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

Authors de Carvalho TD, Wajnsztejn R, de Abreu LC, Marques Vanderlei LC, Godoy MF, Adami F, Valenti VE, Monteiro CBM, Leone C, da Cruz Martins KC, Ferreira C

Received 27 May 2013

Accepted for publication 12 August 2013

Published 11 April 2014 Volume 2014:10 Pages 613—618

DOI https://doi.org/10.2147/NDT.S49071

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 4

Tatiana Dias de Carvalho,1,2 Rubens Wajnsztejn,3 Luiz Carlos de Abreu,2,7 Luiz Carlos Marques Vanderlei,4 Moacir Fernandes Godoy,5 Fernando Adami,2 Vitor E Valenti,6 Carlos B M Monteiro,2,7 Claudio Leone,7 Karen Cristina da Cruz Martins,2 Celso Ferreira1

1Departamento de Medicina, Disciplina de Cardiologia, Universidade Federal de São Paulo, UNIFESP, São Paulo, Brazil; 2Laboratório de Escrita Científica da Faculdade de Medicina do ABC, FMABC, Santo André, Brazil; 3Núcleo Especializado em Aprendizagem, Programa de pós-graduação em Ciências da Saúde da Faculdade de Medicina do ABC, FMABC, Santo André, Brazil; 4Departamento de Fisioterapia da Faculdade de Ciências e Tecnologia, Universidade Estadual Paulista, UNESP, Presidente Prudente, São Paulo, Brazil; 5Núcleo Transdisciplinar de Estudos do Caos e da Complexidade. Faculdade de Medicina de São José de Rio Preto, FAMERP, São José do Rio Preto, Brazil; 6Departamento de Fonoaudiologia da Faculdade de Filosofia e Ciências, Universidade Estadual Paulista, UNESP, Marília, Brazil; 7Departamento de Saúde Materno-Infantil da Faculdade de Saúde Pública da Universidade de São Paulo, São Paulo, Brazil

Background: Attention deficit hyperactivity disorder (ADHD) is characterized by decreased attention span, impulsiveness, and hyperactivity. Autonomic nervous system imbalance was previously described in this population. We aim to compare the autonomic function of children with ADHD and controls by analyzing heart rate variability (HRV).
Methods: Children rested in supine position with spontaneous breathing for 20 minutes. Heart rate was recorded beat by beat. HRV analysis was performed in the time and frequency domains and Poincaré plot.
Results: Twenty-eight children with ADHD (22 boys, aged 9.964 years) and 28 controls (15 boys, age 9.857 years) participated in this study. It was determined that the mean and standard deviation of indexes which indicate parasympathetic activity is higher in children with ADHD than in children without the disorder: high frequency in normalized units, 46.182 (14.159) versus 40.632 (12.247); root mean square of successive differences, 41.821 (17.834) versus 38.150 (18.357); differences between adjacent normal-to-normal intervals greater than 50 milliseconds, 199.75 (144.00) versus 127.46 (102.21) (P<0.05); percentage of differences between adjacent normal-to-normal intervals greater than 50 milliseconds, 23.957 (17.316) versus 16.211 (13.215); standard deviation of instantaneous beat-to-beat interval, 29.586 (12.622) versus 26.989 (12.983).
Conclusion: Comparison of the autonomic function by analyzing HRV suggests an increase in the activity of the parasympathetic autonomic nervous systems in children with ADHD in relation to the control group.

Keywords: attention deficit hyperactivity disorder, autonomic nervous system, children, heart rate variability

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