Skip to main content
Top
Published in: ADHD Attention Deficit and Hyperactivity Disorders 4/2012

01-12-2012 | Review Article

Attention-deficit hyperactivity disorder and cardiac vagal control: a systematic review

Authors: Joshua A. Rash, Aldo Aguirre-Camacho

Published in: ADHD Attention Deficit and Hyperactivity Disorders | Issue 4/2012

Login to get access

Abstract

Attention-deficit hyperactivity disorder (ADHD) is characterized by behavioural disinhibition, deficient emotional self-regulation, inattention, and hyperactivity. The constellation of deficits found in children with ADHD implicates autonomic dysregulation characterized by deficient control of the heart by parasympathetic influences. While it is generally assumed that autonomic regulation of the heart is impaired during ADHD, the information pertaining to this dysregulation is limited. A systematic review of three databases was conducted between January and March 2012 for peer reviewed publications examining the relationship between cardiac vagal control (CVC) and ADHD without comorbid psychopathology. 19 articles were reviewed with only 6 meeting inclusion criteria. Findings were not unanimous but suggested that children with unmedicated ADHD experienced lower levels of CVC than did healthy controls. It was difficult to evaluate whether children with ADHD exhibited a different pattern of withdrawal and application of CVC than did normal controls. Findings suggested CVC reactivity depended on the task employed but children with ADHD experienced dampened CVC reactivity during tasks that involved self-regulation and emotion regulation. Finally, medication acted to correct the autonomic imbalance experienced by children with ADHD but did not bring this imbalance into normal levels. Given that so few studies were identified, no firm conclusions can be made, and there is a clear need for additional research in this area. Recommendations for future research are discussed.
Literature
go back to reference Barkley RA (1985) The social interactions of hyperactive children: developmental changes, drug effects, and situational variations. In: McMahon RP (ed) Childhood disorders: behavioral-developmental approaches. Bruner/Mazel, New York, pp 218–243 Barkley RA (1985) The social interactions of hyperactive children: developmental changes, drug effects, and situational variations. In: McMahon RP (ed) Childhood disorders: behavioral-developmental approaches. Bruner/Mazel, New York, pp 218–243
go back to reference Barkley RA (2003) Attention-deficit/hyperactivity disorder. In: Mash EJ, Barkley RA (eds) Child Psychopathology, 2nd edn. Guilford Press, New York, pp 75–143 Barkley RA (2003) Attention-deficit/hyperactivity disorder. In: Mash EJ, Barkley RA (eds) Child Psychopathology, 2nd edn. Guilford Press, New York, pp 75–143
go back to reference Barkley RA (2010) Deficient emotional self-regulation is a core component of ADHD. J ADHD Relat Disord 1:5–37 Barkley RA (2010) Deficient emotional self-regulation is a core component of ADHD. J ADHD Relat Disord 1:5–37
go back to reference Beauchaine T (2001) Vagal tone, development, and Gray’s motivational theory: toward an integrated model of autonomic nervous system functioning in psychopathology. Dev Psychopathol 13(2):183–214PubMedCrossRef Beauchaine T (2001) Vagal tone, development, and Gray’s motivational theory: toward an integrated model of autonomic nervous system functioning in psychopathology. Dev Psychopathol 13(2):183–214PubMedCrossRef
go back to reference Beauchaine TP, Katkin ES, Strassberg Z, Snarr J (2001) Disinhibitory psychopathology in male adolescents: discriminating conduct disorder from attention-deficit/hyperactivity disorder through concurrent assessment of multiple autonomic states. J Abnorm Psychol 110(4):610–624. doi:10.1037/0021-843X.110.4.610 PubMedCrossRef Beauchaine TP, Katkin ES, Strassberg Z, Snarr J (2001) Disinhibitory psychopathology in male adolescents: discriminating conduct disorder from attention-deficit/hyperactivity disorder through concurrent assessment of multiple autonomic states. J Abnorm Psychol 110(4):610–624. doi:10.​1037/​0021-843X.​110.​4.​610 PubMedCrossRef
go back to reference Benarroch EE (1993) The central autonomic network: functional organization, dysfunction, and perspective. Mayo Clin Proc 68(10):988–1001PubMed Benarroch EE (1993) The central autonomic network: functional organization, dysfunction, and perspective. Mayo Clin Proc 68(10):988–1001PubMed
go back to reference Berntson GG, Cacioppo JT, Quigley KS (1993) Respiratory sinus arrhythmia: autonomic origins, physiological mechanisms, and psychophysiological implications. Psychophysiology 30(2):183–196PubMedCrossRef Berntson GG, Cacioppo JT, Quigley KS (1993) Respiratory sinus arrhythmia: autonomic origins, physiological mechanisms, and psychophysiological implications. Psychophysiology 30(2):183–196PubMedCrossRef
go back to reference Breton JJ, Bergeron L, Valla JP, Berthiaume C, Gaudet N, Lambert J, St-Georges M, Houde L, Lepine S (1999) Quebec child mental health survey: prevalence of DSM-III-R mental health disorders. J Child Psychol Psychiatry 40(3):375–384. doi:10.1111/1469-7610.00455 PubMedCrossRef Breton JJ, Bergeron L, Valla JP, Berthiaume C, Gaudet N, Lambert J, St-Georges M, Houde L, Lepine S (1999) Quebec child mental health survey: prevalence of DSM-III-R mental health disorders. J Child Psychol Psychiatry 40(3):375–384. doi:10.​1111/​1469-7610.​00455 PubMedCrossRef
go back to reference Buchhorn R, Conzelmann A, Willaschek C, Störk D, Taurines R, Renner T (2012) Heart rate variability and methylphenidate in children with ADHD. ADHD Atten Defic Hyperact Disord 4(2):85–91. doi:10.1007/s12402-012-0072-8 CrossRef Buchhorn R, Conzelmann A, Willaschek C, Störk D, Taurines R, Renner T (2012) Heart rate variability and methylphenidate in children with ADHD. ADHD Atten Defic Hyperact Disord 4(2):85–91. doi:10.​1007/​s12402-012-0072-8 CrossRef
go back to reference Calkins SD, Keane SP (2004) Cardiac vagal regulation across the preschool period: stability, continuity, and implications for childhood adjustment. Dev Psychobiol 45(3):101–112. doi:10.1002/dev.20020 PubMedCrossRef Calkins SD, Keane SP (2004) Cardiac vagal regulation across the preschool period: stability, continuity, and implications for childhood adjustment. Dev Psychobiol 45(3):101–112. doi:10.​1002/​dev.​20020 PubMedCrossRef
go back to reference Crowell SE, Beauchaine TP, Gatzke-Kopp L, Sylvers P, Mead H, Chipman-Chacon J (2006) Autonomic correlates of attention-deficit/hyperactivity disorder and oppositional defiant disorder in preschool children. J Abnorm Psychol 115(1):174–178. doi:10.1037/0021-843X.115.1.174 PubMedCrossRef Crowell SE, Beauchaine TP, Gatzke-Kopp L, Sylvers P, Mead H, Chipman-Chacon J (2006) Autonomic correlates of attention-deficit/hyperactivity disorder and oppositional defiant disorder in preschool children. J Abnorm Psychol 115(1):174–178. doi:10.​1037/​0021-843X.​115.​1.​174 PubMedCrossRef
go back to reference El-Sheikh M, Hinnant JB, Erath S (2011) Developmental trajectories of delinquency symptoms in childhood: the role of marital conflict and autonomic nervous system activity. J Abnorm Psychol 120(1):16–32. doi:10.1037/a0020626 PubMedCrossRef El-Sheikh M, Hinnant JB, Erath S (2011) Developmental trajectories of delinquency symptoms in childhood: the role of marital conflict and autonomic nervous system activity. J Abnorm Psychol 120(1):16–32. doi:10.​1037/​a0020626 PubMedCrossRef
go back to reference Hinshaw SP (1994) Attention deficits and hyperactivity in children. Sage, Thousand Oaks Hinshaw SP (1994) Attention deficits and hyperactivity in children. Sage, Thousand Oaks
go back to reference Malliani A, Montano N (2002) Heart rate variability as a clinical tool. Ital Heart J 3(8):439–445PubMed Malliani A, Montano N (2002) Heart rate variability as a clinical tool. Ital Heart J 3(8):439–445PubMed
go back to reference Musser ED, Backs RW, Schmitt CF, Ablow JC, Measelle JR, Nigg JT (2011) Emotion regulation via the autonomic nervous system in children with attention-deficit/hyperactivity disorder (ADHD). J Abnorm Child Psychol 39(6):841–852. doi:10.1007/s10802-011-9499-1 PubMedCrossRef Musser ED, Backs RW, Schmitt CF, Ablow JC, Measelle JR, Nigg JT (2011) Emotion regulation via the autonomic nervous system in children with attention-deficit/hyperactivity disorder (ADHD). J Abnorm Child Psychol 39(6):841–852. doi:10.​1007/​s10802-011-9499-1 PubMedCrossRef
go back to reference Negrao BL, Bipath P, van der Westhuizen D, Viljoen M (2011) Autonomic correlates at rest and during evoked attention in children with attention-deficit/hyperactivity disorder and effects of methylphenidate. Neuropsychobiology 63(2):82–91. doi:10.1159/000317548 PubMedCrossRef Negrao BL, Bipath P, van der Westhuizen D, Viljoen M (2011) Autonomic correlates at rest and during evoked attention in children with attention-deficit/hyperactivity disorder and effects of methylphenidate. Neuropsychobiology 63(2):82–91. doi:10.​1159/​000317548 PubMedCrossRef
go back to reference Randall WC (1994) Efferent sympathetic innervation of the heart. In: Armour JA, Ardell JL (eds) Neurocardiology. Oxford University Press, New York, pp 77–94 Randall WC (1994) Efferent sympathetic innervation of the heart. In: Armour JA, Ardell JL (eds) Neurocardiology. Oxford University Press, New York, pp 77–94
go back to reference Saul J.P (1990) Beat-to-beat variations of heart rate reflect modulation of cariac autonomic outflow. Physiol 5(1):32–37 Saul J.P (1990) Beat-to-beat variations of heart rate reflect modulation of cariac autonomic outflow. Physiol 5(1):32–37
go back to reference Szatmari P (1992) The epidemiology of attention-deficit hyperactivity disorders. Child Adolesc Psychiatr Clin N Am 1(2):361–372 Szatmari P (1992) The epidemiology of attention-deficit hyperactivity disorders. Child Adolesc Psychiatr Clin N Am 1(2):361–372
go back to reference Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology (1996) Heart rate variability. Standards of measurement, physiological interpretation, and clinical use. Eur Heart J 17(3):354–381 Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology (1996) Heart rate variability. Standards of measurement, physiological interpretation, and clinical use. Eur Heart J 17(3):354–381
go back to reference Thayer JF, Hansen AL, Saus-Rose E, Johnsen BH (2009) Heart rate variability, prefrontal neural function, and cognitive performance: the neurovisceral integration perspective on self-regulation, adaptation, and health. Ann Behav Med 37(2):141–153. doi:10.1007/s12160-009-9101-z PubMedCrossRef Thayer JF, Hansen AL, Saus-Rose E, Johnsen BH (2009) Heart rate variability, prefrontal neural function, and cognitive performance: the neurovisceral integration perspective on self-regulation, adaptation, and health. Ann Behav Med 37(2):141–153. doi:10.​1007/​s12160-009-9101-z PubMedCrossRef
go back to reference Tonhajzerova I, Ondrejka I, Adamik P, Hruby R, Javorka M, Trunkvalterova Z, Mokra D, Javorka K (2009) Changes in the cardiac autonomic regulation in children with attention deficit hyperactivity disorder (ADHD). Indian J Med Res 130(1):44–50PubMed Tonhajzerova I, Ondrejka I, Adamik P, Hruby R, Javorka M, Trunkvalterova Z, Mokra D, Javorka K (2009) Changes in the cardiac autonomic regulation in children with attention deficit hyperactivity disorder (ADHD). Indian J Med Res 130(1):44–50PubMed
go back to reference Von Neumann J, Kent RH, Bellinson HR, Hart BI (1941) The mean square successive difference. The Ann Math Stat 12(2):153–162CrossRef Von Neumann J, Kent RH, Bellinson HR, Hart BI (1941) The mean square successive difference. The Ann Math Stat 12(2):153–162CrossRef
Metadata
Title
Attention-deficit hyperactivity disorder and cardiac vagal control: a systematic review
Authors
Joshua A. Rash
Aldo Aguirre-Camacho
Publication date
01-12-2012
Publisher
Springer Vienna
Published in
ADHD Attention Deficit and Hyperactivity Disorders / Issue 4/2012
Print ISSN: 1866-6116
Electronic ISSN: 1866-6647
DOI
https://doi.org/10.1007/s12402-012-0087-1

Other articles of this Issue 4/2012

ADHD Attention Deficit and Hyperactivity Disorders 4/2012 Go to the issue