Attention-deficit/hyperactivity disorder and task-related heart rate variability: A systematic review and meta-analysis

Andreea Robe; Anca Dobrean; Ioana A Cristea; Costina R Păsărelu; Elena Predescu

doi:10.1016/j.neubiorev.2019.01.022

Attention-deficit/hyperactivity disorder and task-related heart rate variability: A systematic review and meta-analysis

Neurosci Biobehav Rev. 2019 Apr:99:11-22. doi: 10.1016/j.neubiorev.2019.01.022. Epub 2019 Jan 24.

Authors

Andreea Robe¹, Anca Dobrean², Ioana A Cristea³, Costina R Păsărelu⁴, Elena Predescu⁵

Affiliations

¹ Doctoral School "Evidence-based assessment and psychological interventions", Babeʂ-Bolyai University, Cluj-Napoca, Romania; The International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeʂ-Bolyai University, Cluj-Napoca, Romania.
² The International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeʂ-Bolyai University, Cluj-Napoca, Romania; Department of Clinical Psychology and Psychotherapy, Babeʂ-Bolyai University, Cluj-Napoca, Romania. Electronic address: anca.dobrean@ubbcluj.ro.
³ Department of Clinical Psychology and Psychotherapy, Babeʂ-Bolyai University, Cluj-Napoca, Romania; Department of Clinical, Neuro and Developmental Psychology Vrije Universiteit Amsterdam, The Netherlands.
⁴ The International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeʂ-Bolyai University, Cluj-Napoca, Romania; Department of Clinical Psychology and Psychotherapy, Babeʂ-Bolyai University, Cluj-Napoca, Romania.
⁵ Department of Neuroscience, Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, Romania.

PMID: 30685483
DOI: 10.1016/j.neubiorev.2019.01.022

Abstract

Background: Research suggests that Attention-Deficit/Hyperactivity Disorder (ADHD) is associated with autonomic nervous system dysregulation, but the findings were mixed.

Method: We conducted a literature review and meta-analysis to quantify the effect of ADHD on vagally-mediated heart rate variability (HRV). PsycINFO, PubMed, Web of Science and Scopus, were searched for case-control or cohort studies reporting measures of vagally-mediated HRV, after a task demand, among individuals with ADHD relative to healthy subjects.

Results: Thirteen articles comprising a total of 869 patients with ADHD and 909 healthy participants were included. As compared to controls, ADHD patients had reduced vagally-mediated HRV, corresponding to a small effect size (Hedge's g = 0.20; CI 95% 0.01 to 0.40). Heterogeneity was high (Q (18) = 76.59, p < 0.001; I² = 77%). There was some evidence of small study effects. Task type, respiration rate assessment and associated comorbid disorders were statistically significant moderators.

Conclusions: These findings provide evidence for the associations between ADHD and autonomic dysregulation. Future studies addressing HRV reactivity are needed.

Keywords: Attention deficit hyperactivity disorder; Cardiac vagal control; Heart rate variability; Meta-analysis; Vagally-mediated HRV.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't
Systematic Review

MeSH terms

Attention Deficit Disorder with Hyperactivity / drug therapy
Attention Deficit Disorder with Hyperactivity / physiopathology*
Behavior / drug effects
Central Nervous System Stimulants / therapeutic use*
Heart Rate / physiology*
Humans
Methylphenidate / therapeutic use
Vagus Nerve / drug effects*
Vagus Nerve / physiology

Substances

Central Nervous System Stimulants
Methylphenidate