Association between Attention Deficit Hyperactivity Disorder and the Autonomic Nervous System: An Update

Abstract

This article constitutes a review of the research on the relationship between Attention Deficit Hyperactivity Disorder (ADHD) and autonomic nervous system (ANS) functionality. It also explores the possibility of using heart rate variability (HRV) to investigate the link between ADHD and autonomic dysfunction. One line of inquiry that has been the focus of sudies on the pathogensis of ADHD is the dysfunction of the autonomic system. The physiological measurements used to evaluate autonomic dysfunction are concentrated in the cardiovascular system. Databases were searched to identify studies published prior to August 2020. Studies that examined ANS with regard to medication use/treatment were excluded, while those related to ADHD etiopathogenesis were prioritized. In the present article, 52 studies, three of which were systematic reviews and meta-analyses, were evaluated. In general, although the etiopathogenetic association between ADHD and autonomic dysfunction (especially reduced parasympathetic activity) is remarkable, the findings are nonetheless contradictory. Heterogeneity, subtypes, and comorbidities in cases of ADHD appear to complicate the relationship with autonomic dysfunction.

Keywords

• attention deficit hyperactivity disorder
• autonomic dysfunction
• central autonomic network
• autonomic nervous system
• heart rate variability

Dikkat Eksikliği Hiperaktivite Bozukluğu İle Otonom Sinir Sisteminin İlişkisi: Bir Güncelleme

Öz

Bu makale, Dikkat Eksikliği Hiperaktivite Bozukluğu (DEHB) ile otonom sinir sistemi (OSS) işlevselliği arasındaki ilişki üzerine yapılan araştırmaların bir derlemesini oluşturmaktadır. Ayrıca DEHB ve otonomik işlev bozukluğu arasındaki bağlantıyı araştırmak için kalp hızı değişkenliğini (KHD) kullanma olasılığını ele almaktadır. DEHB'nin patogenezine ilişkin araştırmaların odak noktası olan bir araştırma alanı otonom sistemin işlev bozukluğudur. Otonom disfonksiyonu değerlendirmek için kullanılan fizyolojik ölçümler kardiyovasküler sistemde yoğunlaşmıştır. Ağustos 2020'den önce yayınlanan çalışmaları belirlemek için veri tarandı. OSS'yi ilaç kullanımı/tedavisi açısından inceleyen çalışmalar hariç tutulurken, DEHB etyopatogenezi ile ilgili olanlar önceliklendirildi. . Bu makalede, üçü sistematik derleme ve meta-analiz olan 52 çalışma değerlendirilmiştir. Genel olarak, DEHB ile otonomik disfonksiyon (özellikle azalmış parasempatik aktivite) arasındaki etyopatogenetik ilişki dikkat çekici olsa da, bulgular yine de çelişkilidir. DEHB vakalarında heterojenlik, alt tipler ve komorbiditeler otonomik disfonksiyon ile ilgili yorumları zorlaştırıyor gibi görünmektedir.

Anahtar Kelimeler

• dikkat eksikliği hiperaktivite bozukluğu
• otonom disfonksiyon
• merkezi otonom ağ
• otonom sinir sistemi
• kalp hızı değişkenliği

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