Effect of methylphenidate treatment on heart rate variability in children with attention-deficit hyperactivity disorder

Year 2017, , 271 - 276, 30.06.2017

Derya Karpuz , Olgu Hallıoğlu Fevziye Toros Bahar Taşdelen

https://doi.org/10.17826/cutf.322894

Cited By: 2

Abstract

Purpose: The aim of the present study is to determine the effect of attention deficit and hyperactivity disorder and the use of methylphenidate for its treatment on autonomic function dysfunction by using   heart rate variability.

Material and Methods: Parameters of untreated attention deficit and hyperactivity disorder patients (n=99), patients who have been on MPH treatment for last three months methylphenidate group) (n=100) and 125 healthy children similar age and sex were compared. Electrocardiographic data were obtained by recording 200 heart beats in supine position, and records were   collected with PC-based ECG acquisition system (PC-ECG 1200) and evaluated. 

Results: Mean standard deviation of NN interval (SDNN) and root mean square of the successive differences (RMSSD) were lower  both in untreated attention deficit and hyperactivity disorder and methylphenidate groups  compared to control groups, but only in methylphenidate group, it was significantly lower. It was also determined that LF values were higher in both untreated attention deficit and hyperactivity disorder and methylphenidate groups and the difference between methylphenidate group and controls were statistically significant.   

Conclusion: In children with attention deficit and hyperactivity disorder, parasympathetic activity decreased, indicating autonomic dysfunction and this decrease was more marked in patients on methylphenidate.  Therefore, in patients using methylphenidate, care should be exercised for cardiovascular risks such as arrhythmia and sudden cardiac death.

Keywords

Attention-Deficit Hyperactivity Disorder, Heart Rate Variability, Methylphenidate

Dikkat eksikliği ve hiperaktivite bozukluğu olan çocuklarda metilfenidat tedavisinin kalp hızı değişkenliği üzerine etkisi

Abstract

Amaç: Bu çalışmanın amacı dikkat eksikliği ve hiperaktivite bozukluğu olan çocuklarda hastalığın ve metilfenidat kullanımının otonomik fonksiyon bozukluğu üzerine etkilerini kalp hızı değişkenliği kullanılarak belirlemektir.

Gereç ve Yöntem: Dikkat eksikliği ve hiperaktivite bozukluğu tanılı tedavi almayan hastalar (n=99, üç aydır metilfenidat tedavisi alan hastalar (metilfenidat grubu) (n=100) ve yaş ve cinsiyet yönünden benzer 125 sağlıklı çocuğun kalp hızı değişkenliği parametreleri karşılaştırıldı. Elektrokardiyografik veriler supin pozisyonda 200 kalp atımının kayda alınması ile elde edildi ve kayıtlar PC-based ECG acquisition system (PC-ECG 1200) de toplanarak değerlendirildi. 

Bulgular: Ortalama NN intervallerinin standart sapmasında (SDNN) ve ardışık NN aralıklarının farklılıklarının karelerinin toplamının karekökünün (RMSSD) hem ilaçsız dikkat eksikliği ve hiperaktivite bozukluğu hem de metilfenidat grubunda kontrol grubuna göre düşük olmakla birlikte sadece metilfenidat grubunda diğer iki gruba göre anlamlı derecede düşük olduğu belirlendi. İlaçsız dikkat eksikliği ve hiperaktivite bozukluğu ve metifenidat grubunda LF değerinin daha yüksek olduğu ve bu yüksekliğin metilfenidat grubunda kontrol grubuna göre anlamlı olduğu görüldü.

Sonuç: Dikkat eksikliği ve hiperaktivite bozukluğu olan çocuklarda otonomik disfonksiyonu gösteren parasempatik aktivitenin azaldığı ve metilfenidat kullanan hastalarda da bu azalmanın belirgin olduğu saptanmıştır. Bu nedenle metilfenidat kullanan hastalarda aritmi ve ani kardiyak ölüm gibi kardiyovasküler riskler açısından dikkatli olunmalıdır.

Keywords

Dikkat eksikliği ve hiperaktivite bozukluğu, kalp hızı değişkenliği, Methylphenidate

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