silvers JA, Van Tieghem M, Choy T, O'Sullivan K, Fifer WP, Tottenham N. Child-parent cardiac transference is decreased following disrupted/absent early care. Dev Psychobiol 2021; 63:1279-1294. [PMID: 33590482 DOI: 10.1002/dev.22102] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 01/13/2021] [Accepted: 01/17/2021] [Indexed: 11/09/2022]
Abstract
Parental input shapes youth self-regulation development, and a lack of sensitive caregiving is a risk factor for youth mental health problems. Parents may shape youth regulation through their influence over biological (including neural) and behavioral development during childhood at both micro (moment-to-moment) and macro (global) levels. Prior studies have shown that micro-level parent-child interactions shape youth's biology contributing to youth mental health. However, it remains unclear whether prior disrupted/absent care affects those moment-to-moment parent-youth interactions in ways that increase risk for youth psychopathology. In the current study, we calculated transfer entropy on cardiac data from parent-youth dyads where the youth had either been exposed to disrupted care prior to adoption or not. Transfer Entropy (TE) tracks information flow between two signals, enhancing quantification of directional coupling, allowing for the examination of parent-child and child-parent influences. Using this novel approach, we identified lower cardiac information transfer from youth-to-parents in dyads where the youth had been exposed to disrupted/absent early care. Moreover we showed that the degree to which the parent's physiology changed in response to youth's physiology was negatively related to the youth's mental health, representing a potential pathway for elevated mental health risk in populations exposed to disrupted/absent early care.
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Affiliation(s)
| | - Nicolò Pini
- Columbia University Irving Medical Center, New York State Psychiatric Institute, New York, NY, USA
| | | | | | - Tricia Choy
- University of California, Riverside, CA, USA
| | | | - William P Fifer
- Columbia University Irving Medical Center, New York State Psychiatric Institute, New York, NY, USA
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Julia Yan J, Schoppe-Sullivan SJ, Beauchaine TP. Paternal antisociality and growth in child delinquent behaviors: Moderating effects of child sex and respiratory sinus arrhythmia. Dev Psychobiol 2020; 63:1466-1481. [PMID: 33377526 DOI: 10.1002/dev.22083] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 12/04/2020] [Accepted: 12/10/2020] [Indexed: 12/23/2022]
Abstract
Children of fathers with antisocial personality disorder (ASPD) are at risk for developing delinquency, and both biological and environmental mechanisms contribute. In this study, we test parasympathetic nervous system (PNS) function as a vulnerability/sensitivity attribute in predicting intergenerational associations between fathers' antisociality and children's delinquency scores. We followed 207 children (ages 8-12 years at intake; 139 boys) across three annual assessments. Fathers' antisociality was measured via maternal reports on the Family Interview for Genetic Studies (FIGS). At Year 1, children's resting respiratory sinus arrhythmia (RSA) was measured. At Years 1, 2, and 3, child delinquent behaviors were assessed using the delinquency subscale of the Youth Self-Report. At age 8, boys' delinquency scores were associated weakly with paternal antisocial behaviors. However, boys' delinquency scores increased steeply thereafter specifically for those who had fathers with higher antisocial symptoms. In addition, associations between delinquency and paternal antisociality were largest for boys with higher resting RSA. For girls, growth in delinquency was unrelated to both father antisociality and resting RSA. These findings (a) suggest moderating effects of children's age, sex, and PNS function on associations between father antisocial behavior and offspring delinquency; and (b) provide insights into differential vulnerability among children of fathers with ASPD.
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Affiliation(s)
- Jia Julia Yan
- Department of Human Development and Family Studies, Utah State University, Logan, UT, USA
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Speer KE, Semple S, Naumovski N, McKune AJ. Measuring Heart Rate Variability Using Commercially Available Devices in Healthy Children: A Validity and Reliability Study. Eur J Investig Health Psychol Educ 2020; 10:390-404. [PMID: 34542492 PMCID: PMC8314243 DOI: 10.3390/ejihpe10010029] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 01/08/2020] [Accepted: 01/08/2020] [Indexed: 12/25/2022] Open
Abstract
Heart rate variability (HRV) is an accepted method for determining autonomic nervous system activity and cardiovascular risk in various populations. This study assessed the validity and reliability of a commercially available finger photoplethysmography (PPG) system for measuring pediatric HRV in a real-world setting. Sixteen healthy children (4.06 ± 0.58 years) were recruited. The PPG system was compared to the Polar H10 heart rate (HR) sensor validated against ECG (gold standard) for HRV measurement. Seated short-term resting R-R intervals were recorded simultaneously using both systems. Recordings were performed on 3 days at the participants’ school. Paired t-tests, effect sizes and Bland–Altman analyses determined the validity of the PPG system. The relative and absolute reliability of both systems were calculated. No HRV parameters were valid for the PPG system. Polar H10 yielded moderate (0.50–0.75) to good (0.75–0.90) relative reliability with R-R intervals and the standard deviation of instantaneous and continuous R-R variability ratio showing the best results (ICCs = 0.84). Polar H10 displayed better absolute reliability with the root mean square of successive differences, R-R intervals and HR showing the lowest values (TEM% < 12%). The use of the Polar H10 and not the PPG system is encouraged for HRV measurement of young children in an educational real-world setting.
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Affiliation(s)
- Kathryn E. Speer
- Faculty of Health, Discipline of Sport and Exercise Science/University of Canberra, Canberra (ACT) 2617, Australia; (S.S.); (A.J.M.)
- Research Institute for Sport and Exercise/University of Canberra, Canberra (ACT) 2617, Australia
- Correspondence:
| | - Stuart Semple
- Faculty of Health, Discipline of Sport and Exercise Science/University of Canberra, Canberra (ACT) 2617, Australia; (S.S.); (A.J.M.)
- Research Institute for Sport and Exercise/University of Canberra, Canberra (ACT) 2617, Australia
| | - Nenad Naumovski
- Faculty of Health, University of Canberra, Canberra (ACT) 2617, Australia;
| | - Andrew J. McKune
- Faculty of Health, Discipline of Sport and Exercise Science/University of Canberra, Canberra (ACT) 2617, Australia; (S.S.); (A.J.M.)
- Research Institute for Sport and Exercise/University of Canberra, Canberra (ACT) 2617, Australia
- Discipline of Biokinetics, Exercise and Leisure Sciences, School of Health Sciences/University of KwaZulu-Natal, Durban 4041, (KwaZulu-Natal), South Africa
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Bellato A, Arora I, Hollis C, Groom MJ. Is autonomic nervous system function atypical in attention deficit hyperactivity disorder (ADHD)? A systematic review of the evidence. Neurosci Biobehav Rev 2020; 108:182-206. [DOI: 10.1016/j.neubiorev.2019.11.001] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 10/31/2019] [Accepted: 11/01/2019] [Indexed: 12/26/2022]
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Groeneveld KM, Mennenga AM, Heidelberg RC, Martin RE, Tittle RK, Meeuwsen KD, Walker LA, White EK. Z-Score Neurofeedback and Heart Rate Variability Training for Adults and Children with Symptoms of Attention-Deficit/Hyperactivity Disorder: A Retrospective Study. Appl Psychophysiol Biofeedback 2019; 44:291-308. [PMID: 31119405 PMCID: PMC6834758 DOI: 10.1007/s10484-019-09439-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
ADHD is a common condition that causes suffering for those affected and economic loss for society at large. The current standard treatment for ADHD includes stimulant medications, which are not effective for all patients, may include side effects, and can be non-medically misused. Z-score neurofeedback (NFB) and heart rate variability (HRV) biofeedback are alternative treatment strategies that have been associated with Attention-Deficit/Hyperactivity Disorder (ADHD) symptom improvement. We utilized a retrospective pre-post study design to quantify the change in clients' ADHD symptoms after combined NFB + HRV treatment (which included simultaneous z-score training at four sites). We also assessed whether relevant physiological measures changed in accordance with the protocol, which would be consistent with effective NFB + HRV training. Adults (n = 39) and children (n = 100) with Borderline or Clinical ADHD classifications by the Achenbach System of Empirically Based Assessment (ASEBA) received 30 sessions of NFB + HRV training. Measures were compared before and after treatment for the ASEBA, the Integrated Visual and Auditory Continuous Performance Test (IVA), ADHD medication use, HRV and breathing parameters, and quantitative electroencephalogram (QEEG) parameters. Average ASEBA Attention-Deficit/Hyperactive Problems score improved after treatment for adults and children (p < 0.0001), with Cohen effect sizes (dz) of -1.21 and -1.17, respectively. 87.2% of adults and 80.0% of children experienced improvements of a magnitude greater than or equal to the Minimal Clinically Important Difference. After treatment, 70.8% of adults and 52.8% of children who began in the ASEBA Clinical range, and 80.0% of adults and 63.8% of children who began in the ASEBA Borderline range, were classified in the Normal range. IVA scores also improved after treatment. Changes in HRV and breathing pattern after treatment were consistent with the protocol. QEEG parameters after treatment were closer to the age-based normative mean, which is consistent with effective z-score NFB training.
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Affiliation(s)
| | - Anna M. Mennenga
- Neurocore, 201 Monroe Avenue NW Suite 300, Grand Rapids, MI 49503 USA
| | | | - Rachel E. Martin
- Neurocore, 201 Monroe Avenue NW Suite 300, Grand Rapids, MI 49503 USA
| | - Rachel K. Tittle
- Neurocore, 201 Monroe Avenue NW Suite 300, Grand Rapids, MI 49503 USA
| | - Kyle D. Meeuwsen
- Neurocore, 201 Monroe Avenue NW Suite 300, Grand Rapids, MI 49503 USA
| | - Linda A. Walker
- Neurocore, 201 Monroe Avenue NW Suite 300, Grand Rapids, MI 49503 USA
- Saybrook University, Alameda, CA USA
| | - Elyse K. White
- Neurocore, 201 Monroe Avenue NW Suite 300, Grand Rapids, MI 49503 USA
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Bayo-Tallón V, Esquirol-Caussa J, Pàmias-Massana M, Planells-Keller K, Palao-Vidal DJ. Effects of manual cranial therapy on heart rate variability in children without associated disorders: Translation to clinical practice. Complement Ther Clin Pract 2019; 36:125-141. [PMID: 31383430 DOI: 10.1016/j.ctcp.2019.06.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 06/11/2019] [Accepted: 06/30/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND and purpose: Heart rate variability (HRV) represents a marker of autonomic activity, self-regulation and psychiatric illness. Few studies of manual therapy have investigated the neurophysiological effects of manual cranial therapy (MC-t). This study assessed the neurophysiological short/medium-term effects of two manual therapy interventions: massage therapy (Mss-t) and MC-t. MATERIALS AND METHODS A double-blind clinical trial was conducted with 50 healthy children, randomized into two groups who received a Mss-t intervention or MC-t. The variables analysed included vital signs (temperature, respiratory rate, heart rate, blood pressure) and HRV components, including the root mean square of successive differences (RMSSD), high frequency (HF), low frequency (LF) and LF/HF ratio. RESULTS Both interventions produced short-term parasympathetic effects, although the effects of MC-t were more persistent. CONCLUSION The persistence of the MC-t intervention suggested a prominent vagal control and better self-regulation. Autonomic imbalances in mental pathologies may benefit from the neurophysiological effects of MC-t.
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Affiliation(s)
- Vanessa Bayo-Tallón
- Universitary Research Service of Physical Therapy, Servei Universitari de Recerca en Fisioteràpia -S.U.R.F, Autonomous University of Barcelona, Cerdanyola del Vallès, Spain.
| | - Jordi Esquirol-Caussa
- Universitary Research Service of Physical Therapy, Servei Universitari de Recerca en Fisioteràpia -S.U.R.F, Autonomous University of Barcelona, Cerdanyola del Vallès, Spain.
| | - Montserrat Pàmias-Massana
- Executive Direction of Adult, Child and Juvenile Mental Health Area at Corporación Sanitaria y Universitaria Parc Taulí (Neurosciences) (Autonomous University of Barcelona, Cerdanyola del Vallès, Spain
| | - Kalia Planells-Keller
- Executive Direction of Adult, Child and Juvenile Mental Health Area at Corporación Sanitaria y Universitaria Parc Taulí (Neurosciences) (Autonomous University of Barcelona, Cerdanyola del Vallès, Spain
| | - Diego J Palao-Vidal
- Executive Direction of Adult, Child and Juvenile Mental Health Area at Corporación Sanitaria y Universitaria Parc Taulí (Neurosciences) (Autonomous University of Barcelona, Cerdanyola del Vallès, Spain
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29
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Siennicka A, Quintana DS, Fedurek P, Wijata A, Paleczny B, Ponikowska B, Danel DP. Resting heart rate variability, attention and attention maintenance in young adults. Int J Psychophysiol 2019; 143:126-131. [PMID: 31255739 DOI: 10.1016/j.ijpsycho.2019.06.017] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 06/25/2019] [Accepted: 06/26/2019] [Indexed: 01/26/2023]
Abstract
Heart rate variability (HRV) is a widely used measure that reflects autonomic (parasympathetic) control of the heart. HRV has been linked with attentional performance, but it is unclear to what extent resting HRV is associated with both attention and attentional maintenance. In order to address this, we calculated HRV in seventy-four young and healthy volunteers (43 men, age: 21.6 ± 2.4), who completed the D2 Test of Attention (D2), which was used to calculate an index of Concentration Performance (CP) and a measure of attention maintenance, the coefficient of variation (CV). After accounting for the effects of sex and age on HRV, there was no significant association between HRV and CP (p = .2), but a significant relationship between HRV and CV (p = .03). Overall, our study demonstrates that attention maintenance, but not attentional performance, is associated with higher resting state HRV which suggests that attentional performance from D2 subtest-to-subtest may reflect HRV's facilitation of behaviour flexibility.
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Affiliation(s)
- A Siennicka
- Department of Physiology, Wroclaw Medical University, Wroclaw, Poland; Department of Cardiology, Military Hospital in Wroclaw, Poland.
| | - D S Quintana
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, University of Oslo, and Oslo University Hospital, Oslo, Norway
| | - P Fedurek
- Department of Life Sciences, University of Roehampton, London, United Kingdom
| | - A Wijata
- Faculty of Biomedical Engineering, Silesian University of Technology, Zabrze, Poland
| | - B Paleczny
- Department of Physiology, Wroclaw Medical University, Wroclaw, Poland; Department of Cardiology, Military Hospital in Wroclaw, Poland
| | - B Ponikowska
- Department of Physiology, Wroclaw Medical University, Wroclaw, Poland
| | - D P Danel
- Ludwik Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wroclaw, Poland
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Abstract
Abstract
Attention deficit/hyperactivity disorder (ADHD) is one of the most frequently seen mental disorders in children with an increasing risk for other mental disorders. ADHD represents a primary biological dysfunction of the central nervous system, such as dysregulation of frontal-subcortical-cerebellar catecholaminergic circuits and imbalances in the dopaminergic system. However, autonomic nervous system, comprised of two primary branches - sympathetic and parasympathetic nervous systems that are normally in dynamic balance, plays an essential role in the regulation of body functions. Although it is generally assumed that the autonomic regulation is impaired during ADHD the information related to this dysregulation is limited. One of the options to observe changes of autonomic balance in ADHD is pupillary light reflex (PLR). Pupillometric evaluation can be used for the assessment of functioning of both autonomic nervous system branches and certain parameters of pupil responsivity can be helpful as a tool for medical diagnostic and treatment. In conclusion, these findings suggest the pupillometry as a non-invasive method that can indicate abnormalities in the complex central autonomic network regulating PLR.
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Robe A, Dobrean A, Cristea IA, Păsărelu CR, Predescu E. Attention-deficit/hyperactivity disorder and task-related heart rate variability: A systematic review and meta-analysis. Neurosci Biobehav Rev 2019; 99:11-22. [DOI: 10.1016/j.neubiorev.2019.01.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 01/09/2019] [Accepted: 01/21/2019] [Indexed: 01/04/2023]
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Saenen ND, Provost EB, Cuypers A, Kicinski M, Pieters N, Plusquin M, Vrijens K, De Boever P, Nawrot TS. Child's buccal cell mitochondrial DNA content modifies the association between heart rate variability and recent air pollution exposure at school. ENVIRONMENT INTERNATIONAL 2019; 123:39-49. [PMID: 30496980 PMCID: PMC6329889 DOI: 10.1016/j.envint.2018.11.028] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 10/29/2018] [Accepted: 11/12/2018] [Indexed: 05/23/2023]
Abstract
BACKGROUND Studies investigating short-term exposure to ambient air pollution and heart rate variability (HRV) suggest that particulate matter (PM) exposure is associated with reductions in measures of HRV. Mitochondria are sensitive to PM exposure and may represent a biologically relevant underlying mechanism. However, evidence in children is lacking. OBJECTIVES Here we examine whether PM has an influence on children's HRV and evaluate whether mitochondrial DNA content (mtDNAc) reflects individual susceptibility. METHODS Within a panel study in primary school children (aged 9-12 years), we measured HRV in a subset of 60 children on three different days during school-time using four indicators: normal-to-normal intervals (SDNN), square root of mean squared difference of normal-to-normal intervals (rMSSD), high frequency (HF), and low frequency (LF). This resulted in a total number of 150 visits (median number of visits per child: 2.5/child). MtDNAc was measured using qPCR in buccal cells. We measured recent PM exposure at the school. Residential 24-hour mean exposure to PM was modelled with a high resolution spatial temporal model. Mixed-effects models were used to estimate the association between HRV and recent PM exposure and potential effect-modification by mtDNAc. RESULTS Children were on average [SD] 9.9 [1.2] years and comprised 39 girls. Median [25th-75th] recent outdoor PM2.5 and PM10 exposure at school was 6.20 [2.8-12.8] μg/m3 and 29.3 [24.7-42.0] μg/m3, respectively. In children with low mtDNAc (25th percentile), we observed for each 10 μg/m3 increment in recent PM2.5 exposure a lowering in the LF parameter with 9.76% (95% CI: -16.9 to -1.99%, p = 0.02; pint = 0.007). Children with high mtDNAc did not show this association. For PM10 exposure, we observed an inverse association with three HRV indicators in children with low mtDNAc: -2.24% (95% CI: -4.27 to -0.16%; p = 0.04; pint = 0.02) for SDNN, -5.67% (95% CI: -10.5 to -0.59%; p = 0.03; pint = 0.04) for HF and -6.64% (95% CI: -10.7 to -2.38%; p = 0.003; pint = 0.005) for LF. CONCLUSIONS HRV is inversely associated with recent PM air pollution, especially in children with low mtDNAc. Our data revealed that mtDNAc determines susceptibility to adverse autonomic effects of recent PM exposure in children.
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Affiliation(s)
- Nelly D Saenen
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
| | - Eline B Provost
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium; Unit Environmental Risk & Health, Flemish Institute for Technological Research (VITO), Mol, Belgium
| | - Ann Cuypers
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
| | - Michal Kicinski
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
| | - Nicky Pieters
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
| | - Michelle Plusquin
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
| | - Karen Vrijens
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
| | - Patrick De Boever
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium; Unit Environmental Risk & Health, Flemish Institute for Technological Research (VITO), Mol, Belgium
| | - Tim S Nawrot
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium; Department of Public Health & Primary Care, Occupational & Environmental Medicine, Leuven, Belgium.
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Gomez T, Gupta A, Rashmi Krishnan UK, Chakraborty A, Sathyaprabha TN, Thennarasu K. Correlation between Heart Rate Variability and Bladder Sensations During Filling and Voiding Phase of Urodynamic Study in Patients with Myelopathy. Ann Indian Acad Neurol 2019; 22:61-66. [PMID: 30692761 PMCID: PMC6327692 DOI: 10.4103/aian.aian_453_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Objective: The objective of this study was to correlation between heart rate variability (HRV) and bladder sensations during filling and voiding phase of urodynamic study (UDS) in patients with myelopathy. Materials and Methods: Myelopathy patients (traumatic and nontraumatic) within 6 months of illness were included in the study. Demographic data, etiopathological diagnosis, and urinary complaints were noted. UDS was performed and simultaneous HRV calculated at each event of filling and voiding phase by recording and calculating standard deviation of normal-to-normal (NN) interval (SDNN), root mean square of successive differences, total power (TP), average heart rate, high frequency (HF), low-frequency (LF) ratio, and data analyzed. Results: The study included 30 patients (23 males) with a mean age of 31.2 years (range 18–60 years, standard deviation 11.6). The mean of LF in normalized units showed an increase from 43.6 ± 14.1 at baseline to 48.9 ± 17.4 at strong desire to void (SDV) and at urgency to 44.1 ± 14.5. HF at baseline 40.4 ± 14.1 reduced to 36.4 ± 12.8 at SDV and rose at urgency to 41.2 ± 13.2. LF/HF at baseline was 1.3 ± 0.8, which increased to 1.6 ± 1.1 at SDV and reduced at urgency to 1.2 ± 0.6. Significant change in mean value was seen in TP (P = 0.01) and SDNN (P = 0.009) at first desire to void. Significant positive trend was seen in TP (P = 0.048) and SDNN (P = 0.042) during filling. Conclusion: Comparison of HRV measures failed to show significant rise in sympathetic or parasympathetic component in myelopathy patients during UDS and requires more critical evaluation.
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Affiliation(s)
- Tenzil Gomez
- Department of Neurological Rehabilitation, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Anupam Gupta
- Department of Neurological Rehabilitation, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - U K Rashmi Krishnan
- Department of Neurological Rehabilitation, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Anirban Chakraborty
- Department of Neurophysiology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | | | - K Thennarasu
- Department of Biostatistics, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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Ottaviani C. Brain-heart interaction in perseverative cognition. Psychophysiology 2018; 55:e13082. [PMID: 29607505 DOI: 10.1111/psyp.13082] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 03/08/2018] [Accepted: 03/09/2018] [Indexed: 12/28/2022]
Abstract
The move from the concept of homeostasis to that of allostasis has led reactivity stress research to widen the object of its investigation: from the brief physiological response that occurs when one is facing a stressor to what happens when one is anticipating or recovering from a stressor. A paradigmatic example is represented by perseverative cognition, during which human beings react "as if" they were constantly facing a concrete stressor. The core idea behind this review is that the cognitive inflexibility that characterizes perseverative cognition is reflected in both our body (by increased autonomic nervous system rigidity assessed by heart rate variability; HRV) and our brain (by reduced prefrontal-amygdala functional connectivity). This is a review of studies conducted in different settings (laboratory, daily life), populations (healthy, major depression, generalized anxiety), location (United States, Europe), and age groups (children, adults) that consistently replicated the association between autonomic, subjective, and behavioral measures of cognitive inflexibility during perseverative cognition. Moreover, compelling neuroimaging data suggest that HRV reduction from pre- to post-induction of perseverative cognition is associated with both structural and functional brain abnormalities reflecting impaired prefrontal inhibitory control over subcortical structures (e.g., diminished prefrontal-amygdala functional connectivity). The integration of neuroscience techniques with clinical autonomic research has advanced our understanding of the neurobiology of brain-heart interaction during perseverative cognition, potentially yielding to more effective treatment packages. This is clinically relevant if one considers that perseverative cognition is a pervasive transdiagnostic factor that carries prognostic risk for both psychological and somatic health.
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Affiliation(s)
- Cristina Ottaviani
- Department of Psychology, Sapienza University of Rome, Rome, Italy.,Neuroimaging Laboratory, Santa Lucia Foundation, Rome, Italy
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35
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Mind-Body Therapy for Children with Attention-Deficit/Hyperactivity Disorder. CHILDREN-BASEL 2017; 4:children4050031. [PMID: 28441363 PMCID: PMC5447989 DOI: 10.3390/children4050031] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 04/03/2017] [Accepted: 04/18/2017] [Indexed: 12/26/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is pervasive among the pediatric population and new treatments with minimal adverse effects are necessary to be studied. The purpose of this article is to review current research studying mind–body therapies for treatment of children diagnosed with ADHD. Literature was reviewed pertaining to the effectiveness of movement-based therapies and mindfulness/meditation-based therapies for ADHD. Many positive effects of yoga, Tai Chi, physical activity, and meditation may significantly improve symptoms of ADHD among children.
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Griffiths KR, Quintana DS, Hermens DF, Spooner C, Tsang TW, Clarke S, Kohn MR. Sustained attention and heart rate variability in children and adolescents with ADHD. Biol Psychol 2017; 124:11-20. [DOI: 10.1016/j.biopsycho.2017.01.004] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 01/12/2017] [Accepted: 01/13/2017] [Indexed: 12/19/2022]
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Landgren M, Nasic S, Johnson M, Lövoll T, Holmgren D, Fernell E. Blood pressure and anthropometry in children treated with stimulants: a longitudinal cohort study with an individual approach. Neuropsychiatr Dis Treat 2017; 13:499-506. [PMID: 28243103 PMCID: PMC5317316 DOI: 10.2147/ndt.s123526] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Knowledge about the long-term effects on blood pressure (BP) and body mass index (BMI) when treating young patients for attention-deficit/hyperactivity disorder (AD/HD) with stimulants is limited. Most of the studies have reported mean and not individual values for anthropometrics and BP in treatment with stimulants. This seems to be the first study of changes based on the analyses of individual data measured over time. PATIENTS AND METHODS Seventy young patients (aged 8-18 years) diagnosed with AD/HD and responding well to treatment with stimulants were followed for a mean period of 3 years and 3 months. BP, heart rate, height, weight, and BMI were transformed to standard deviations or z-scores from before treatment to the last registered visit. RESULTS The mean dose of methylphenidate was 0.95 mg/kg. The mean increase of systolic and diastolic BP was 0.4 z-score and 0.1 z-score, respectively. The systolic BP was associated with BMI; a higher BMI at baseline increased the risk for an increase in systolic BP. Ten percent of the total group had a weight at follow-up of <-1.5 standard deviation (SD) and 12% had a height of <-1.5 SD. Mean height at follow-up was -0.2 SD, but 40% had a reduced height of at least 0.5 SD during the treatment period. BMI on a group level was reduced from +0.8 SD to +0.3 SD. Of the 19 patients with a BMI >+1.5 SD at baseline, 50% had a significantly reduced BMI. CONCLUSION Consequences of stimulant treatment must be evaluated individually. Besides significant effects on core AD/HD symptoms, some patients have lower BMI and BP and some increase/maintain their BMI and/or increase their systolic BP. The risk of reduced height trajectory needs further research.
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Affiliation(s)
- Magnus Landgren
- Department of Pediatrics, Unit of Developmental Disorders, Skaraborg's Hospital, Mariestad; Gillberg Neuropsychiatry Centre, University of Gothenburg, Gothenburg
| | | | - Mats Johnson
- Department of Pediatrics, Unit of Developmental Disorders, Skaraborg's Hospital, Mariestad; Gillberg Neuropsychiatry Centre, University of Gothenburg, Gothenburg
| | - Trygve Lövoll
- Department of Pediatrics, Unit of Developmental Disorders, Skaraborg's Hospital, Mariestad
| | - Daniel Holmgren
- Department of Pediatrics, Skaraborg's Hospital, Skövde; University of Gothenburg, Gothenburg, Sweden
| | - Elisabeth Fernell
- Gillberg Neuropsychiatry Centre, University of Gothenburg, Gothenburg
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