Article

A controlled study of autonomic nervous system function in adults with attention-deficit/hyperactivity disorder treated with stimulant medications: results of a pilot study.

Department of Internal Medicine, Providence Hospital and Medical Centers, Southfield, MI 48075, USA.
Journal of Attention Disorders (Impact Factor: 2.4). 12/2006; 10(2):205-11. DOI: 10.1177/1087054706288108
Source: PubMed

ABSTRACT Despite the fact that autonomic nervous system (ANS) abnormalities are commonly found in adults and predict increased cardiovascular mortality, no studies have assessed ANS function in adults with attention-deficit/hyperactivity disorder (ADHD) taking stimulants.
This pilot study evaluated ANS function in adults with ADHD in comparison with an age- and gender-matched control group.
The authors found that 4% of the control group had some abnormalities in the ANS in comparison with 24% of the ADHD group.
Because the control group had higher levels of exercise fitness, and the level of abnormalities in the ADHD group was comparable with that of the general population, the significance of these findings is unknown. In addition, we did not determine if ANS abnormalities were present in individuals with ADHD who were not on stimulant medications. Further research is warranted to determine if there is any association between ADHD and stimulant use and ANS abnormalities.

0 Followers
 · 
58 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: According to self-report and unsystematic observational data adult patients with attention-deficit/hyperactivity disorder suffer from increased vulnerability to daily life stressors. The present study examined psychological and physiological stress responses in adult ADHD subjects in comparison to healthy controls under laboratory conditions. Thirty-six subjects (18 patients with DSM-IV ADHD diagnosis, 18 sex- and age-matched healthy controls) underwent the Trier Social Stress Test (TSST; Kirschbaum, C., Pirke, K.-M., Hellhammer, D.H., 1993. The "Trier Social Stress Test"--a tool for investigating psychobiological stress responses in a laboratory setting. Neuropsychobiology 28, 76-81), a standardized psychosocial stress protocol which contains a stress anticipation phase and a stress phase with a free speech assignment and subsequent performance of a mental arithmetic. Physiological stress measures were salivary cortisol as an indicator of the HPA axis, heart rate (HR), and time- and frequency-domain heart rate variability (HRV) parameters. Subjective stress experience was measured via self-report repeatedly throughout the experimental session. In line with previous theoretical and empirical work in the field of childhood ADHD, it was hypothesized that the ADHD and control group would exhibit comparable baseline levels in all dependent variables. For ADHD subjects, we expected attenuated responses of the physiological parameters during anticipation and presence of the standardized stressor, but elevated subjective stress ratings. Hypotheses were confirmed for the baseline condition. Consistent with our assumptions in regard to the psychological stress response, the ADHD group experienced significantly greater subjective stress. The results for the physiological variables were mixed. While ADHD subjects revealed an attenuated HR during the stress phase, no significant group differences were found for the other parameters, although a trend was observed for both the low frequency/high frequency (LF/HF) ratio of the HRV power spectral analysis and salivary cortisol (the latter possibly indicating generally lower cortisol levels in ADHD subjects). In summary, the present findings are the first to demonstrate a significant alteration of a specific physiological stress measure (HR) and, more clearly, of psychological aspects of the stress response in adults suffering from ADHD. In regard to the physiological stress response, it is recommended that future studies employ larger sample sizes and a more comprehensive range of physiological stress parameters. Additionally, the issue of transferability of laboratory results to real life stressors needs to be addressed.
    Psychoneuroendocrinology 07/2008; 33(5):612-24. DOI:10.1016/j.psyneuen.2008.01.016 · 5.59 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Associations between cardiovascular stress markers, subjective stress reactivity, and executive functions were studied in 60 adults (30 with attention-deficit/hyperactivity disorder, ADHD, and 30 controls) using the Paced Auditory Serial Addition Test (PASAT, a test of executive functions) as a cognitive stressor. Despite higher self-perceived stress, the adults with ADHD showed lower or atypical cardiovascular stress reactivity, which was associated with poorer performance on PASAT. Using cardiovascular stress markers, subjective stress, and results on PASAT as predictors in a logistic regression, 83.3% of the ADHD group and 86.9% of the controls could be classified correctly.
    Journal of Clinical and Experimental Neuropsychology 01/2011; 33(1):63-73. DOI:10.1080/13803395.2010.493145 · 2.16 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Adults with attention-deficit/hyperactivity disorder (ADHD) are more frequently presenting for diagnosis and treatment. Medication is considered to be appropriate among available treatments for ADHD; however, the evidence supporting the use of pharmacotherapeutics for adults with ADHD remains less established. In this article, the effectiveness and dosing parameters of the various agents investigated for adult ADHD are reviewed. In adults with ADHD, short-term improvements in symptomatology have been documented through the use of stimulants and antidepressants. Studies suggest that methylphenidate and amphetamine maintained an immediate onset of action, whereas the ADHD response to the nonstimulants appeared to be delayed. At a group level, there appears to be some, albeit not entirely consistent, dose-dependent responses to amphetamine and methylphenidate. Generally speaking, variability in diagnostic criteria, dosing parameters and response rates between the various studies was considerable, and most studies were of a relatively short duration. The aggregate literature shows that the stimulants and catecholaminergic nonstimulants investigated had a clinically significant beneficial effect on treating ADHD in adults.
    Expert Review of Neurotherapeutics 10/2011; 11(10):1443-65. DOI:10.1586/ern.11.137 · 2.83 Impact Factor
Show more