Heart rate variability as an indicator of autonomous nervous system activity in children with attention deficit hyperactivity disorder

as attention-deficit/hyperactivity disorder (ADHD). Methods: A total of 51 children with new ADHD diagnosis who were not received any treatment formed the study group and 51 age and sex-matched healthy children were en-rolled as the control group. 24-hour heart rate (HR) recordings were performed with rhythm Holter monitoring and HRV parameters indicating autonomous nervous system (ANS) functions were evaluated. Children in ADHD group were further divided into two groups as ‘severe’ and ‘mild’ ADHD according to Clinical Global Impressions-ADHD-Severity scale. Results: HRV parameters were comparable between ADHD and control groups. Whereas, percent-age of consecutive NN intervals over 50 msn (pNN50) and minimum Spectral Power per hour (minSPH) values were lower; while, maximum 1-hour heart rate Holter (maxHRH) and mean heart rate (HR) values were higher in severe ADHD group than those of control group. Conclusion: These results support that as the severity of ADHD increases, ANS dysfunction becomes more overt. Further large scale, multi-centered, randomized-controlled clinical trials are needed to clarify possible role of ANS dysfunction in ADHD etiopathogenesis. (Anatolian Journal of Psychiatry 2018; 19(5):493-500)

Dikkat eksikliği hiperaktivite bozukluğu olan çocuklarda otonom sinir sistemi aktivitesinin bir göstergesi olarak kalp hızı değişkenliği

Amaç: Bu çalışmanın amacı, yeni tanı konan ve hiç ilaç kullanmamış dikkat eksikliği hiperaktivite bozukluğu (DEHB) olan çocuklarda kalp hızı değişkenliğini (KHD) değerlendirmektir. Yöntem: Ölçütlere uyan toplam 51 DEHB’li çocuk çalışma grubunu oluşturdu ve bunlarla benzer yaş ve cinsiyetteki 51 sağlıklı çocuk kontrol grubu olarak çalışmaya alındı. Yirmi dört saatlik ritm Holter kayıtları yapıldı ve otonom sinir sistemi (OSS) işlevlerini gösteren HRV paramet-releri değerlendirildi. DEHB grubundaki çocuklar, klinik global değerlendirme-DEHB ciddiyet ölçeğine göre ‘ciddi’ ve ‘hafif’ DEHB gruplarına ayrıldı. Bulgular: DEHB ve Kontrol grubu arasında KHD parametreleri açısından anlamlı bir fark saptanmadı. Ciddi DEHB grubunun, 50 msn’nin üzerindeki ardışık NN aralıklarının tüm NN sayısına oranı (pNN50) ve minimum spectral power per hour (minSPH) değerlerinin ortalamaları kontrol grubuna göre daha düşük iken, maksimum 1-hour heart rate Holter (maksHRH) ve ortalama kalp hızı (KH) değerleri daha yüksekti. Sonuç: Bu sonuçlar, DEHB şiddeti arttıkça, OSS işlev bozukluğunun daha fazla olduğunu desteklemektedir. DEHB etiyo-patogenezinde OSS işlev bozukluğunun olası rolünü açıklığa kavuşturmak için daha büyük ölçekli, çok merkezli, randomize-kontrollü klinik çalışmalara gerek vardır. (Anadolu Psikiyatri Derg 2018; 19(5):493-500)

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